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Many Medical Tests, Procedures Not Always Needed

New Public Service Campaign Questions Overuse of Commonly Ordered Tests

Questionable Tests, Procedures continued...

Some people come to their doctor wanting tests that he or she otherwise wouldn't have ordered. The new campaign materials can also help the doctor explain why they don't need the test and have the patient understand why.

Marie Savard, MD, says tests and testing are no substitute for a thorough physical exam by a skilled doctor. She is a Philadelphia-based internist and the author of several books, including How to Save Your Own Life. "We need to go back to the days of a good physical and medical history," she says. "A lot of these tests may not be necessary for people who have no findings on a physical exam."

"I am all for being much more intelligent about our use of unnecessary and expensive tests," Savard says. "Doctors have gotten away from physical exam. It is easier to order a blood test."

Her advice? "Be your own squeaky wheel. If you know something is not right or have symptoms, discuss your concerns with your doctor and make sure they are taken seriously.

"These tests may be overused, but they have their place and can be lifesaving," she says.

Who?s Involved in the New Campaign?

The other medical groups who are part of the campaign include the American Academy of Allergy, Asthma, & Immunology, the American Academy of Family Physicians, the American College of Physicians, the American College of Radiology, the American Gastroenterological Association, the American Society of Clinical Oncology, the American Society of Nephrology, and the American Society of Nuclear Cardiology. On the consumer side, 11 groups, including the AARP, Alliance Health Networks, Leapfrog Group, Midwest Business Group on Health, and the National Business Coalition on Health, are working with Consumer Reports.

Including some of the tests and procedures mentioned above, here's a larger list, by medical specialty.

Family physicians say you probably don't need:

  • Imaging tests for low back pain during the first six weeks
  • Antibiotics for mild or moderate sinus infections, unless symptoms last for seven days or symptoms worsen after getting better
  • The DEXA osteoporosis test if you're a woman younger than 65 or a man under 70 with no risk factors
  • Pap tests if you're a woman under age 21 or a woman who had a hysterectomy for a non-cancer reason

The American College of Physicians says you probably don?t need:

  • ECG tests if you don't have symptoms and are at low risk of heart disease
  • Brain imaging (CT or MRI scans) if you fainted and have a normal neurological exam
  • Pre-operative chest X-rays if you don't appear to need them

Cancer doctors say you probably don't need:

  • Treatments aimed at eliminating solid tumors if you are weak and frail, did not benefit from previous treatments, and there's no sign more treatment will help
  • PET, CT, or bone scans if you have early-stage prostate cancer with low risk of spreading
  • PET, CT, or bone scans if you have early-stage breast cancer with low risk of spreading
  • Biomarker tests or imaging surveillance studies if you've had curative treatment for breast cancer

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