Defensive Medicine: Do I Need This Test?

(CBS)
Wyatt Andrews is a correspondent for CBS News based in Washington.
Sometimes, my own, actual life bears a resemblance to what I cover.

This very morning, by coincidence, my doctor sent me to have a c/t scan, (cat scan) to help diagnose a minor pain which I keep complaining about but which he can't figure out. Cat scans, which typically cost several thousand dollars, are often cited as the key example of what's called defensive medicine: the practice of ordering too many tests or medical procedures "just to be sure" of a diagnosis. The costs of defensive medicine are likely in the ten of billions of dollars, but what are we are patients supposed to do? Should I have questioned such an expensive test? To save (CBS's) money, should I have asked for an x-ray instead?

Tonight's story, which is on the nationwide practice of defensive medicine, focuses on the case of a Richmond college student who went to the emergency room with stomach pain and (guess what?) was immediately given two cat scans.

She had a harmless ovarian cyst, but her father had a near stroke. He got an $8,500 bill -- most of which, $6,500, was for his daughter's two cat scans. The hospital defends the test, saying they had to rule out other complications, such as a kidney stone. But the student's father, who is also a physician, could have and should have found her cyst with a thousand dollar ultrasound.

However you judge this particular case, defensive medicine adds billions to the costs of health care, in unneeded imaging tests, diagnostic tests and surgeries. Too often, it's not about having an extra test "just to be sure;" the doctor is ordering extra tests to protect against being sued.

Several health care experts say there is a list of questions to ask your doctor to help screen the necessary from unnecessary procedure.
1) Why is this test needed?
2) Is there an alternate test that's less expensive.
3) Could the results of this test really change my diagnosis or treatment?
4) What's the risk if I decline the test?
You have a right to ask: Did I ask these questions before I got my own cat scan? Honestly? I asked two of the four, question 1 and question 3, essentially because I really want to know this pain isn't serious. (We'll know by Friday.)

Skeptics say we will never truly reform defensive medicine -- that we have to cap damage awards from malpractice lawsuits first -- because of this critical point: a test what might be defensive and unnecessary in one patient, might also help or save the life of another.
  • Wyatt Andrews

    Wyatt Andrews is a CBS News National Correspondent based in Washington D.C. He is responsible for tracking trends in politics, health care, energy, the environment and foreign affairs.

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