An Intelligent Column on Medical Errors
Dr. Sanjay Gupta, he of CNN and countless “talking head” segments, recently wrote a well-reasoned op-ed about the explosion in unnecessary medical tests. Like others before him, Gupta admits that a great many physicians order unnecessary tests, not because these tests are likely to benefit the patient, but as a hedge against future lawsuits.
But Dr. Gupta’s analysis goes further, unpacking some of the most important repercussions of our testing addiction: up to 200,000 preventable deaths every year occur due to medical mistakes. Not surprisingly, those tests play a starring role.
In medicine, as in most things, doing more introduces more risk, and consequently, more mistakes. If medicine is based on the principle, “First do no harm,” then one wonders how so many risky tests fit the bill. Here’s Gupta:
Herein lies a stunning irony. Defensive medicine is rooted in the goal of avoiding mistakes. But each additional procedure or test, no matter how cautiously performed, injects a fresh possibility of error. CT and M.R.I. scans can lead to false positives and unnecessary operations, which carry the risk of complications like infections and bleeding. The more medications patients are prescribed, the more likely they are to accidentally overdose or suffer an allergic reaction. Even routine operations like gallbladder removals require anesthesia, which can increase the risk of heart attack and stroke.
And so on. It is an important point that has gone unsaid until now, and one which dovetails nicely with the other growing issues I have discussed elsewhere: increased drug resistance and skyrocketing costs.
I am proud to run an LA sinus practice that far outpaces the nation in accuracy and safety. Some tests are indeed necessary, of course, especially when the risk associated with that test is outstripped by the danger of doing nothing. But moderation is paramount: we do not have all the answers, and sometimes professional instinct and experience are just as accurate as the best screening technology.
So: ask your doctors if those tests are necessary, and then ask why. Having these answers in hand is a great way to protect your health and checkbook simultaneously.