Photo: Adam VoorhesBy Jessica Girdwain
"Is this test really necessary?" That's the question every woman should ask at her next doctor's visit. According to a report in the Archives of Internal Medicine, 28 percent of primary care physicians admit to overtreating patients, including by ordering potentially unwarranted tests as a precaution against malpractice suits. Unfortunately, excessive screening can open the door to unnecessary surgeries and medications--not to mention needless anxiety. Here, four tests to reconsider.
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The purpose: Detecting heart abnormalities that can indicate cardiovascular disease
Why you might want to skip it: If you're in good health with few risk factors for heart disease--older age, high blood pressure, a history of smoking, a sedentary lifestyle--there's no evidence that an ECG will reduce your risk of having a heart attack, according to the 2012 recommendations from the U.S. Preventive Services Task Force (USPSTF). You're also more likely to get a false positive, which can lead to follow-up testing and even surgery--such as an angioplasty--you don't need.
You could be better off... lowering your risk for heart disease, says Michael LeFevre, MD, co-vice chair of the USPSTF, by managing your blood pressure, quitting smoking, losing weight, and exercising regularly.
(in which a tube equipped with a camera is inserted into the upper digestive system)
The purpose: Diagnosing conditions like gastroesophageal reflux disease (GERD)
Why you might want to skip it: "The treatment for GERD--which can include proton pump inhibitors [drugs that reduce stomach acid]--is the same whether you're diagnosed based on an endoscopy or on your symptoms, like heartburn, sore throat, and difficulty swallowing," says Amir Qaseem, MD, PhD, director of clinical policy at the American College of Physicians. "Any invasive procedure carries the risk of complications. In this case, your gastrointestinal tract could be perforated during the exam."
You could be better off... trying proton pump inhibitors for four to eight weeks, says Qaseem. If your pain persists, an endoscopy can rule out more serious but rare conditions that might lead to esophageal cancer.
Imaging (MRI, CT scans) for lower back pain
The purpose: Pinpointing the source of your discomfort
Why you might want to skip it: According to a 2010 study, MRIs not only don't improve recovery but can increase a patient's likelihood of having surgery as much as eightfold. What's more, imaging tests expose you to radiation that, over time, may increase your risk for cancer.
You could be better off... rehabbing with physical therapy and taking anti-inflammatory meds. "I recommend these treatments first if the patient doesn't have any red flags like cancer or bone infection," says Zackary Berger, MD, PhD, assistant professor at Johns Hopkins School of Medicine.
Bone mineral density scan
The purpose: Screening for osteoporosis
Why you might want to skip it: A study in the journal Menopause found that 40 percent of women who received the scans did not meet the standard criteria for testing, such as being 65 or older or at risk for osteoporosis. If the test reveals mild bone loss, you may be prescribed osteoporosis medication, even though evidence suggests it would have little effect. "Taking medication you don't need can expose you to side effects," says Margery Gass, MD, executive director of the North American Menopause Society. "Ironically, these drugs can also increase the risk of fractures of the femur."
You could be better off... waiting until you're 65. "If you're 50 or over, keeping your bones strong is essential," says Gass, "so start strength training and eat foods that are high in calcium and vitamin D."
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Photo: Adam VoorhesBy Jessica Girdwain