Medical Tests You May Not Need

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By: , – By Abigail Cuffey, of Woman's Day
10/29/2012 6:00 AM   :  13 comments   :  7,026 Views

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There's no doubt medical screenings (such as MRIs and CT scans) save lives, but in some cases, they're just not necessary. "Some doctors may prescribe a test 'just to be safe,' and many patients don't think to question it, but the truth is, you should always discuss with your physician why you need a test before you go for it," says Christine Cassel, MD, president of the American Board of Internal Medicine.

 
Simple questions to get the conversation going:
  • "How will the results of this test improve my treatment?"
  • "What are the risks of the test?" 
  • "What are the risks if I don't have it?" 

Three tests you should question:
 
1. MRI for low back pain that has lasted for six weeks or less or isn't related to an existing disease or spine issue

Why you may not need it Back pain is the fifth most common reason for all doc visits, "but most cases aren't related to a serious problem and MRIs don't usually show anything that helps with a diagnosis," says Glen Stream, MD, president of the American Academy of Family Physicians.
 
2. CT scan for headaches

Why you may not need it Unless you have a serious warning sign (like a sudden, severe headache), odds are the scan won't find anything that leads to treatment, says Dr. Cassel. A CT scan exposes you to high levels of radiation, so if you can, you want to avoid one.
 
3. DEXA (dual-energy X-ray absorptiometry), an X-ray that looks at your bone density, if you're under 65 years old

Why you may not need it If you're under 65 and have no risk factors (like a family history of osteoporosis or an unexplained fall, minor injury or fracture), there's no reason to know your bone density, says Dr. Stream.
For the full list of tests that should always raise a red flag, go to ChoosingWisely.org.
 


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Have you been prescribed a test that wasn't necessary? If so, how did you handle it?


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Comments

  • 13
    I went through menopause very early in my life (30s) so my doctor asked me to get a bone density test and sure enough I was losing too much too fast so there are times when getting these tests done before some standard date is a good idea. - 11/13/2013   10:25:06 PM
  • JMB369
    12
    I think that part of what needs to be taken into account is the physician/patient relationship over time. My primary care physician knows that I do not like unnecessary tests, and that I will refuse medication unless it is the only means for a cure. Because of this, when she recommends a test to me or to my husband, we know it is for good reason.

    Because of this relationship of trust, my husband was diagnosed earlier this year with an aggressive type of prostate cancer -- not the 'wait-and-see" variety. He had surgery, and did not require radiation or chemo.

    I have had a slow heart beat for over 30 years -- possibly longer! Because of increasing fatigue this year, it was recommended that I see a cardiologist. The stress test indicated that my heart responds to exercise appropriately, and I do NOT need a Pacemaker. On the other hand, the 24-hour EKG (Holter monitor test) indicated that I have serious arrhythmia, and those "missed" or premature beats were reducing the oxygen input to my brain and muscles intermittently. I am now on medication.

    The cardiologist wants to do an echocardiogram to be sure there are no structural heart abnormalities, but I intend to question the necessity for doing this procedure. I do not want to stick my head in the sand and ignore a possible problem, but I am also of the opinion that if it ain't broke, don't fix it. I have a follow-up visit next week, after being on the antiarrhythmia medication for 5 weeks, and we will discuss the echocardiogram at that time.

    I agree that we need to be actively involved in our health care, and we need to question when tests are necessary and when they simply confirm a diagnosis. - 11/13/2013   9:20:32 AM
  • 11
    I disagree about the DEXA. I have no family history of osteo but having a full hysterectomy send me into sudden menopause, and my lifelong struggle to get sufficient calcium daily, I don't want to end up a statistic and discover I now have osteo only when I fall. To be able to determine if my bone density is holding its own or worsening I needed a baseline.

