Skip to main content

When to Say ‘Whoa!’ to Your Doctor

Mar 18, 2014 01:45PM, Published by Arden Haley, Categories: Health, Today




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 the top five examples culled from those lists:

1. EKGs and exercise stress tests for heart disease

The problem: For many people, an EKG—which records the heart’s electrical activity through electrodes attached to the chest—is a standard part of a routine exam. Some also regularly get an exercise stress test, which is an EKG done as they walk on a treadmill. Both are key if you have symptoms of heart disease or are at high risk of it. But for other people, the tests are not as accurate and can lead to unnecessary follow-up and treatment.

The risks: Those follow-up tests can include CT angiograms, which expose you to a radiation dose equal to 600 to 800 chest X-rays, and coronary angiography, which exposes you to further radiation. Inappropriate testing can also lead to overtreatment with drugs or even surgery.

The costs: An EKG typically costs about $50 and an exercise stress test about $200 to $300, according to the HealthCareBlueBook.com. Subsequent interventions that are prompted by unneeded tests can add thousands to the tab.

When to consider the tests: An EKG and exercise stress test should often be ordered if you have chest pain, an irregular heartbeat, or other symptoms of heart disease. They can also make sense for people with diabetes or other coronary risk factors who are just starting to exercise.

2. Imaging tests for lower-back pain

The problem: Getting an X-ray, CT scan, or MRI can seem like a good idea. But back pain usually subsides in about a month, with or without testing. Back-pain sufferers in a 2010 study who had an MRI within the first month didn’t recover any faster than those who didn’t have the test—but were eight times as likely to have surgery, and had a five-fold increase in medical costs.

The risks: One study projected 1,200 new cancer cases based on the 2.2 million CT scans done for lower-back pain in the U.S. in 2007. CT scans and X-rays of the lower back are especially worrisome for men and women of childbearing age, because they can expose testicles and ovaries to substantial radiation. Finally, the tests often reveal abnormalities that are unrelated to the pain but can prompt needless worry and lead to unnecessary follow-up tests and treatment, sometimes including even surgery.

The costs: An X-ray of the lower back typically ranges from about $200 to $285, an MRI from $875 to $1,225, and a CT scan from $1,080 to $1,520. Imaging accounts for a big chunk of the billions Americans spend for lower-back pain each year.

When to consider the tests: They often make sense if you have nerve damage, or signs of a serious underlying condition. Red flags can include a history of cancer, unexplained weight loss, recent infection, loss of bowel control, urinary retention, or loss of leg strength.

3. CT scans and MRIs for headaches

The problem: Many people want a CT scan or MRI to see if their headache is caused by a brain tumor or other serious illness. And doctors often comply to provide reassurance and to avoid lawsuits. But all that’s usually needed is a careful medical history and neurological exam. Adding a CT scan or MRI rarely helps.

The risks: Brain scans can reveal things that appear worrisome but aren’t. For example, doctors might mistake a twist in a blood vessel for an aneurysm. Those findings can trigger follow-up tests, and prompt referrals to specialists for expensive consultations. And CT scans of the head can deliver a radiation dose that’s the equivalent of 15 to 300 chest X-rays.

The costs: A standard brain CT scan costs about $340, and a brain MRI about $660. Referrals to a specialist or subsequent treatment is extra, of course.

When to consider the tests: They’re often warranted if you have an abnormal result on a neurological exam, or if your doctor can’t diagnose the problem based on your symptoms and medical exam. See a doctor if you have head pain that is sudden or explosive; different from headaches you’ve had in the past; brought on by exertion; or accompanied by fever, a seizure, vomiting, loss of coordination, or a change in vision, speech, or alertness.

4. Bone-density scans for low-risk women

The problem: Many women are routinely screened for weak bones with an imaging test called a DEXA scan. If it detects outright osteoporosis, the results can help you and your doctor decide how to treat the problem. But many people learn they have only mild bone loss, a condition known as osteopenia, and for them the risk of fracture is often quite low.

The risks: A diagnosis of osteopenia often leads to treatment with such drugs as alendronate (Fosamax) and ibandronate (Boniva), which pose numerous risks. Those include thigh fractures, throat or chest pain, difficulty swallowing, heartburn, and more rarely, bone, eye, joint and muscle pain, bone loss in the jaw, and possibly, abnormal heart rhythm. But there is little evidence that people with osteopenia benefit from the drugs.

