Why wouldn’t you want an EKG every year as part of your check up? Why would you not want to be ” target=”_blank”>the annual chest X ray that your doctor keeps ordering? Is it because you’re eager to save money for your insurance company? Is it because you think going without the test will help others who are more needy get the test in some complex rationing scheme? No. You should forego the above tests because they are much more likely to harm than help you.
Unfortunately, some of the care physicians deliver is entirely without benefit. I’m not saying merely that some care hasn’t been proven to be effective. That can be excused, since in many fields the scientific evidence is scant and the individual doctor’s judgment is our only guide. I’m saying that much of the care that is delivered has been rigorously proven to be ineffective or harmful.
Why are doctors ordering so many useless tests and treatments? Some blame “defensive medicine” the practice of ordering tests or treatments not for the patient’s benefit but to protect the physician from liability. Some blame unsophisticated or demanding patients. Neither of these explanations is fully persuasive.
Whatever the cause of this pervasive delivery of care that is worthless or worse, a group of American physician specialty societies have partnered with the American Board of Internal Medicine Foundation to do something about it. Their initiative, ” target=”_blank”>Costs keep skyrocketing. Any efforts by the insurers to limit payment are answered with emotional shouting about “rationing”. Rationing is when you don’t use something so someone else can have it. We’re talking about things that simply have no benefit and shouldn’t be given to anyone.
Choosing Wisely is a welcomed effort. I hope it succeeds, but I predict it will not. As long as the perverse economic incentives persist so will the useless but expensive therapies and tests. ” target=”_blank”>The Choosing Wisely website
” target=”_blank”> Doctors seek end to 5 cancer tests, treatments (Chicago Tribune)
” target=”_blank”>WolframAlpha U.S. healthcare expenditures time series (click on “linear scale” by the graph to get a clear picture)
Important legal mumbo jumbo:
Anything you read on the web should be used to supplement, not replace, your doctor’s advice. Anything that I write is no exception. I’m a doctor, but I’m not your doctor.
