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Doctors admit they order too many tests.

Unnecessary tests and procedures may add up to $50 billion a year to the nation's medical bill.

That estimate comes from Dr. Robert H. Brook, vice chairman of medicine at UCLA and director of the health sciences program at the Rand Corp. who, according to an article in the current issue of Harper's Bazaar, said:

"Every study that has seriously looked at the issue comes to the same conclusion. Doctors frequently subject patients to unnecessary diagnostic procedures, unwarranted dangers and needless expense."

In an American Medical Association survey, 75 percent of all physicians responding answered "yes" to the question of whether they ordered more tests than they really thought were necessary.

There are several reasons for this epidemic of unneeded tests. Physicians' fear of malpractice suits -being sued because they failed to order or perform certain screening procedures - is one factor. But according to a study in the New England Journal of Medicine, it was found that doctors who have a financial stake in imaging equipment -X-ray, ultrasound or CAT scan machines - are four to four-and-a-half times more likely to order those tests than doctors without vested interests. And they are also likely to charge more.

Here are some of the basic questions that need to be answered about medical tests:

--What is the purpose of the test? How will results affect your treatment? If the information is unlikely to change a doctor's recommendation, the test shouldn't be done.

--How is the test performed? Does it involve injections, medicines, dyes, X-rays, pain? It pays to get a second opinion.

--Where and by whom will the exam be performed and interpreted? One result of recent studies is that high-volume, licensed clinical laboratories have been found to have lower error rates than smaller facilities.

--How accurate is the test? The more inaccurate, the less worthwhile.

--What are the dangers? Pain, infection, allergic reaction or death are all possible complications.

--From the/inn Arbor News, 11/21/91
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Publication:Special Delivery
Date:Sep 22, 1992
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