10 Overprescribed Medical Tests and Treatments

  • Male rubbing his lower back
    1. Imaging Tests for Lower Back Pain Within the First Six Weeks
    Most people with lower back pain improve within a month using self-care measures, according to the American Academy of Family Physicians (AAFP). It doesn’t matter whether they get an imaging test or not. In fact, early imaging tests may lead to other procedures that complicate recovery and waste money. Instead, AAFP recommends imaging tests right away only when red flags are present: signs of nerve damage, a history of cancer, unexplained weight loss, fever, or a recent infection.

  • Allergies
    2. Routine Antibiotics for Mild-to-Moderate Sinusitis
    Sinusitis is usually viral. This means antibiotics won’t work. Despite this, AAFP reports that doctors prescribe antibiotics in 80% of acute sinusitis cases. Acute means it’s an intense bout of sinusitis for a few weeks. Taking antibiotics when you don’t need them can cause uncomfortable side effects and lead to infections resistant to antibiotics in the future. But there are times when antibiotics are necessary. This includes having discolored nasal sections and facial or dental pain for seven days or more. Or having symptoms that return after initial improvement.

  • stethoscope and EKG
    3. EKGs and Other Cardiac Screenings in People Without Symptoms
    EKGs and other cardiac screening tests can save your life if you’re having symptoms of heart disease. These tests are also vital if you have a history of heart disease or are at high risk of developing it. But they are generally not useful in healthy people with no symptoms. In fact, the results can be misleading in low-risk people, leading to unnecessary and costly procedures. Ask your doctor about your risk factors for heart disease to see if these tests make sense for you.

  • Blood Test
    4. Routine Blood and Urine Tests in People Without Symptoms
    Evidence seems to suggest that many routine blood tests and urine tests are of little value for healthy people without symptoms. This includes basic chemistry panels, complete blood counts, and thyroid tests. However, that doesn’t mean all blood tests are useless. If you’re having symptoms, they can help get to the bottom of them. For healthy adults without symptoms, a cholesterol screening provides valuable information. And it’s important to screen for type 2 diabetes if you already have high blood pressure.

  • doctor-discussing-x-ray-with-patient
    5. Bone Density Scan for Osteoporosis in Adults With No Risk Factors
    This applies to women younger than 65 years and men younger than 70 years of age. A bone density (DEXA) scan to screen for osteoporosis is useful if you’re older. It’s also useful if you’re younger and have risk factors for osteoporosis. But many younger healthy people who undergo DEXA scanning end up with a diagnosis of osteopenia—or mild bone thinning. Despite a low risk of fracture with osteopenia, they often end up on drugs with significant side effects and costs. Talk with your doctor about your risks. And strengthen your bones with weight-bearing exercise and calcium and vitamin D.

  • Doctor looking at X-ray, x-ray, doctor, lung, chest
    6. Chest X-Rays and Lab Tests Before Surgery in Healthy People
    Most healthy people don’t need routine lab tests or a chest X-ray before surgery. This is especially true if it’s a low-risk surgery where complications are unlikely. These tests rarely add useful information in these cases. But they do cost money, take time, and can lead to false alarms. This can lead to more testing, procedures, and even a delay in your surgery for no reason. These tests are more useful for people with chronic medical conditions, bleeding disorders, or symptoms of a heart or lung condition.

  • http://content.bettermedicine.com/3e/ed3aa1018811e1811412313d033e31/file/cholesterolT-SS-prostate%20cancer.jpg
    7. PSA Testing in Low-Risk Men
    Doctors screen men for prostate cancer in two ways—a digital rectal exam and a PSA blood test. But PSA levels can be high for other reasons, including an enlarged prostate and recent sexual activity. In fact, most men with high levels don’t have prostate cancer. And a high result can lead to other testing, including prostate biopsy. Still, a PSA test is useful for some men. If you’re age 50 to 74 or have a high risk of prostate cancer, ask your doctor if a PSA test is right for you.

