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Inside Health Care: Overtested


After a persistent cold which arose after travels to Asia, American Board of Internal Medicine Foundation EVP and COO, Daniel Wolfson, M.H.S.A., felt it was necessary to visit a physician. During this visit, his primary care doctor recommended an EKG to gain baseline statistics. 'Too sick and too tired to fight back, I reluctantly agreed to the test,' Wolfson said. He later learned that 'a baseline EKG yields little useful clinical information.' The National Physicians Alliance has recommended that 'EKGs as tests should be eliminated for asymptotic adults without a family history.' After two decades with this primary care physician, Wolfson found a new doctor.

Family doctor Davis Liu, M.D., recommends that anytime you switch doctors or insurance, be sure to share your medical records with your primary care doctor. He recalled the experience of a 55-year-old healthy woman who recently joined his practice. Her former doctor recommended a colonoscopy five years after her first colonoscopy, which was confirmed by her medical record. However, the guidelines from the American Cancer Society state, 'For most patients with no family history of colon cancer and a normal colonoscopy, recommendations are to repeat in 10 years, not five.' Dr. Liu credits having her test history with saving her 'time, money, and unnecessary treatment.' He says getting 'another doctor's opinion and insights can be very important.'

Orthopedic surgeon Howard J. Luks, M.D., would agree. Many people come to him for second opinions for knee replacement surgery. Dr. Luks was surprised by how many patients didn't begin by asking, 'Do I need a knee replacement?' A lot of the patients he saw were previously told by other doctors that they would be up in a week and not warned of the potential complications associated with the procedure. 'It really is incumbent upon us as physicians to let people know exactly what it is they are in for, as best as we can,' says Dr. Luks. Using the process of shared decision making, he discusses with people a list of 'reasonably foreseeable risks,' their expected goals, their outcomes, and the time they expect to be in rehabilitation before returning to 'normal,' if that ever occurs. After this, some people realized that they 'weren't ready' for surgery or 'their symptoms didn't warrant it.'

Executive Vice President and Chief Operating Officer, Daniel Wolfson, M.H.S.A., blogs on ABIM Foundaiton's Medical Professionalism Blog. Family physician, Davis Liu, M.D., blogs on Saving Money and Surviving the Healthcare Crisis. Orthopedic surgeon, Howard J. Luks, M.D., blogs under his name.

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Trudy says
September 6, 2013 at 4:12 PM

I am going to have to come to your shop. I am so excited, I bohugt a few jars at the Pork and Brew festival. I'm out My Oh My, I'm so addicted to these delightful little bites of goodness. In the south we say c'est si bon ; means taste so good!