Just say don't: Doctors question routine tests and treatments

[FUZO]

TweetThat's how many medical tests, treatments and other procedures - many used for decades - physicians have now identified as almost always unnecessary and often harmful, and which doctors and patients should therefore avoid or at least seriously question.

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[6p6]

TweetSo true!

[Dzone]

TweetSo much of the tests drs do are cya. I remember when I was in the hospital they tried to CT scan me everyday! I told them NO! I dont want another CT scan!!!

[bandaidwoman]

TweetThe problem is , doctors get sued for tests we don't order.

Even though the ACP and USPTF says no routine testing of PSA is necessary, a medical school got sued for not ordering it A doctor is sued for following the USPSTF guidelines on prostate cancer screening. If someone shows up in the ER with abdominal pain, no doctor has been sued for ordering a cat scan but plenty have been sued for not ordering one.

Of course, the USPTfS guidelines ignored data in blacks and those with family history of prostate cancer, historically the group with earlier and more aggressive guidelines.

This article did not mention it but the most over used test is an MRI.

98% of the MRIs I order are unneccessary but the patients twist my arm and scream blood murder. I tell them the MRI only tells me what's wrong with their spine, not the cause of their pain. ( Numerous studies that show no correllation with pain and how bad or how good the mri looks). I only order it if I suspect neoplasm, cord impingement, spinal abscess or demyelination disorder. In fact, the only thing predictive of a person's back pain is not their mRI but job satisfaction! The Mris show DJD, facet hypertorphy etc. etc, which is common in our aging population.

Even though I only do pap smears every three years in women who are HPV negative, I still like to do pelvic once a year to ensure there is no rectal or perivaginal disorders. ( I recently found a lichen sclerosis that had progessed to squamous cell carcinoma in a 40 yr old).

For years I have told my patients checking liver function tests after the first 3 months on a statin is unnecessary since the data ( despite internet blogging), shows statins do not hurt the liver, in fact, they help reverse changes in those with Hep C and NAFLD. ( the idiosyncratic reactions will occur the first few months) Finally research, ( see article in Lancet) and the FDA is backing me up. In fact, the FDA has never recommended routine liver testing in those on pravastatin..

[bandaidwoman]

TweetMost physicians and patients believe that statins harm the liver: myth #7 - National heart health | Examiner.com

here is the article. the problem is the media never backs me up when i tell my patients there is absolutely no need to order liver function tests every 3-6 months or why MRIs are overused.