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Do Docs Order Unnecessary Medical Tests?
Olivia_WebMD_Staff posted:
Nine major medical groups say that many of us may be getting medical tests that we don't need . Check out this blog that gives a really great list.

Do you think doctors often order tests patients don't need? Why?
ComEdCoord responded:
What I have found is that *I* need to be my own advocate because the doctor is not (I don't mean that in a negative way either). I try to give the best description of the symptoms I have so that my doctor can make the right dx w/the correct procedure. Doctors are eager to prescribe medications more than they are to delve into what is going on.

I had been given several different anti-depressants for chronic back pain which caused huge weight gain. At the same time, I was tired all the time. Work and come home and lay around and sleep.

I have a new doctor who ran routine labs on me (at my suggestion)---my other doctor never ran labs, always prescribed and always did x-rays though---and discovered that I have hypothyroidism and very low magnesium. A few weeks on naturthroid and I feel like a new woman. I'm starting to lose weight and have increased energy. Why couldn't my other doctors figure that out? Just start with a routine lab!
fcl responded:
I think I can honestly say that I don't believe I have ever had an unnecessary exam.
anowlin responded:
There are times when doctors order tests which seem excessive; however, the ordering of these test follow a protocol which is considered good medical practice. If a,b,c,d,e,f,g are eliminated as potential causes of your complaints; then the doc can state he's followed standard procedure that has been established.

However, they can go overboard thinking that if they don't to test 'h,' 'i,' and 'j,' that they'll not have met the burden of proof needed by insurance companies to justify a diagnosis. WHO pays for these excesses? WE do. We need to change this system, because doc too often order excessive tests to avoid lawsuits. Defensive medicine!
brunosbud replied to anowlin's response:
Excellent post...

The best remedy to "defensive" medicine is "preventative"medicine. Unfortunately, that's something that would require effort on the patient's part...

And, who wants that?
nursingbug replied to brunosbud's response:
It is a combo of factors- some is expectation on the patient's part- many expect testing for issues that don't need to be done, but in an effort for customer service many doctors have a hard time explaining this.
Sometimes it is not updating practice standards- hard not to do what you were taught to do in medical school- although this is not a good excuse in my book.
Sometimes it is an effort to be thorough- I am not a doctor but I can only guess the fear that you may miss something important, and in the decision point it is easier to er on the side of caution. In my own experience as a nurse I usually will do more testing if I think it is all indicated (more frequent bp checks, glucose checks, exams etc) on my shift. It is not an issue for me though because it does not raise expenses- although it may greatly annoy the patient. I cannnot count though the times my hunch was right and I caught an issue before it turned into a major disaster.
I agree with brunosbud though about the preventative medicine issue- unfortuately it does not pay to do much preventative medicine so it gets sidelined often.
anowlin replied to brunosbud's response:
I agree. For years, the doctor days of Marcus Welby prevailed as he made house calls, stayed up until all hours returning phone calls and the like. Those days are not likely to come back, but in it's return are days when physicians and patient's can be partners in care. Unfortunately, I find that too many patients like the "Father Knows Best" medical model where the patient was told what to do AND NOT WHY, by the doctor. I'd rather know the WHY.
marysings responded:
We live in a nation of "sue-happy" people. Doctors have to CYA all the time.

It's a shame.
bobby75703 responded:

MarySings above has the reason why.

Many times I have said to myself. "This test isn't needed for me. Its needed for the doctor as a CYA for himself. I'm paying money for an unnecessary test to cover the doctor's hind end."

But there can be another motivation. Medicine is private business in the States. Its perfectly normal to up sell in any business. Doesn't matter what product or service is being offered. Could be a used car, a hamburger, or medical tests.

The big difference between selling a hamburger and medical tests-- when buying a burger they ASK YOU if you would like fries with your order. With medical tests your paying for more services, like it or not.
DoOvers responded:
Of course they do! One of the best defenses to many of the malpractice lawsuits is proof showing that you were being pro-active and covering every millimeter. If the lawsuits stopped so would a lot of the b.s.
An_241873 responded:
Yes and no. Yes they have to cover their butts, but on the other side there are a lot of things that do not have to be done. I work in a lab and see this constantly. For instance, there are 2 basic panels of blood work one does liver function tests as well as protien tests, the other only does electrolytes and glucose. For those that come into the ER it is a basic need to get the bigger panel, but if someone has been an inpatient for a while and there is no mystery to what is wrong, then there is no need for the big panel. Even something as simple as that could save the patient money, but because so many people are so quick to sue ( and yes I can personally be sued not just the hospital) I am very glad they doctors make sure all their t's are crossed and i's are dotted.
jenlewi responded:
Not only do patients get tests they don't need, they get SURGERY they don't need. Insurance companies have lists of procedures they don't want to approve, and they have lists of steps the doctor and patient must take prior to getting one of those procedures.

Example: My doctor and I both agreed that at age 35, with periods so heavy I became dangerously anemic, the ideal solution would be a hysterectomy. The insurance company insisted we try a D&C, then birth control pills, then surgery for endometriosis, then shots..... After being jerked around for 18 months, 7 drugs and two surgeries, my doctor got someone at the insurance company on the line and asked directly what it would take to get me a hysterectomy immediately. The answer? Stage 4 cancer or an abdominal injury that made a hysterectomy the only viable method of stopping the bleeding. The insurance company thought it was being more than reasonable when it said it would pay for monthly transfusions rather than surgery to actually correct the problem. I'm 45 now and still swear vehemently every time my PAP smear is normal. If that doesn't seem wrong to you, you need serious help.
39Grandkids replied to ComEdCoord's response:
I just changed Dr's because he was having me come back to offen
redbeet replied to 39Grandkids's response:
I am trying to find a Naturopathic doctor who have knowledge about herbs in the South Jersey area. Anyone know of one please post an address.

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