In my last post, I praise the Choosing Wisely® list, which is aimed at cutting down on unnecessary testing by docs.
I got into medicine because it is FUN, and, of course, to help people. I think most of my colleagues did so as well. I get up every day and I get to go to work and figure out puzzles all day. How cool is that? Sure, it may not always be unwarranted or a bad thing, but testing and more testing can definitely take the fun out of taking care of patients… I want to figure out your problem the old-fashioned way with a good old history and physical! Then and only then, get a test if it is warranted. This is the correct way, and the safe way, to help improve your quality of life.

So why else am I in favor of the Choosing Wisely® (and the mentality behind it)?
Our over-testing can place the patient in harms way, especially if your doctor is not vigilant. There are only three results that can come from any medical study or test. You might find what you are looking for, find nothing (negative/normal result), or a result that is unexpected. A test that shows what you are highly suspecting should be the most common result. Testing that shows nothing or is “normal” should be far and few between. Warranted screening testing or similar testing is not what I am talking about here – I am talking about a patient who has a problem for which an active diagnosis is being sought. On the other hand, we would all hope the any and all screening testing would come up normal.
Tests that show something unintended are where it can get scary folks. And this is something few ever really think about. It is sort of “beware of what you ask for.” Of course, an unintended result such as serendipitous finding an early case of early leukemia or similar is a good thing. Nobody can deny what that discovery can mean to that person and their family.






