Doctor - Is This Test Necessary?
In my last column we reviewed one reason patients are given so many medical tests. We learned that doctors will order many more tests than necessary because, if a problem occurs, the test documentation may later provide a defense against a resulting lawsuit. It’s called defensive medicine.
There are additional reasons we are subjected to so many tests. First, tests can substitute for time spent with patients. It takes doctors less time to review extra test results than it takes to ask us questions, listen to our answers, then determine exactly which tests are really necessary.
Another reason is income. When doctors own the instruments used for testing, like CT scanners or MRI machines, they get paid for running the tests. Insurance reimburses doctors more for procedures than it does for patient face time. More tests mean more money in the doctor’s pocket.
I don’t blame doctors for ordering too many tests. If you were a doctor and had your choice between spending too much time with a patient, or making extra money by ordering unnecessary tests, knowing they could also help you in a later lawsuit, which would you choose?
While I understand their motivation, I don’t like it. Some medical tests can be dangerous. They may expose us to radiation or infection. They take up our time or cause us to miss work. And don’t forget that even when insurance pays for tests, we pay for them. The insurance companies get their money from us to begin with.
How can we patients make sure we aren’t being over-tested?
If your doctor orders a series of tests, ask the purpose for each. His answer may reveal whether you really need them.
Tell him you want to be sure your insurance covers them, or that you can’t afford the tests because you are uninsured. Then, ask him what the alternative will be if a test isn’t covered or you can’t afford it. Listen closely to his answer. It may give you a clue as to whether it’s imperative you get that test.
By all means, if the test is necessary for diagnosing you or determining the next steps toward keeping you healthy, then be tested. It’s important.
If not? Then work with your doctor to find an alternative.
Even if we understand why defensive medicine exists, we must practice defensive patienting, too. |
