Indian forum: Health - Should patients say no to too many tests?
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30 May 2015 14:42

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.

30 May 2015 14:46

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.

30 May 2015 14:47

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.

30 May 2015 14:48

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.