The costs: A DEXA scan costs about $132. The price for a month’s supply of generic alendronate is $38 to $70, and $125 to $148 for Fosamax, the brand-name version. People often take the drugs for years.

When to consider the test: Women should have the scan at age 65 and men at age 70. Younger women and men ages 50 to 69 should consider the test if they have risk factors such as a fracture from minor trauma, rheumatoid arthritis, low body weight, a parent who had a hip fracture, or if they have used corticosteroid drugs for a long time, or they drink excessively or smoke. Whether follow-up tests are needed depends on the results of the initial scan.

5. Antibiotics for sinusitis

The problem: People with sinusitis—congestion combined with nasal discharge and facial pain—are often prescribed antibiotics. In fact, 15 to 21 percent of all antibiotic prescriptions for adults are to treat sinusitis. But most people don’t need the drugs. That’s because the problem almost always stems from a viral infection, not a bacterial one—and antibiotics don’t work against viruses.

The risks: About one in four people who take antibiotics report side effects, such as a rash, dizziness, and stomach problems. In rare cases, the drugs can cause anaphylactic shock. Overuse of antibiotics also encourages the growth of bacteria that can’t be controlled easily with drugs. That makes you more vulnerable to antibiotic-resistant infections and undermines the usefulness of antibiotics for everyone.

The costs: Not all antibiotics are expensive, but since doctors write so many prescriptions for them, the total cost to the health-care system is substantial—at least $31 million a year.

When to consider antibiotics: Usually only if symptoms last longer than a week to 10 days or they are accompanied by a high fever or other possible signs of a bacterial infection.
_______________________________________________

When to Say “Whoa” to Your Doctor provided by Anne Arundel Medical Center

* What’s Up? does not give medical advice. This material is simply a discussion of current information, trends, and topics. Please seek the advice of a physician before making any changes to your lifestyle or routine.


thrive health wellness


You might also like

Thumb_main2

New Guidelines for Reducing Stroke 
Risks Unique to Women

For the first time, guidelines have been developed for 
preventing stroke in women.

Pitch Perfect: What really separates humans from the rest of the animal kingdom?

Human beings, it turns out, are completely unique in their ability to throw—even when compared to our chimpanzee cousins.

  • Swamp Candy

    01/27/2015
    10:00pm

    Enjoy music by Swamp Candy every Tuesday night in the Tavern from 10pm-1am | No Cover 21+ Blues ...


  • ANNIE

    01/27/2015
    08:00pm

    Leapin’ Lizards! The popular comic strip heroine takes center stage in one of the world’s best-lo...


  • Club Crabtowne

    01/27/2015
    06:00pm — 08:00pm

    Club Crabtowne is welcoming new members to share in our cultural and outdoor recreational events....


  • Annapolis Maritime Museum School's Out Camp

    01/27/2015
    09:00am — 04:00pm

    Annapolis Maritime Museum Education Center is offering School's Out Camp. When school is closed,...


  • Little River Band

    01/27/2015
    08:00pm

    Headlining their own major shows in America and touring internationally with the likes of the Doo...


  • Rolling Individual Tryouts for 10U Travel Team Announced The Head Coach for the 10U Annapolis...


  • Let's Sew: Q&A

    01/27/2015
    02:30pm — 04:00pm

    For ages 8-18. Bring your pattern, supplies, and questions for a project you've started or would ...


  • Turtle Tuesday!

    01/27/2015
    09:00am — 04:00pm

    This camp is only for the most enthusiastic, terrapin crazy, tortoise-tastic, beak bonkers, shell...


  • Billie Holiday Project

    01/27/2015
    12:00am

    In Baltimore you will find a stunning mural project and alternative gallery, The Billie Holiday P...


  • Art in Public Places

    01/27/2015
    12:00am

    The city of Annapolis is a prime example of an alternative gallery as it displays sculpture, phot...


  • Pressing Strings

    01/29/2015
    10:00pm

    No Cover | 21+ http://www.pressingstrings.com/ Opened for the Beach Boys at Pier Six Pavilion...


  • ANNIE

    01/29/2015
    08:00pm

    Leapin’ Lizards! The popular comic strip heroine takes center stage in one of the world’s best-lo...


  • Tiempo Libre

    01/29/2015
    08:00pm

    Classically trained at Cuba’s premier conservatories, the members of three-time Grammy-nominated ...


