Do You Need That Pre-surgical Test?

Tests such as EKG (for the heart), chest X-ray and blood tests may all be unnecessary in the case of minor surgery on the feet, or eyes or minor cosmetic surgery.

If you have a heart or other medical conditions, some extra tests may be advisable. When in doubt, ask your doctor about the advantages and risks of tests that they propose, and question what the consequences of skipping the tests might be.

Allergy tests which don’t work

Linda Cox MD of the American Academy of Allergy, Asthma & Immunology warns that a blood test known as immunoglubulin (IgG) which is often given for suspected allergy cases, just doesn’t work. She adds that when an allergy is suspected in any given patient, it is common practice to test a wide range of substances by means of blood and skin testing. Instead, by narrowing down the possibilities by careful questioning about where and when symptoms occur, it is possible to give a much smaller number of tests. This can result in a less invasive and cheaper diagnostic process — something everyone likes, right?

Heart screening with no symptoms or low risk

This is a waste of money and runs the risk of false positive results, where people suffer anxiety unnecessarily through being told they have or may potentially have heart disease, when in reality they don’t.

How can I avoid unnecessary medical tests or treatments?

If you don’t feel that you have been given a good reason (or any kind of reason) for a test or treatment, you owe it to yourself to politely question the need for it. It’s your body and you should safeguard it! Doctors are obliged to get your informed consent before a procedure, which means that they should explain:

• The reasons why a treatment is being proposed.
• The benefits of the treatment.
• The risks of the treatment. 
• Alternative options, including doing nothing, and the potential consequences of alternative courses of action.

In particular, your doctor or healthcare professional (ophthalmologist, podiatrist, nurse, physiotherapist etc) should be able to assure you that a test or treatment is really necessary, that it’s backed up by evidence to support its use, is not harmful (or the potential harm is outweighed by the likely benefit) and does not duplicate another test or treatment.

Where can I learn more about this?

The American Board of Internal Medicine (ABIM) Foundation decided it was time to tackle this issue and asked nine medical societies to list their top recommendations for tests or treatments to question or avoid.  From the results received they compiled lists which have been used in an initiative called Choosing Wisely (see ‘Links’ below) which has more information.