Do you believe the more tests a doctor orders the better the Doc? Does ordering many tests mean insecurity? Perhaps ordering a test equals less time and questions ask that could make a diagnosis or arrive at the best treatment?

We are taught in medical school that 80% of the diagnosis is in the history and physical exam. Both require time! A detailed physical exam, hands on, using a stethoscope in at least 18 places – that is a careful thoughtful evaluation. Don’t forget the exam is clothes off and no noise nor interruptions.

Medical tests are not absolutely safe. Over ordering of imaging studies (scans) can result in exposure to radiation especially in the case of CTs. Never mind the many incidental findings – findings that do not explain your condition. Simply put an abnormal finding with no known medical significance. This reality occurs in more cases than you can imagine where upon a dilemma arises. Then a decision: order more tests, ignore or let the patient decide. Below are some results for specific conditions and tests.

Headache sufferers all too often have a brain imaging study ordered with less than 1% revealing the cause. In 20% of those brain CT scans (radiation exposure equal to 8 months of natural radiation) there are ‘incidental’ finding. If instead a brain MRI (no radiation) was ordered – 10 -12% have incidental findings.

If your work-up includes an abdominal CT scan (equivalent to 3 years of natural background radiation) while it may help with a diagnosis, 50% of these scans are read by radiologists to have ‘incidental findings’ which may leads to more tests and apprehension.

Remember medical radiation is cumulative in out bodies! Read my earlierĀ Radiation blog on this.