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'Worried Well' Often Ignore Negative Test Results: Study
Date:2/26/2013

uences of this problem are unnecessary tests that add to the cost of medical care, and of doctors refusing to give new tests, which may force patients to seek medical help elsewhere, one expert said.

"There are no guarantees related to our health, and there is virtually no absolute certainty in medicine," said Dr. David Katz, director of the Yale University Prevention Research Center.

"We -- doctors and patients alike -- are obligated to deal with probabilities," he said. "When the probability of disease is very low before testing, a negative test cannot make it much lower."

There is an opportunity to educate the public in how probability influences medical decisions, Katz said. "This is information doctors and patients can and should share, to reach robust and reassuring conclusions together," he said.

"Doctors, however, should indulge patients only in testing that is of real potential value," Katz added.

Bruno added that doctors need to use their judgment when ordering tests and base them on the need for the test and whether the test is cost-effective.

There is more pressure now on doctors to justify their care, Bruno said.

"Doctors are really having to demonstrate they are delivering appropriate care, prescribing the right treatments and ordering the right tests," he said.

There are some patients who are delusional about their health, and these patients should seek mental health treatment, Bruno added.

More information

For more on hypochondria, visit the U.S. National Library of Medicine.

SOURCES: Bryan Bruno, M.D., acting chair, psychiatry, Lenox Hill Hospital, New York City; David Katz, M.D., M.P.H., director, Yale University Prevention Research Center, New Haven, Conn.; Feb. 25. 2013, JAMA Internal Medicine, online


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