Do You REALLY Need That Test or Procedure? (Maybe, Maybe Not)

Every year in America, $200 billion is spent on unnecessary medical tests and treatments. Not only are these services costly, but they may also be harmful and can lead to medical errors. Chances are, you’ve had tests, treatments or procedures that you didn’t really need.

Often, we’re not told we have choices when it comes to our medical care. We’ve all been there. Your doctor says you need ‘annual’ bloodwork, a ‘routine’ chest x-ray, or a new medication and you agree to it. No questions asked. But this mindset has to change.

Being informed and asking questions can help you avoid getting expensive care that isn’t necessary.

Here Are The Questions You Need to Ask Before You Say Yes To Any Test, Treatment or Procedure

1. Why do I need this?
2. What would happen if I don’t do it?
3. What are the risks?
4. Are there other options?
5. How much does it cost?
6. Is it covered by my insurance?
7. What lab processes the results?
8. Is the lab in-network with my insurance?
9. Where will this be done?
10. Is it painful? How will my pain be managed?
11. Will I need anesthesia? What type?
12. Will I need someone to drive me home?
13. Will I need time off from work and activities?
14. When should I expect the results?
15. Who will call me with the results?
16. What is the plan based on my results?
17. How should I prepare?

Click here to download a PDF of these questions.

Avoid Repeating Tests or Procedures

Make sure you’re not getting tests or procedures repeated unnecessarily. For instance, your primary care provider may order a chest x-ray but you’ve just had a chest CT scan done that was ordered by your cardiologist. It’s likely you don’t need both. Nor do you need the extra dose of radiation!

Make sure you’re bridging the gap in communication that can happen when you see more than one provider. Let everyone on your healthcare team know what’s going on. To help with this, click here for a free health summary that you can print and take with you to your appointments.

Why Do Medical Providers Order So Many Unnecessary Tests, Treatments, and Procedures?

In a recent study published in Plos One, physicians across the United States were asked to share their thoughts on unnecessary medical care. They reported the three most common reasons for overtreatment was the fear of being sued; pressure/requests from patients; and difficulty accessing medical records.

Here are a few more reasons for overtreatment in our healthcare system:

• Medical providers aren’t communicating with one another leading to the same tests or treatments being prescribed over and over. This is especially common with bloodwork, scans, x-rays, and medications.
• Providers usually don’t know the costs of the tests and treatments they’re ordering. This leads to a relaxed attitude when prescribing treatments and tests, especially when patients have insurance.
• Often, providers will order tests out of habit or because the culture of their organization calls for it. For example, many patients in hospitals will get “daily labs.” This means blood is drawn and analyzed every day even if it’s not necessary.
• Some providers profit from unnecessary tests or procedures. For instance, if a physician owns a radiology center and sends you there for CT scans or MRIs, she profits. In fact, the study published in Plos One found that more than 70 percent of doctors believe that other doctors (not themselves!) are more likely to perform unnecessary procedures when they profit from them.
• The pharmaceutical and medical device industries pay medical providers to do promotional talks and consulting gigs. Many providers claim these payouts don’t influence their prescribing habits. I call BS on that one. Use this tool from ProPublica to see if (and how much) your provider is getting paid by these industries.
• The more treatments providers order, the more they get paid. For example, insurance companies pay doctors for each session of radiation therapy ordered for patients with breast cancer. A 2010 study in the New England Journal of Medicine showed that a 3-week regimen of radiation therapy was as effective as a 6-week course for patients with certain types of breast cancer. Yet according to a study conducted by EviCore Health Care, only 48% of eligible patients got this shorter course. The financial incentive to prescribe more could be a factor.

Of course, not every medical provider values profits over patients. There are many wonderful, compassionate clinicians out there who want the very best for you. Unfortunately, bad eggs do exist.  And their greed is harming patients and driving up the cost of healthcare for everyone.

Choosing Wisely

Choosing Wisely is a national campaign that seeks to “advance a national dialogue on avoiding unnecessary medical tests, treatments, and procedures.” See what the recommendations are for your tests, treatments, and procedures at choosingwisely.org.

Key Points

• Ask lots of questions before you say yes to any test, procedure or treatment so you can decide what’s best for you.
• Keep in mind that some tests, procedures, and treatments ARE necessary.
• Providers sometimes order tests out of habit or because of organizational culture. Ask if you really need those ‘yearly’ labs or a ‘routine’ chest x-ray.
• When it comes to your healthcare, you do have choices!

 

Have a question for me? Or just want to share your experiences with the healthcare system? Email me at crystal@prudentpatient.com

I’d love to hear from you!