  • The 18th Annual Bay to Ocean Writers Conference will be held February 28, 2015 at Chesapeake Coll...


  • 2015 Progressive Insurance Baltimore Boat Show

    01/29/2015
    11:00am — 09:00pm

    The 2015 Progressive Insurance Baltimore Boat Show drops anchor at the Baltimore Convention Cente...


  • Hip and Knee Pain 101

    01/29/2015
    06:00pm — 07:30pm

    If you have chronic hip or knee pain then you know how it can interrupt your life, health and hap...


  • The Liar

    01/29/2015
    08:00pm

    This sparkling comedy, fast witted and robustly-paced, is the story of a man who can't tell the t...


  • Rolling Individual Tryouts for 10U Travel Team Announced The Head Coach for the 10U Annapolis...


  • Story Time

    01/29/2015
    10:30am — 11:00am

    For ages 2-5 with an adult. Sing, play, read, write, and talk about a different theme each week. ...


  • Australian Wine Night at National Aquarium

    01/29/2015
    06:30pm — 09:00pm

    Drink up in the land down under! Join National Aquarium for Australian Wine Night, an Australia D...


  • Billie Holiday Project

    01/29/2015
    12:00am

    In Baltimore you will find a stunning mural project and alternative gallery, The Billie Holiday P...


  • Art in Public Places

    01/29/2015
    12:00am

    The city of Annapolis is a prime example of an alternative gallery as it displays sculpture, phot...


  • Winter White-Out Wine Tasting

    01/29/2015
    06:00pm — 08:00pm

    Just because it is winter doesn't mean that you can't drink whites. We will be tasting some fabul...


  • Bach +

    01/29/2015
    06:15pm — 07:15pm

    The January 29th concert features Shaughn Dowd on flute, Kim Miller on violin, Kathy Birch on cel...


  • Doctors on Call: Injury Screening Appointments ACCOMPLISH YOUR NEW YEARS FITNESS RESOLUTIONS INJ...


  • A new hapkido school has opened in the Annapolis area. Traditional hapkido is an effective form o...


  • ANNIE

    01/30/2015
    08:00pm

    Leapin’ Lizards! The popular comic strip heroine takes center stage in one of the world’s best-lo...


  • Jekyll & Hyde

    01/30/2015
    08:00pm

    Synopsis: An evocative tale of the epic battle between good and evil: JEKYLL & HYDE. Convinced t...


  • The Smithereens

    01/30/2015
    06:30pm

    Known for writing and playing catchy 1960s-influenced power pop that inspired countless alternati...


  • The Smithereens

    01/30/2015
    09:30pm

    Known for writing and playing catchy 1960s-influenced power pop that inspired countless alternati...


  • The 18th Annual Bay to Ocean Writers Conference will be held February 28, 2015 at Chesapeake Coll...


  • 2015 Progressive Insurance Baltimore Boat Show

    01/30/2015
    11:00am — 09:00pm

    The 2015 Progressive Insurance Baltimore Boat Show drops anchor at the Baltimore Convention Cente...


  • The Liar

    01/30/2015
    08:00pm

    This sparkling comedy, fast witted and robustly-paced, is the story of a man who can't tell the t...


  • Rolling Individual Tryouts for 10U Travel Team Announced The Head Coach for the 10U Annapolis...


  • LATIN JAZZ ALL-STARS

    01/30/2015
    08:00pm — 09:30pm

    This concert will feature musicians who have mastered the fiery rhythms and many styles of the Af...


  • LOVE is RED

    01/30/2015
    05:00pm — 07:00pm

    'Love is Red' Queen Anne's County Centre for the Arts, 206 S. Commerce St. in Centreville, will ...


  • LOVE is RED

    01/30/2015
    05:00pm — 07:00pm

    'Love is Red' Queen Anne's County Centre for the Arts, 206 S. Commerce St. in Centreville, will ...


  • Gerry Swarbrick

    01/30/2015
    08:30pm — 11:30pm

    Come down and enjoy some great live music performed by some of our favorite local performers. Wit...


  • Fadó Hopped Up Burger Month

    01/30/2015
    04:00pm

    Fadó Hopped Up Burger Month: every Friday and Saturday this month we’re making specialty burgers....


