Medical Tests: Which Ones Do You Really Need?Wednesday, 13 Mar 2013 10:34 AM By Sylvia Booth Hubbard
"First, do no harm," is a prime directive for doctors. But there
are times when medical tests do the patient more harm than good
by leading to unnecessary and dangerous biopsies, by damaging
internal organs, and even by raising the risk of cancer. They
are also a big part of the reason for America’s soaring medical
costs.
After decades of a “test-first, ask-questions-later” mentality,
there recently has been a profound shift in the attitude of
nation’s healthcare providers.
The American Board of Internal Medicine (ABIM) Foundation
recently issued new guidelines regarding 45 medical tests it
believes are overused and may expose patients to possible harm.
Family physician Dr. Stephanie Haridopolos is glad to see the
ABIM's recommendations. "I think patients are being given too
many tests," she tells Newsmax Health. "Unfortunately, America
has become a litigious society, and many of the overused
diagnostic tests are performed to make sure the doctors aren't
missing something.
"Medical costs are skyrocketing, and one of the reasons is that
diagnostic tests are overprescribed. But another reason is that
Americans are better educated. They are aware of the different
tests available, and they themselves demand them."
Common tests and treatments the ABIM says are overused include:
• CT scans for uncomplicated headaches. Dangers
include unnecessary radiation, which can potentially cause
cancer, and false-positives, which lead to even more unnecessary
tests.
• General testing for allergies. Tests for
specific allergies, determined by doctors asking patients a few
simple questions, are more effective than expensive, complicated
IgG and IgE tests.
• Chest X-rays before surgery. They are
unnecessary, says the ABIM, unless you have heart problems.
• MRI, CT scans, or X-rays within the first six weeks of
low back pain. Back pain is common and often resolves
itself within four to six weeks.
• Heart screening tests in low-risk patients
with no symptoms. EKGs and other cardiac screening are more
likely to have a false-positive result that will lead to more
tests and invasive procedures than they are to find a problem.
• Antibiotics for mild sinusitis. Most
sinusitis will resolve on its own, yet more than 80 percent of
patients with sinusitis are prescribed antibiotics, leading to
the spread of bacteria resistant to antibiotics.
• Bone scans (DEXA screening) for osteoporosis.
Screenings shouldn't be used in women under the age of 65 and
men under 70 who have no risk factors.
• Colonoscopies should not begin until the age
of 50 for people with no risks, and if results are normal,
another one isn't needed for 10 years.
• CT scans for someone who has
fainted but didn't have a seizure.
If there are no accompanying symptoms, such as a seizure, and
the patient has no known neurological problems, a CT scan isn't
likely to improve the outcome.
• NSAID painkillers for people
with certain medical conditions.
NSAID (nonsteroidal anti-inflammatory drugs), such as ibuprofen,
can be dangerous for patients with certain medical problems such
as high blood pressure, heart failure, and kidney disease.
Acetaminophen, tramadol, or the short-term use of narcotic
painkillers is often safer.
"Patients have to take responsibility," says Dr. Haridopolos.
"Don't try to talk your doctor into giving you something you
don't need.
"Patients should not demand a test or a treatment that isn’t
warranted and has the potential to do them more harm than good.”
The full version of this article appeared in Newsmax magazine.
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here.
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