Patients usually assume that the more diagnostic tests performed by their doctor the better, thinking more testing means greater understanding. In reality, unnecessary medical tests cost the country billions of dollars every year and may actually put patients in greater harm. Doctors need to understand when certain diagnostic tests are needed, and when those tests are superfluous.
Many of these unnecessary diagnostic tests are simply redundant; an ultrasound will detect some cancers better than an MRI, so ordering both only increases the number of medical bills. Others pose an actual risk to patients, like yearly electrocardiogram (exercise) stress tests. Studies have shown that patients at low-risk for heart disease who nonetheless receive yearly exercise stress tests are likely to receive false-positive tests that lead to unnecessary medical treatments, like surgeries to insert cardiac stents. Risks of cardiac stents include perforated arteries and blood clots.
Unnecessary tests also place a huge financial burden on everyone. A 2010 study by the Institute of Medicine found that the American health care system wastes $750 billion a year, which is more than the entire US budget for K-12 education. Many tests, like the electrocardiogram stress test, that are performed annually on patients who don’t need them give too much weight to minor abnormalities. Only patients with an assessed high risk of a medical condition should be given certain diagnostic tests.
The American Board of Internal Medicine started the Choosing Wisely campaign to identify unnecessary diagnostic tests and medical procedures. They have published more than 400 recommendations to doctors. Unnecessary medical tests include:
Annual Pap smears‑Though originally recommended annually for women between the ages of 30 and 65, doctors now recommend every 3 years unless the woman has a higher than normal risk of cervical cancer (like a family history of cervical cancer). Pap smears that occur more often may lead to additional unnecessary testing.
Annual comprehensive eye exams for children who do routine screening‑If children routinely pass eye screenings then additional annual exams only serve to raise medical bills and increase the child’s time away from school.
PET/ CT scans in healthy individuals-PET and CT scans of healthy patients are likely to identify harmless findings that lead to more unnecessary tests and possibly unnecessary medical treatments.
Colonoscopies that occur more than once every 10 years in average-risk patients– Like many of these other recommendations, colonoscopies of average risk patients that occur too often are likely to lead to additional unnecessary tests and treatments.
Imaging scans for back pain– A thorough physical examination and study of medical history of a patient is often sufficient for diagnosing back pain. Imaging tests like MRIs, X-rays, and CT scans will not help patients and will only increase costs.
Many other recommendations are available on the Choosing Wisely website. If you are worried about the necessity of diagnostic tests, talk to your doctor and discuss the purpose of your diagnostic tests.
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