The Doctors: How Do You Know If A Procedure Is Unnecessary?
Dr. Travis Stock sat down with guests Dr. Martin Makary, author of Unaccountable: What Hospitals Won’t Tell You and How Transparency Can Revolutionize Healthcare, and Dr. Leana Wen, author of When Doctors Don’t Listen: How To Avoid Misdiagnoses and Unnecessary Tests. This was part of this episode’s theme of revealing what doctors don’t often talk about with patients.
Dr. Travis Stork sat down with Dr. Martin Makary and Dr. Leana Wen to talk about how you know when a procedure is necessary and how you can be an advocate for yourself. (Tyler Olson / Shutterstock.com)
For example, how does a patient know if something is necessary or not? Dr. Leana Wen said that you should always ask why when a doctor recommended a test or a procedure. Ask why you need the test and how it’s going to affect your management, especially if your doctor doesn’t mention risks. Every test has risks. It’s also important to ask why if your doctor doesn’t mention alternatives to testing. Dr. Makary said you should ask what happens if you don’t get the procedure done.
The Doctors: Over-Prescribed Procedures
Then they talked about over-prescribed procedures, which includes pediatric CT scans, stress tests, EKGs, and follow-up radiological procedures. There’s a problem with over-prescribed procedures. For example, Dr. Makary said that according to the Journal of Radiology, 51 percent of follow-up radiological procedures like X-Rays or CAT scans are unnecessary. “We don’t need to chase nothing,” he said.
The problem is the balance. Dr. Travis Stork said he has a friend who explained to a patient with abdominal pain that she didn’t need a CT scan right then. He wanted to watch and wait. The patient ended up needing surgery 12 hours later and Dr. Travis’s friend was sued for over $1 million.
The Doctors: How To Change The Medical Community
Dr. Travis described this as a “tug of war” situation. He said it’s hard to balance watchful waiting with over-prescribing treatment.
Dr. Leana Wen said that it’s important for patients to join the conversation about medicine because without patient input, you can’t change the system. All of the doctors agreed to change the medical community, we need patients and doctors to come together.
I’m concerned about over recommending tests. My issue began with a lingering cough a year ago which has now disappeared after several antibiotics including one for H pylori! I have no symptoms of anything but several more tests are still recommended including one that is a “prolonged esophagus monitoring with electrode” that is a tube inserted thru my nose down thru my esophagus with the other end attached to a device on my wrist that is worn for 2-7 days! I’m a full time busy So. California Realtor with no issues but some arthritis in my ankle and fingers! Its an HMO nightmare! I desperately want to escape back into a PPO!