  • middle-age-couple-walking
    8. Testosterone Therapy in Men With Erectile Dysfunction
    As men age, testosterone levels slowly fall. Older men also tend to have more problems with erectile dysfunction (ED). But ED usually results from low blood flow to the penis and not low testosterone. Besides, safer effective ED therapies are available. If you have other symptoms of low testosterone, your doctor may test your testosterone levels. Testosterone therapy may be necessary if your levels are low. Otherwise, think twice about using it. Testosterone therapy is costly and can cause harmful side effects.

  • Pregnant woman and husband at doctor
    9. Elective C-Sections and Labor Inductions Before 39 Weeks
    There are legitimate medical reasons for scheduling an early delivery—before 39 weeks. But scheduling C-sections or labor inductions for convenience before 39 weeks isn’t in the baby’s best interest. Babies born before this time are at increased risk of breathing and feeding problems, and needing intensive care. There are significant risks for the mom as well. Letting birth happen naturally in its own time allows both the mom’s and baby’s bodies to prepare.

  • Not Everyone With Psoriasis Gets Arthritis
    10. Annual Pap Smears in Low-Risk Women Age 21 to 65
    A yearly Pap smear is no longer necessary for most women, according to the American College of Obstetricians and Gynecologists (ACOG). Instead, ACOG recommends a Pap smear every three years. It works as well as an annual screening because cervical cancer develops slowly. It also cuts down on unnecessary follow-up testing and procedures. Women older than 65 may not need a Pap smear at all. If your risk of cervical cancer is high, ask your doctor how often you need a Pap smear.

10 Overprescribed Medical Tests and Treatments

About The Author

Sarah Lewis is a pharmacist and a medical writer with over 25 years of experience in various areas of pharmacy practice. Sarah holds a Bachelor of Science in Pharmacy degree from West Virginia University and a Doctor of Pharmacy degree from Massachusetts College of Pharmacy. She completed Pharmacy Practice Residency training at the University of Pittsburgh/VA Pittsburgh Healthcare System. 
  1. American Academy of Family Physicians: Fifteen Things Physicians and Patients Should Question. ABIM Foundation. http://www.choosingwisely.org/doctor-patient-lists/american-academy-of-family-physicians/
  2. Bone-Density Tests: When You Need Them—and When You Don’t. ABIM Foundation. http://www.choosingwisely.org/doctor-patient-lists/bone-density-tests/
  3. Chest X-Rays Before Surgery: When You Need Them—and When You Don’t. ABIM Foundation. http://www.choosingwisely.org/doctor-patient-lists/chest-x-rays-before-surgery/
  4. Delivering Your Baby: Why Scheduling Early Delivery Is Not a Good Idea. ABIM Foundation. http://www.choosingwisely.org/doctor-patient-lists/delivering-your-baby/
  5. EKGs and Exercise Stress Tests: When You Need Them for Heart Disease—and When You Don't. ABIM Foundation. http://www.choosingwisely.org/doctor-patient-lists/ekgs-and-exercise-stress-tests/
  6. Good Stewardship Working Group. The "top 5" lists in primary care: meeting the responsibility of professionalism. Arch Intern Med. 2011 Aug 8;171(15):1385-90.
  7. Imaging Tests for Lower-Back Pain: When You Need Them—and When You Don't. ABIM Foundation. http://www.choosingwisely.org/doctor-patient-lists/imaging-tests-for-lower-back-pain/
  8. Lab Tests Before Surgery: When You Need Them—and When You Don’t. ABIM Foundation. http://www.choosingwisely.org/doctor-patient-lists/lab-tests-before-surgery/
  9. Pap Tests: When You Need Them—and When You Don't. ABIM Foundation. http://www.choosingwisely.org/doctor-patient-lists/pap-tests/
  10. PSA Blood Test for Prostate Cancer: When Men Need It—and When They Don’t. ABIM Foundation. http://www.choosingwisely.org/doctor-patient-lists/the-psa-blood-test-for-prostate-cancer/
  11. Rethinking the Value of the Annual Exam. American College of Physicians. http://www.acpinternist.org/archives/2010/01/annual.htm
  12. Treatment for Erection Problems: When You Need Testosterone Treatment—and When You Don’t. ABIM Foundation. http://www.choosingwisely.org/doctor-patient-lists/treatment-for-erection-problems/
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Last Review Date: 2019 Apr 20
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