While patients understand that surgical operations carry risks, they often fail to realize that even apparently benign simple blood tests can also harm them. This is because tests can be unreliable, but sadly patients don’t appreciate the limitations of these tests, and doctors don’t bother to explain these to them.
Ordering the tests is easy, and this is something doctors do routinely. After all, this is what doctors are supposed to do, and this is what patients expect. Often doctors will not apply their mind , either when deciding which tests to order; or when to order them, because this is the path of least resistance. Labs also tempt doctors to order too many tests, by offering convenient “lab panels”, which mean that doctors will mindlessly order tests, most of which are not needed, because this is the simplest thing for them to do .
However, interpreting the tests can be a complex task. Even worse, after the test result comes back, if it’s abnormal (the probability of getting an abnormal result is in direct proportion to the number of tests ordered) , they are then so focused on treating the abnormality rather than the patient , that they end up wasting a lot of the poor patient’s time and money because they chase a lot of irrelevant red herrings.
Sadly, the health insurance industry is also inadvertently contributing to this epidemic of overtesting, by paying for medical lab tests as part of their “health checkup ” packages.
Patients are careful when they sign up for surgery, which is why doctors take their signature on the informed consent form before doing a surgical operation. I think the same rules need to apply for doing tests as well. Otherwise, once the doctor finds an abnormality, he will send you on a wild goose chase , trying to fix the problem. You may find yourself being referred from one doctor to another, each of whom runs even more tests. Very few doctors have the maturity to be able to ignore abnormal results which are of no clinical relevance.
This is why the patient’s presenting clinical problem often gets neglected in the process of treating the abnormal test result. One you do the test , you have embarked on the slippery slope of having your problem get medicalized, and once you get into the clutches of the medical system , it can be extremely hard to extricate yourself. If you want to make sure you don’t become ill because of “testitis” please do your homework before you agree to do a test.
The question you need to ask is surprisingly simple – how will the results of this test change my treatment options ? And if they won’t, then please don’t agree to do the test just because the doctor says ” we need to be sure we are not missing anything ” – this is not a good reason for running tests !