About the author:

Howard J. Luks, MD

Howard J. Luks, MD

A Board Certified Orthopedic Surgeon in Hawthorne, NY. Dr. Howard Luks specializes in the treatment of the shoulder, knee, elbow, and ankle. He has a very "social" patient centric approach and believes that the more you understand about your issue, the more informed your decisions will be. Ultimately your treatments and his recommendations will be based on proper communications, proper understanding, and shared decision-making principles – all geared to improve your quality of life.

4 comments on “Over-testing, Over-utilization – Unintended Consequences and Associated *Costs*

  • OK…I’ll bite on your Twitter comment.I agree with you basic premise that a “well performed interview and exam is usually more often correct at arriving at the diagnosis— or at least equally successful — than an MRI or CT. “The problem is that the evidence clearly suggests that a “well performed” medical interview is more the exception than the rule at least among primary care physicians. I have seen plenty of studies which have looked at physician fulfillment of patient requests (driven by DTC advertising and the like) and the results show that while some physicians acquiesce to such requests, most physicians are able to deflect those requests which are clearly unreasonable. While I don’t condone over testing, I can certainly understand why patients would ask for an MRI or CT if they are worried enough to see a physician. Fear of cancer. Every one of us knows of at least one person who died of cancer that was somehow missed by their doctor (personal physician). Tests like MRIs and CT scans are the tools used to diagnose cancer so why not get scanned. After all… as the scenario goes, my neighbor had a pain every time she did XYZ and her doctor told her to stop doing what caused the pain…and she was dead of cancer in 2 months. Kent Bottles post in Healthcare Business Blog spoke eloquently to this kind of problem. If and when physicians regain the moral high ground by communicating better with patients, helping them understand their choice and providing them with the support they need and want to self manage their chronic conditions, I expect patient trust will increase and imaging request will decline. In the mean time, everyone person I know is quickly coming to realization that they can’t depend upon their doctor to do what’s right or in what their best interest anymore. It’s an unfortunate situation.

  • I agree with you… and my own personal observations are that physicians are guilty more often than patients, when it comes to requesting advanced imaging studies.

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