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Is American Medicine Too Test Happy?
Date:12/29/2011

for a false positive, which can lead to a string of other unnecessary follow-up tests and procedures, each with their own sets of potential health hazards.
  • The risk that a condition will be identified that never would have been clinically significant but now will probably be treated.
  • A routine electrocardiogram, for example, might identify some nonspecific condition that leads to a cardiac catheterization, an invasive medical procedure that carries its own set of health risks, Weinberger said.

    "Unnecessary testing is not necessarily benign," he said. "It can lead to situations that can pose health risks to patients."

    Clearly, patients should become more active in asking whether tests are necessary. But as most anyone who's been a patient can attest, asking such questions can be daunting for anyone, but especially for a sick person who needs treatment.

    Weinberger said he has personal experience when it comes to the difficulty of challenging tests as a patient. He recently had arthroscopic surgery for a knee injury, but before the procedure he had to undergo a battery of diagnostics that included lab tests, a chest X-ray and an electrocardiogram -- all unnecessary, as far as he could tell. And yet, he had the tests without questioning them.

    "My experience shows you how hard it is," Weinberger said. "If there's anyone who was in a position to question these tests, it's someone like me." But, he admitted, "you don't want to antagonize the person who's going to provide your care. Sometimes the easiest road is to just go along."

    His organization, the American College of Physicians, has started tackling the issue through what it calls its High-Value, Cost-Conscious Care Initiative, which aims to reduce unnecessary testing by educating physicians and patients alike on the benefits, harms and costs of tests linked to specific ailments.

    "We're basically trying to develop a list of those types of things that are overu
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