From the Connect team: The ABIM Foundation is working with professional physician groups to identify medical tests and treatments that are often overused. In this campaign, called Choosing Wisely, the doctors themselves are coming up with lists of tests or procedures that are often done but often not needed and sometimes even risky. Consumer Reports is working with these groups to produce reports for consumers explaining when the tests and treatments are necessary — and when they aren’t. And they chose to publish their content our community because they want your feedback. While this content may not be disease-specific, we think it plays an important role in our efforts to help you become a more knowledgeable, empowered health consumer. So, peruse the recommendations, read the articles and share your experiences and thoughts — we and the groups involved are eager to hear.

Doctors often order tests and recommend drugs or procedures when
they shouldn’t—sometimes even when they know they shouldn’t. In fact, nearly half of primary-care physicians say their own patients get too much medical care, according to a survey published in 2011 by researchers at Dartmouth College. And the Congressional Budget Office says that up to 30 percent of the health care in the U.S. is unnecessary.

All that unneeded care can be hazardous to your health — and your wallet. For example, X-rays and CT scans expose you to potentially cancer-causing radiation, and can lead to follow-up tests and treatment with additional risks. And the costs can be substantial. A 2011 study found that the price tag for 12 commonly overused tests, such as annual electrocardiograms (EKGs) for heart disease and imaging tests for lower-back pain, was about $6.8 billion.

The problem has become so serious that such groups as the American College of Physicians, the National Physicians Alliance, and a coalition of medical societies in a project called Choosing Wisely have compiled lists of tests and treatment doctors themselves say are done too often. Below are our top five examples culled from those lists. (For more information, go to
ConsumerReports.org/cro/ChoosingWisely.)

Top Five Tests Doctors Say Are Overdone

  1. EKGs and Exercise Stress Tests for Heart Disease
  2. Imaging Tests for Lower-Back Pain
  3. Imaging Tests for for Headaches
  4. Bone-Density Tests: When You Need Them — and When You Don't
  5. Treating Sinusitis: Don't Rush to Antibiotics

Why Do Doctors Provide Unnecessary Care?

One reason is that patients, motivated perhaps by an ingrained belief that more care is always better care — not to mention ads from drug companies — ask for it. And all too often doctors comply, in part because it’s faster and easier than explaining why a test or drug might not be a good idea.

Of course, doctors have other motivations, too, including financial ones. For example, research suggests that those who invest in imaging equipment order more CT scans and MRI tests than doctors who haven’t made the investment. Some doctors say they practice aggressively to protect themselves from lawsuits. More than 80 percent of primarycare doctors in our 2010 survey said the need to practice defensive medicine interfered with their ability to provide optimal care.

A reason doctors are less likely to own up to: It’s hard to kick bad habits. But researchers say that doctors often embrace evidence that reinforces their practice style while ignoring evidence that conflicts with it. For example, results from a trial published in 2007 found that angioplasty—an invasive procedure — worked no better than drugs plus lifestyle changes for people with stable heart disease. But several years later a study found that most doctors still chose angioplasty without giving those simpler, less expensive steps a shot first.

Ask These Questions

Do I really need this test or procedure?
The answer should be direct and simple. Tests should help you and your doctor decide how to treat your problem, and procedures should help you live a longer, healthier life.
What are the downsides?
Discuss the risks as well as the chance of inaccurate results or findings that will never cause symptoms but may require further testing. Weigh the potential complications against possible benefits and the symptoms of the condition itself.
Are there simpler, safer options?
Sometimes lifestyle changes will provide all the relief you need.
What happens if I do nothing?
Ask if your condition might worsen—or get better—if you don’t have the test or procedure now.
How much does it cost?
Ask whether there are less expensive alternatives, or generic versions of brand-name drugs.

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What do you think of the Choosing Wisely campaign? Share your thoughts in the comments section below.