When a panel of nine medical organizations concluded this spring that Americans are being overtested and overtreated with alarming frequency, it was a wake-up call to many patients and doctors. Medical professionals, advocacy groups, and 16 medical societies have since joined the initiative, known as Choosing Wisely, to curtail overtreatment, which costs the U.S. $700 billion annually and harms patient health. Needless prescription drugs cause thousands of deaths each year, according to statistics, while tests like CT scans expose patients to hazardous radiation, often without solving medical issues – and, in some cases, creating new ones. In what's known as a "therapeutic cascade," one test can lead to more tests, procedures, even surgery, says Dr. Christine Cassel, head of Choosing Wisely. "If you have a little speck on an X-ray or a slightly high blood test, a physician feels obligated to check it out," even though you don't have symptoms. Testing's domino effect can lead to invasive procedures for no reason, says Cassel. In April, the panel released a list of 45 overprescribed tests and drugs; it will name 80 more this winter. "What this is about is choice, not that you should never have these things," Cassel says. "We're in an era when patients need to ask hard questions of doctors, and doctors need to answer them. Most physicians will welcome that conversation, since many order tests because patients expect them." Here, 10 treatments to discuss with your doctor before taking action:
EKGs or other heart stress tests during a physical
If you don't have a family history of heart disease, a stress test increases the risk of false positives, which can lead to invasive procedures like catheterization and potentially harmful drugs like antiarrhythmic medication.
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