"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.”
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