Should patients say no to too many tests?

Should patients say no to too many tests?

Introduction:

Awareness in the field of medicine has helped mankind diagnose and treat some of the most scared diseases. We are told that an early diagnostic can save lives and lead to faster recovery. To make this possible most patients are eager to go through as many tests that they doubt to be necessary and doctors are more than willing to prescribe them for the next appointment. The Society for Less Investigative Medicine (SLIM) was initiated last year by a few cardiologists in the All India Institute of Medical Sciences (AIIMS) in Delhi but now doctors from all over the country and from across various disciplines have joined hands to prevent patients from the ill effects of unnecessary tests. But the fact remains that patients are more curious these days since they rely on researches before a visit to the doctor and have already made their assumptions based on symptoms. Only when patients cooperates with doctors this mission can be accomplished.

Yes:

1. Over-diagnosis can lead to unnecessary treatments that can be harmful to health. People fear that they might catch a diseases just because some symptoms exist and tests show a vicinity or existence of certain elements. Medicines to prevent diseases from happening in future often deteriorate health.

2. Over-tests leads to wastage of resources. A whooping amount is spent each year on these tests. Tests that require technology are even more expensive. Unless absolutely required patients can reply on the suggestions of doctors regarding treatment without having to go through unnecessary tests.

3. Checking regularly does not make one healthier or less prone to diseases. Studies show that unnecessary blood tests in particular can increase the potential for "false positives or the identification of an abnormality that may not actually pose a health risk", which can be harmful for it eventually leads to unnecessary diagnoses and treatment.

4. Some tests like MRI are extremely sensitive. If one subjects 20 people to MRI at least 18 of them will show some of the other kind of abnormality. These are common problems which do not require excessive treatments but since test shows certain abnormality, the doctor is bound to suggest treatments.

5. CT scans and X-rays expose you to potentially cancer causing radiation. There are some common so-called-routine tests, such as colonoscopy or cardiac catheterization which are sometimes associated with serious complications.

6. Too many tests can make the person prone to anxiety and apprehensions. Children start developing fear of needles right from the initial years. Apart from the obvious, some tests are extremely uncomfortable. You will know what I am talking about only if you have ever gone through a mammogram, pap smear or prostate examination.

7. Many times it is a nexus that works among the doctors and pathology lab owners where in the doctors are offered a share of earning for each patient they refer for test.

No:

1. Unless the cause for the problem is known, how can a doctor begin with medications or any other treatments. Based on assumptions, health conditions of a patient who might be suffering from a different diseases than what he is being treated for, the patient's health can deteriorate.

2. Patients need to have trust on the doctor. If the doctor is ordering for a test, it is obvious that he is having doubts. It is necessary that the doctor should be sure of the treatment he is about to start with a patient and to be accurate, doctors need to ensure that they are not going to expose the patient to a wrong treatment.

3. In case of emergency if a doctor feels that the patient might not be able to recover unless an immediate treatment or surgery is done, tests have to be carried out.

4. Delayed treatment can be bad for patients suffering from extreme conditions. Doctors offering treatment based on his experiences and assumptions are later ridiculed and threatened if the patient succumbs under the condition.

Conclusion:

Indian doctors have joined hands in this initiative to stop unwanted tests and if patients can cooperate too, things can be better and there will eventually be less complaining about doctors trying to burn holes into the pockets of patients with expensive tests. SLIM's objectives are similar to the Choosing Wisely movement in the US which began in 2012 and currently has 70 specialty society partners who have released recommendations for their respective specialties.