Getting patients and physicians to ask the right questions

Overtesting — it’s an epidemic threatening consumers of U.S. health care. The notion that testing can be anything but beneficial belies the common assumption that more information is always better, as exemplified by billionaire Mark Cuban’s proclamation earlier this year that he obtains “baseline” quarterly blood tests and encourages others to do so. Knowledge is power, right? Not always. Aside from adding economic strain to our already beleaguered health care system, overtesting can harm patients from the adverse effects of the test itself or as a result of the interventions that ensue. In an effort to curb excessive testing, some physicians advocate asking first how a test will affect the medical decision making for the patient (i.e., the “management” of the patient’s case), and then only proceeding if the test can in some way lead to a change in that patient’s treatment. If we’re not going to do anything differently based on the results, then why do it? I hear the “don’t order a test unless it’s going to change management!” adage voiced frequently; from the Stanford residents who I train, from colleagues, and from esteemed experts around the country. Unfortunately, while the question, “How will this test change management?” is a step in the right direction in terms of an evidence-based approach, it’s still not the right question. Virtually any test can change management, but not always for the better. No test is perfect; most tests hav...
Source: Kevin, M.D. - Medical Weblog - Category: Journals (General) Authors: Tags: Physician Cancer Pediatrics Source Type: blogs