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Why do doctors order so many tests?

Dr. David L. Katz, MD, MPH
Preventive Medicine
Overtesting may account for an incredible one-third of all healthcare expenditure in the United States. Why do excessive tests get done?

Sometimes, it is about profit. One of the problems here is that procedures and the use of technology are far better compensated than the application of hard-earned knowledge to a robust decision not to do a procedure. Attempts to fix this systemically in medicine have thus far failed -- and need to succeed. Good medicine should be rewarded. At present, "more" medicine is.

Another issue is momentum -- often referred to as the "standard of care." The more a test gets ordered under given circumstances, the more it gets ordered under those circumstances! What everyone is doing becomes the standard of care whether it’s a good standard or a bad standard, and the standard pulls everyone along with it.

Another issue is that doctors and patients are both people -- and motivated by the same basic impulses. One of which is: it’s fun to play with cool toys. As kids, we all share this penchant. But we’re wrong to think we outgrow it. If you have a shiny new car, you want to drive it. If you have beautiful new shoes, you want to wear them. If you have new crampons, you want to climb a rock wall. And if you have technology that provides you a privileged view and interesting information about the inner workings of the human body, you want to use it! From a 20-year vantage point, I truly believe that every medical specialist, however erudite, is also a grown-up kid with some very cool toys -- and he or she wants to play. It’s human nature.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.