Has your doctor ever recommended a test, treatment or procedure that made you wonder: Do I really need this?
A coalition of physician groups and Consumer Reports magazine has listed five examples of when you should challenge your doctor’s advice.
They include: EKGs and exercise stress tests, imaging tests for lower-back pain, CT scans and MRIs for headaches, bone density scans for low-risk women, and antibiotics for sinusitis.
John Santa, M.D., director of the Consumer Reports Health Ratings Center, tells Newsmax Health the list was compiled to help patients question their doctors about care that may be unnecessary.
"Our concern here is that many physicians and consumers, we think, aren’t fully informed about the harms involved in some of these procedures and they’re not informed about the downstream implications, including costs," said Dr. Santa, a primary care physician.
To be clear, he noted, the experts are not advising patients to refuse doctors’ orders, but instead to ask: "Do I really need this and why?"
"In fact, virtually all of these topics involve tests or services or products that are very helpful to some people," Dr. Santa said. "But they are not helpful at all to others, and in some cases they could actually cause harm."
He noted experts have estimated up to 30 percent of U.S. healthcare is unnecessary. Several factors may be at work: Many doctors practice "defensive medicine" to reduce malpractice exposure, a lack of standard medical protocols allows for wide variations in practices, financial incentives (i.e. such procedures generate revenues), and patients may demand physicians "do something."
To help patients open conversations with their doctors about unnecessary care, health experts highlighted the following five questionable tests, procedures and treatments:
EKGs and exercise stress tests are important for people with heart disease symptoms or who are at high risk. But for tens of millions of healthy people who receive them, they are not accurate predictors of risk. They can also lead to unnecessary treatment, including CT angiograms or coronary angiography – exposing patients to a radiation doses equal to hundreds of X-rays — as well as needless drugs, angioplasty, and stents.
Imaging tests for lower-back pain rarely lead to treatments that hasten healing. In fact, most back pain, not caused by a serious injury or disease, subsides in about a month with or without testing or treatment. Imaging scans may pose a grave risk from cancer-causing radiation. One alarming one study projects 1,200 new cancer cases for every 2.2 million CT scans for lower-back pain. Tests can also prompt needless worry and further testing and treatment, possibly surgery.
CT scans and MRIs for headaches rarely do more to help patients than a careful medical history or a standard neurological exam. Brain scans can reveal things that appear worrisome that aren’t, triggering more tests and visits with specialists. CT scans deliver a radiation dose that’s the equivalent of hundreds of chest X-rays, increasing cancer risk.
Bone density scans are prescribed to tens of millions of women to screen for weak bones with a test called a DEXA or DXA scan. But many low-risk women who receive them have only mild bone loss – known as osteopenia — that carries a slight risk of fracture. Women in this category don’t need the scans. The good news is that DEXA scans subject patients to only a small amount of radiation.
Antibiotics for sinusitis are frequently prescribed, even though the condition is often viral and the drugs treat only bacterial infections. One in four people have negative side effects from antibiotics and, in rare cases, antibiotics can cause anaphylactic shock. Overuse of antibiotics also promotes drug-resistant bacteria.
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