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.
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 primary-care 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.