The last two blogs reviewed many reasons why physicians order too many laboratory tests. Today, I will cover many of the external forces that may lead to excessive test ordering. An increasing influence is the explosion of niche laboratories with intellectual property rights or an exclusive license that directly market esoteric tests to physicians. Physicians want to be on the cutting edge and may order these tests before their diagnostic utility has been established.
News media often hype the latest “breakthroughs” reported at medical meetings. Patients hear these announcements and request that the physician order one of these tests. However, most of these so-called breakthroughs are works in progress and many fail to live up to their early promise. More than 25% of these presentations at medical meetings remain unpublished after 3 years.
Patients in the United States expect the best medical care. They often search the Internet for medical tests or listen to Dr. Oz. They may demand that their primary physician order an esoteric test, even though he or she may not know the tests’ limitations. Family or patient expects the doctor to do something tangible and ordering tests is a reassurance that something is being done. Waiting for the results of tests may also provide additional time to determine what is wrong with the patient.
Next week, we will review how health screening contributes to unnecessary laboratory testing.