Can you really have too much of a good thing when it comes to medical tests? Apparently, and our nation's tendency to overuse them may be harming patients and sending health care costs soaring, according to a new initiative by the American Board of Internal Medicine (ABIM).
This notion created a big buzz in the healthcare industry yesterday after nine physician specialty groups—like the American College of Radiology and the American Academy of Family Physicians—each revealed their lists of the top five overused tests or procedures in their fields. The resulting list of 45 tests has been made public as part of ABIM's Choosing Wisely campaign, an effort to boost communication between patients and physicians, and scale back on unneeded medicine in the process.
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Here, we get to the bottom of the buzz to see what these new recommendations mean for you.
Early Detection Is Not Prevention
"Do we do too many tests? Absolutely," says Dr. Mary Jane Minkin, Prevention advisor and clinical professor of obstetrics and gynecology at the Yale School of Medicine.
Dr. Minkin says we've been taught that more is better in terms of health care, and as a result, don't understand that early detection is not the same thing as prevention. Others agree.
"This is a good effort to help minimize overzealous testing and imaging," says Jennifer A. Reinhold, PharmD, BCPS, Prevention advisor and assistant professor of clinical pharmacy at the University of the Sciences in Philadelphia.
The Problem With Too Many Tests
Overusing tests drives up healthcare costs and causes patients harm, says Dr. Reinhold. Unneccessary exposure to radiation from imaging, or misdiagnosis leads to unwarranted anxiety, she says. And many people don't understand the complications that arise from false positives on test results, adds Dr. Minkin.
One commonly overused test, for example, is imaging for low back pain. Pain in the lower back is the fifth most common reason people visit a doctor, and imaging is routinely prescribed right off the bat. But the American Academy of Family Physicians says that in general, imaging within the first six weeks of symptoms doesn't do patients any good.
And then there's sinusitis, a common health issue often treated with antibiotics—but shouldn't be, says the American Academy of Allergy, Asthma & Immunology.
"These illnesses often turn out to be viral infections that antibiotics can't help with anyway," says Dr. Reinhold. And the more often they're prescribed, the less likely they are to work when you really need them, she says.
What This Means For Insurance
The big positive of this list, says Dr. Reinhold, is that it can help fix the issue of doctors administering too many tests and procedures, as many insurance companies will likely stop covering ones that are no longer recommended. A possible negative? Not getting a test you need covered. The good news is that the list gives clear circumstances where these tests are still needed, which means that if you really need it, the test should still be covered by your insurance company.
What It Means For You
It's more important than ever to find a doctor you trust and one with whom you feel comfortable asking questions. "Go to your county medical society or call a local medical school and ask which doctors they recommend," says Dr. Minkin. Be an active, informed patient by researching your condition, which means asking your doctor for credible websites, or contacting organizations that specialize in the medical area you're researching, such as the American College of Cardiology for heart disease information.
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