  • Billie Holiday Project

    01/30/2015
    12:00am

    In Baltimore you will find a stunning mural project and alternative gallery, The Billie Holiday P...


  • Metromix Comedy

    01/30/2015
    07:30pm

    Metromix Comedy mixes up the local comics from the area to bring you a variety of talents in one ...


  • Art in Public Places

    01/30/2015
    12:00am

    The city of Annapolis is a prime example of an alternative gallery as it displays sculpture, phot...


  • SAM GROW

    01/30/2015
    09:30pm — 01:30am

    Southern Maryland's home grown country rocker takes the stage once again for another memorable sh...


  • Saturday Wine Tasting

    01/31/2015
    11:00am — 04:00pm

    Join us every Saturday at The Wine Cellars of Annapolis for our free wine tasting! New theme ever...


  • ANNIE

    01/31/2015
    08:00pm

    Leapin’ Lizards! The popular comic strip heroine takes center stage in one of the world’s best-lo...


  • Annapolis Opera Presents: Hansel and Gretel

    01/31/2015
    10:30am — 11:30am

    This production is a 50–minute condensation of Humperdinck’s immortal opera Hansel and Gretel. Th...


  • Jekyll & Hyde

    01/31/2015
    08:00pm

    Synopsis: An evocative tale of the epic battle between good and evil: JEKYLL & HYDE. Convinced t...


  • Hansel and Gretel

    01/31/2015
    10:30am

    The beloved fairy tale favorite returns to delight and introduce young children to the world of o...


  • Catch Navy men's basketball action at Alumni Hall!


  • Good Deale Bluegrass & Eastman String Band

    01/31/2015
    08:00pm — 12:00am

    On its 15 year anniversary, Tim Finch's Good Deale Bluegrass show promises another exciting lineu...


  • The 18th Annual Bay to Ocean Writers Conference will be held February 28, 2015 at Chesapeake Coll...


  • 2015 Progressive Insurance Baltimore Boat Show

    01/31/2015
    10:00am — 09:00pm

    The 2015 Progressive Insurance Baltimore Boat Show drops anchor at the Baltimore Convention Cente...


  • The Liar

    01/31/2015
    08:00pm

    This sparkling comedy, fast witted and robustly-paced, is the story of a man who can't tell the t...


  • Alexander Peters

    01/31/2015
    08:30pm — 11:30pm

    Come down and enjoy some great live music performed by some of our favorite local performers. Wit...


  • Billie Holiday Project

    01/31/2015
    12:00am

    In Baltimore you will find a stunning mural project and alternative gallery, The Billie Holiday P...


  • Art in Public Places

    01/31/2015
    12:00am

    The city of Annapolis is a prime example of an alternative gallery as it displays sculpture, phot...


  • Binology 101: The Basics of Wine Tasting

    01/31/2015
    02:00pm — 03:30pm

    We look at the typical characteristics of popular grape varietals and explain the terminology and...


  • MARSHALL LAW

    01/31/2015
    09:30pm — 01:30am

    Marshall Law combines high-energy country music, rock-and-roll, beer slingin' and ass-kickin. ...


  • The 18th Annual Bay to Ocean Writers Conference will be held February 28, 2015 at Chesapeake Coll...


  • Rolling Individual Tryouts for 10U Travel Team Announced The Head Coach for the 10U Annapolis...


  • Trash To Treasures Camp

    01/26/2015
    09:00am — 04:00pm

    Turn your trash and recyclables into treasures! Make practical gifts and even art from things mos...


  • Let's Sew: Beginner's Class

    01/26/2015
    02:30pm — 04:00pm

    For ages 8-18. Learn the parts of a machine, how to read a pattern, and the basics about fabrics ...


  • Billie Holiday Project

    01/26/2015
    12:00am

    In Baltimore you will find a stunning mural project and alternative gallery, The Billie Holiday P...


  • Art in Public Places

    01/26/2015
    12:00am

    The city of Annapolis is a prime example of an alternative gallery as it displays sculpture, phot...


  • Swamp Candy

    01/27/2015
    10:00pm

    Enjoy music by Swamp Candy every Tuesday night in the Tavern from 10pm-1am | No Cover 21+ Blues ...


  • ANNIE

    01/27/2015
    08:00pm

    Leapin’ Lizards! The popular comic strip heroine takes center stage in one of the world’s best-lo...


 

 

Image title
Image title
Towne Social
Towne Social