Should you really have a chest X-ray before knee surgery? Probably not
By Lola Augustine Brown
More than a million Canadians every year undergo medical tests or treatments that they don’t need and that may do more harm than good, according to a new report released by the Canadian Institute for Health Information and Choosing Wisely Canada (CWC). The latter is a physician-led campaign to reduce unnecessary strain on our health-care system by eliminating tests and treatments that provide little or no benefit to patients.
The report, Unnecessary Care in Canada, was based on a study of eight of 200 recommendations from CWC and concludes that up to 30% of the time, tests such as CT scans or preoperative X-rays were unnecessary. As Good Times reported last year (“To Test or Not to Test,” January/February 2106), not all medical tests are created equal. The report also suggests that sedative-hypnotic medications such a Valium and Ativan are being over-prescribed for older patients with insomnia or agitation.
Among the procedures the report challenges are x-rays and scans for lower back pain, screening mammograms for low-risk women, CT scans for minor head trauma or for hospital patients with delirium but no red flags present, and preoperative tests such as electrocardiograms (ECGs) or chest X-rays for low-risk procedures such as colonoscopy or knee repair.
The report’s authors hope that its results will help physicians to think twice before requesting some tests and to reassure patients who may be the ones pushing for tests in the first place. Unnecessary tests not only put a strain on the health-care system but increase wait times for patients in real need and may even cause harm by exposing patients to radiation unnecessarily.
As patients, we have the right to question our doctor if we feel that we don’t need to get that scan or test, and a good question may be, “What would happen if I didn’t get this test?”