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"Sometimes it's kind of the path of least resistance just to order the test," he said.
Doctors also often order tests or procedures to protect themselves against lawsuits -- so-called defensive medicine -- and also because the fee-for-service system compensates them for it, said Dr. Gilbert Welch, a Dartmouth University internist and health outcomes researcher.
Some doctors think "it's always a good thing to look for things to be wrong," Welch said. It also has become much easier to order tests -- with the click of a mouse instead of filling out forms, and both can lead to overuse, he said.
While many patients also demand routine tests, they're often bolstered by advertisements, medical information online -- and by doctors, too, Welch said.
"To some extent we've taught them to demand these things," he said. "We've systematically exaggerated the benefits of early diagnosis," which doesn't always improve survival. "We don't always tell people there might actually be downsides" to testing.
Jennifer Traig, an Ann Arbor, Mich., author of a book about hypochondria, says patients like her often think, "I'm getting better care if we're checking for more things."
Traig has had many costly high-tech tests, including an MRI and several heart-imaging tests, for symptoms that turned out to be nothing. She thinks doctors were right to order those tests, but that counseling could have prevented her from "wasting resources" and getting tests it turned out she didn't need.
Patients seeking screening information have several online resources, including the National Institutes of Health, http://bit.ly/a8c7P0; the American Cancer Society, http://bit.ly/9w0fli; and a nonprofit advocacy group called the Foundation for Informed Medical Decision Making, http://www.informedmedicaldecisions.org/.
The new guidance from the cancer society last week on PSA testing, echoing others' advice on mammograms, is for doctors and patients to thoroughly discuss testing, including a patient's individual disease risks, general pros and cons of testing and possible harms it may cause.
Dr. Bruce Minsky, a University of Chicago cancer specialist who still favors routine mammograms for women in their 40s, said that emphasis is a positive trend.
"That to me is one of the greatest benefits," he said. "It enhances that communication between the physician and patient."
On the Net:
The National Institutes of Health:
The American Cancer Society: http://bit.ly/9w0fli
Foundation for Informed Medical Decision Making:
Copyright 2010 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.
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