Can You be Over-Tested?
It’s a common scenario: after consulting Dr. Google, a patient arrives in a doctor’s office and insists on receiving certain tests; or a doctor, out of an abundance of caution, chooses to order multiple tests to rule out all possibilities. It can often take less time to order a test than for a physician to explain why doing nothing is sometimes the best option, and some patients might feel that if they didn’t get a prescription or test, they weren’t taken care of.
Research is increasingly telling us that over-testing, including many routine tests ordered during annual physicals, may in fact be be doing more harm than good. And, according to the Canadian Institute for Health Information, every year Canadians undergo more than one million medical tests and treatments they may not need.
But what do we mean by over-testing? And isn’t more always better? Not necessarily, says Dr. Wendy Levinson, the Chair of Choosing Wisely Canada. Unnecessary tests and treatments don’t add value to care, she says. Instead they can detract from care by potentially exposing patients to harm.
Choosing Wisely Canada (CWC) is a national campaign to help physicians and patients engage in conversations about unnecessary tests, treatments and procedures. Many provincial medical associations have endorsed CWC and they’ve developed lists of commonly-used tests and treatments that aren’t actually supported by evidence and could expose patients to harm due to physical risks, potential for false positives and the stress of groundless concerns when waiting for results.
Much of Choosing Wisely’s work has been about educating physicians; however, patients can also play a role in reducing unnecessary testing. CWC encourages patients and doctors to talk openly about the pros and cons of various tests, as most diagnoses and advice result from patient examinations and discussions about history, environment and symptoms.
As part of the Choosing Wisely campaign, the College of Family Physicians of Canada developed a patient video called Do More Screening Tests Lead to Better Health? That is a frank look of the pros and cons of common and often overused tests like mammography, thyroid testing, chest x-ray and ECG, and Pap smears.
CWC also suggests that patients ask their doctors four important questions before agreeing to recommended tests and treatments:
- Do I really need this test, treatment or procedure?
- What are the downsides?
- Are there simpler, safer options?
- What happens if I do nothing?
You can visit Choosing Wisely’s website for more patient resources about this important subject.
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