Are You Getting Too Much Medical Care?

First, do no harm—that’s what medical students are taught. Yet unnecessary drugs and tests, along with overly broad definitions of health conditions, can set you up for unexpected damage  

by Christie Aschwanden
Photograph: Illustration: Brian Stauffer

Talk with your doctor
To avoid medical care you don’t need, start a discussion with your doctor. “Medical recommendations are often wrapped together with value judgments,” says Peter Ubel, MD, a physician, behavioral scientist and author of Critical Decisions: How You and Your Doctor Can Make the Right Medical Choices Together. Which is more important to you: having a label for what ails you or avoiding unnecessary tests that may cost you time, money and worry? Are you willing to adopt healthier lifestyle habits if that allows you to avoid taking a drug? Share your preferences with your doctor. “A patient who can put her values on the table is at an advantage here,” Ubel says.

If possible, do some research before your visit and arrive with a Choosing Wisely list or similar information in hand to help you get the conversation started. Before you agree to a medical test, Wen says, ask your doctor, “What’s this test looking for, what will happen if it’s positive or negative, and how will the results change what we do?” Other important questions, Wen says, include, Is there an alternative to this test? What can we do to lower the risks? Are there tests other than CT scans that can reduce my exposure to radiation? “Every test should be ordered for a specific reason,” Wen says. “If the doctor can’t tell you why he or she is ordering the test, that’s a red flag.” Bottom line: You have the right to refuse any test or treatment you don’t want.

A good doctor listens with her full attention. “Your history, which is your story, can lead to the right diagnosis 80 percent of the time; that’s why telling your story is so important,” Wen says. “Tell your doctor, ‘I believe I’m the expert when it comes to my body, and you’re the expert when it comes to medicine, so let’s work together to figure out what I have.’ ”

I won’t be going back to the doctor who gave me the unnecessary Pap test, but if my next doctor repeats the mistake, I intend to borrow a script that Harris suggested: “I’ve read a lot about this, and not everyone agrees with what you’re recommending. This test has both pros and cons; it’s not compulsory.” If the next doctor won’t listen to my concerns, I’ll keep searching until I find one who does.

Next: The New Science of Living Longer

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First published in the December 2013/January 2014 issue

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