Friday, February 22, 2013

Be smart--don't just accept a medical test


Choosing Wisely is a campaign put on by the American Board of Internal Medicine Foundation (http://choosingwisely.org) to encourage patients to question and learn more about tests they are getting.

The amount of waste is staggering. $175 million in unnecessary back x-rays. $400 million for mammos for women over 75. $527 million for bone density tests for women not at risk for osteoporosis. Brand name cholesterol drugs instead of generic...the list goes on.

Besides being expensive and unneeded, some testing is harmful.  Example: Exposure to x-rays from unneeded CT scans (say for headaches).

I always think--if I do have the thing the test is for, would I accept the known treatments? If not, why get the test?

The major specialties have specific tests they encourage patients to question. Some things you might ask: Why am I getting this test? How many times have you done this procedure? When will I get the results (never take no news is good news for an answer). What are the possible complications? Are there side effects to that drug? Will the stuff interfere with my other drugs?

You can devise your own list of questions at http://ahrq.gov/questions.qb.

I heard the other day that docs often do not explain the life-changing aspects of getting a pacemaker of the type that can give you a jolt from the blue to regulate rhythm. They talk about the procedure of getting it--but not the long-term implications.

Ask, people!

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