HEALTH & SCIENCE

Lab tests go under a critical microscope

Experts point out that good tests used badly can lead to bad medicine.

By Victoria Stagg Elliott, AMNews staff. Nov. 1, 2004.

Sometimes patients are better off if physicians refuse to order a test, according to a panel discussion at last month's annual convention and scientific sessions of the American College of Osteopathic Internists in Chicago.

"Nearly every day in the medical realm, I see patients having blood drawn for one more test that appears to have no value in adding to their care," said Gerald Blackburn, DO, chief of infectious diseases at Botsford Hospital in Farmington Hills, Mich. He also chaired the panel discussion. "And a significant number of my outpatient consultations are to explain away for an hour why that test would have been better off never having been ordered."

It's not the that the tests are bad. To paraphrase Jessica Rabbit from the movie "Who Framed Roger Rabbit?" it's just that they've been drawn that way.

Doctors complain that good tests are sometimes being used on the wrong people, at the wrong time and for the wrong purpose, and that this can lead to much more than just excess cost. The tests may lead physicians down the garden path and expose patients to additional procedures with a greater risk of side effects or complications.

For example, Mark D. Baldwin, DO, a panelist and an internist in Columbus, Ohio, has had to spare patients from unnecessary treatments recommended on the basis of post-dialysis labs showing abnormalities. These abnormalities were most likely caused by the dialysis itself and very likely to normalize without medical intervention.

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