Are Doctors ordering too many tests?

This article discusses the fact that doctors are ordering too many tests, even though that doesn't happen so much here in Spain, we are not devoid of it.
what are the reasons for this?
 1. For fear of missing something, this is every drs. nightmare, missing something and later diagnosing it too late. I have lost many night's sleep over this!

2. To compensate for the fact that they spend too little time with the patient. Patients (not all of course), generally loves tests, they are like a proof that the Dr cares, this is not true! the Dr. cares if she listens to you, and engages, not if she orders tests.

3. Because they believe it's the standard of care to order a bunch of tests.

To reduce the chances of unnecessary testing, it may be a good idea to ask your doctor why a particular test is being done and whether it will ultimately affect the medical management in any way. this is very important, if a test does not change the way something is going to get managed, it is not worth doing.


That is why a new project called Choosing wisely excites me a lot, the very drs that are experts in their subject advise which tests are not worth doing!

lets take a look at the peds list:

1-Antibiotics should not be used for apparent viral respiratory illnesses (sinusitis, pharyngitis, bronchitis).

Although overall antibiotic prescription rates for children have fallen, they still remain alarmingly high. Unnecessary medication use for viral respiratory illnesses can lead to antibiotic resistance and contributes to higher health care costs and the risks of adverse events.

2-Cough and cold medicines should not be prescribed or recommended for respiratory illnesses in children under four years of age.-this is avery common practice here in Spain

Research has shown these products offer little benefit to young children and can have potentially serious side effects. Many cough and cold products for children have more than one ingredient, increasing the chance of accidental overdose if combined with another product.

3-Computed tomography (CT) scans are not necessary in the immediate evaluation of minor head injuries; clinical observation/Pediatric Emergency Care Applied Research Network (PECARN) criteria should be used to determine whether imaging is indicated.

4-Neuroimaging (CT, MRI) is not necessary in a child with simple febrile seizure.

Here is the list for the complete set, of every specialty

the first one is priceless:

"Don’t perform unproven diagnostic tests, such as immunoglobulin G (IgG) testing or an indiscriminate battery of immunoglobulin E (IgE) tests, in the evaluation of allergy.

Appropriate diagnosis and treatment of allergies requires specific IgE testing (either skin or blood tests) based on the patient’s clinical history. The use of other tests or methods to diagnose allergies is unproven and can lead to inappropriate diagnosis and treatment. Appropriate diagnosis and treatment is both cost effective and essential for optimal patient care."

If I see another IgE in a routine blood test, I will scream, I have seen so many of them, we could fund the whole SAS with the cost!!