    I don't now if the test I had was the DEXA or one of the other types of tests, and I do agree you should always know and understand why a particular test is ordered and agree to it, but the sweeping statement in the article that one probably doesn't need the test is just as bad in its own way, going to the other extreme. There are plenty of reasons any test may be ordered, and plenty of individual reasons why it makes sense (or may not make sense). As with anything people need to have conversations with their doctors and be fully involved in their own care. - 11/1/2012   3:46:24 AM
  • EMPONTARIO
    10
    My doctor ordered a bone density scan a couple years after menopause (48) to have a basis for future reference. My mother is currently on medication that can damage bone density and her doctor was very disappointed not to have an earlier reference scan to help keep track. I guess not strictly necessary but useful. - 10/30/2012   7:48:19 PM
  • 9
    I had my last MRI years ago and I had a little tumor and the dr forgot to send me for another. When I sneeze I can't breath. - 10/30/2012   2:01:27 PM
  • 8
    I can't think of a test I've had that wasn't necessary. I agree with others that getting a DEXA scan for baseline information is good. My orthopedic ordered one after I fell and broke my ankle. Luckily, my bone density is very good so that gives me reassurance. As for the CT scan, I was hospitalized with a multiple drug resistant e-coli infection and once they got the fever under control (started at 105.3!) I still had horrible headaches. I thought I was going through caffeine withdrawal (I have done so before) so the nurse gave me caffeine tablets. They helped. My hospitalist came in and said she was concerned and wanted to do a CT. I questioned it, she knew the caffeine tablets had helped, but I had the test done anyways. Turned out that I had a sizeable brain tumor (benign, thankfully) that was removed about four weeks later (after the e-coli was completely gone). I'm grateful for my doctor's instinct. I'm also thankful for the dual medical coverage that we have and wish that everyone had access to complete healthcare so they wouldn't have to be making payments on tests, necessary or otherwise. - 10/30/2012   10:56:39 AM
  • 7
    I agree with most of the above, but bone-density testing is simple enough, non-invasive, and very useful for more women than not. (that journalist problem again!) - 10/30/2012   9:34:19 AM
  • 6
    I've been in situations where doctors have either ordered tests that weren't necessary or didn't order a test that they should have.

    I recently wrote a lengthy letter of complaint to my local hospital in regards to treatment my daughter received in the ER. The long and the short of it is that the doctor implied she was making up her symptoms and I was a hysterical mother. The jerk even put this in the notes my daughter's primary care doctor received. After a visit to her primary care doctor, she was admitted to the hospital for four days. - 10/30/2012   2:48:48 AM
  • 5
    Oh I can think of a few but I am liable to get my comments deleted if I mention them - its something ONLY a man has to deal with . It almost like my GP gets his jollies out of administering them . - 10/29/2012   8:45:06 PM
  • JULIA1154
    4
    I disagree regarding the DEXA. It's relatively inexpensive, non-invasive and can provide an extremely useful baseline if done in the 40s or early 50s. Acting on the information may help women avoid many costly, painful and even life-threatening issues. - 10/29/2012   4:39:57 PM
  • 3
    Great Advice. My doctor has me doing these tests every year. I know I am 53 and have many other health concerns, but osteoporosis doesn't run in my family. My lower back pain--may be arthritis, but I go to a chiropractor and that fixes it. I don't need any extensive tests. - 10/29/2012   11:03:27 AM
  • 2
    I went into the doctor for symptoms of vertigo, pressure in the back of my head, things feeling far away when they were up close, headaches. After checking for sinus he didn't see any symptoms of that he ordered a CT scan to check for a brain tumor. I asked him if that was really necessary, I was like are you sure it isn't sinus infection. Can't you just give me an antibiotic & if the symptoms go away we will know it was sinus, if they don't I will go for the CT scan. He said "I really don't think it is sinus, you asked for my medical opinion, I gave it to you. I think you should get the scan. He has been my doctor for 23 years, so I went for the scan. Two days later his office manager called me & said it was a sinus infection. He prescribed me an antibiotic. It was impacted so he couldn't see any signs of it by his examination. Needless to say I was glad it wasn't a brain tumor, but I am still making payments on the CT scan. - 10/29/2012   9:07:33 AM
  • 1
    Great advice - we should all be more involved in our health care. It's not just the physician's responsibility. - 10/29/2012   8:41:26 AM

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