Medical Tests Not Always the Best Course of Action

Dorian Martin Health Guide
  • Dad finally passed a stack of old magazines to me that he finally had finished reading.  The cover of one them, Newsweek’s issue from August 2011, features a photo of a man being ready for surgery with five doctor’s hands pointing scalpels at his chest. The title of this cover story is: “One Word That Will Save Your Life.” Of course, that word – the favorite of many a two-year-old – is “No!”

    Even though the magazine is a year old, I found the story (which also was published on the Daily Beast) to be thought-provoking. The main point of the story is that Americans often opt for different screenings and procedures that aren’t really necessary and, in fact, can ultimately be dangerous to their health. Reporter Sharon Begley explains that these screenings often lead to findings that cause doctors to request additional tests. And all of these tests may lead to the identification of a possible problem that leads doctors to start an intervention. However, in many cases, that health problem often can go away on its own or ended up being harmless.

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    This point was echoed in a recent column entitled “Too Many Cardiac Tests, Treatments Occur in U.S.” by Dr. David Lipschitz, a geriatrician who serves as the director of the Longevity Center at St. Vincent. He points to recommendations of the U.S Preventative Services Task Force, an independent group of 16 national experts in prevention and evidence-based medicine. This group recommended that healthy individuals who are at low risk of heart disease and who do not have symptoms should not have annual electrocardiograms (EKG) and stress tests. Looking at the research, the task force found that these tests can lead to false results, causing doctors to prescribe additional tests that are not needed. They also noted that a normal EKG and stress test does not do a good job of predicting future cardiac issues.

    Instead, the good doctor suggests that we should write our own prescription to heart health without using an EKG and stress test. “As heart disease is clearly the leading cause of death, it is fair to assume that everyone is in some danger,” Dr. Lipschitz stated. “So taking steps to improve your heart health is far more important and valuable than finding out during a stress test that significant coronary artery disease is already present.”

    In fact, I have my own tale to tell in this area. Right after my mother’s death from Alzheimer’s disease and chronic obstructive pulmonary disease in 2005, I ended up having a heart arrhythmia. I saw my doctor, who could have prescribed all sorts of tests and medications. However, we agreed that the strain of caregiving as well as the changes that my body was undergoing due to menopause probably caused the emergence of the arrhythmia. We agreed that I would return to see my doctor in a month’s time. In the time between appointments, we also agreed that I would try lifestyle changes, including more exercise, a healthier diet, dropping caffeinated beverages, and lowering my stress level. When I went back to see him, I was happy to report that I didn’t think I had the arrhythmia anymore. And after checking my heart beat, he confirmed that I was back to normal.

  • So what screenings do you need? Here’s a list from  Newsweek’s article:

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    • Screening mammograms – recommended when you’re over the age of 50 or have a high risk of breast cancer.
    • Osteoporosis screening – Recommended when you’re over 65 years old.
    • Pap tests – Recommended every three years or more often if there’s an abnormal result. These tests are unnecessary if you’ve had a total hysterectomy or are over 65 years of age.
    • Electrocardiogram – Only recommended if you’ve been diagnosed with heart disease or are at high risk of a stroke or heart attack.
    • Blood panel – This screening is not recommended if you’re healthy and having a routine physical.
    • Stents – These are only recommended if you’ve had a heart attack less than 24 hours prior. However, if you are stable and have only mild chest pain, you shouldn’t have this procedure.
    • Colonoscopy screening – You don’t need this test if you’re over the age of 75 or you’ve had a normal result within the past 10 years.
    • Proton pump inhibitors – Take these only as prescribed for gastric reflux. However, if you have ordinary stomachaches, you don’t need these since the risks exceed the benefits.

    Primary Sources for This Sharepost:

    Begley, S. (2011). No! The one word that can save your life. Newsweek.

    Lipschitz, D. (2012). Too many cardiac tests, treatments occur in U.S.

Published On: August 29, 2012