By David Blyweiss, M.D., Advanced Natural Wellness

March 06, 2013

• Unnecessary medical treatments kill thousands
• What you should know about these common tests
• Take charge and ask the right questions

In the last issue of Advanced Natural Wellness I talked about the over-diagnosis and treatment for both breast and prostate cancer. Today I’m going to touch upon some other diagnostics and treatments often overused in medicine today.

One of the biggest problems I see is that a large number of physicians know they are over treating their patients. In a 2011 survey, a whopping 42% of primary care doctors believed they were giving their own patients too much care.

As a doctor, it’s hard not to.

Consumers are constantly told by the drug companies “ask your doctor about it”. Other doctors feel their patients expect every test under the sun. And medical malpractice laws scare doctors into acting against their better judgment.

So I’m glad to see groups like the American College of Physicians, the American Academy of Family Physicians and the American College of Cardiology working together to provide better medical care guidelines. And while I still think we have a long way to go, it’s certainly a step in the right direction.

Here are some disturbing facts you should know about:

• Estimates say around 30,000 Medicare recipients die each year in the U.S. from overly aggressive treatment.
• About 30% of all health care in the U.S. is unnecessary.
• As much as $800 billion is spent every year on unnecessary health care.

I could write a whole book on the topic. And maybe some day I will. But today I’m just going to focus in on three of my pet peeves.

There are many forms of over-treatment and diagnosis in the medical industry. And I’m not happy with any of them. However, there are a few that really make me grind my teeth at night.

Here’s the short list.

CT-Scans are a phenomenal diagnostic tool when used properly. But they are often over-used.

First, there have been a lot of reports from the Center for Medicare and Medicaid Services about “double scans.” Some doctors are ordering two scans in row for their patients. These double scans include one with a contrast agent, and another without.

This may not sound like a big deal on the surface. But when you take into consideration that CT scans expose patients to about 350 times more radiation than an x-ray, it’s pretty scary. Multiply that by two, and it’s the equivalent of 700 x-rays. The effects of this radiation are cumulative and may increase your risk of certain types of cancer.

Second, research is showing that about one third of all CT scans aren’t necessary. This means about 20 million adults and 1 million children in the U.S. are needlessly being exposed to the radiation emitted from these machines.

In the meantime, these scans may show anomalies that can lead to more unnecessary testing, treatment or surgery – and make you crazy with worry at the same time.

Here are some tips to reduce your exposure to these scans:

• If your doctor orders a CT scan, find out whether an imaging test – one that doesn’t emit radiation – such as an MRI or an ultrasound, could be used instead.
• Don’t agree to a second scan unless there is truly something wrong with the first.
• Pass up on follow-up scans that won’t change your diagnosis or your treatment.

EKG’s and Stress Tests. If you are experiencing chest pain, irregular heartbeat or shortness of breath, an EKG or stress test can determine if you have heart disease and get you the immediate treatment you need.

But some doctors routinely include an EKG and stress test as part of their patient’s regular annual exams. What you may not realize is that taking one of these tests just for the sake of “taking it” isn’t necessary. And it could lead to an inaccurate reading that may lead to further testing.

A false positive result can subject you to much more invasive procedures. This includes things like a CT angiogram or coronary angiography. Each of these exposes you to large doses of radiation and opens you to the risk of arterial perforation.

And, it may lead to overtreatment with drugs and needless surgery.

Here’s my advice.

• If you are diabetic or have symptoms of heart disease (chest pain, heart palpitations and so forth) an EKG or stress test can be a life saver. They aren’t “bad medicine,” they are just over used.
• With that being said, if you don’t have any symptoms and are not at high risk, it isn’t necessary to undergo these types of tests during your regular check-ups.

Upper Endoscopy tests are a tool used to diagnose patients with persistent heartburn and indigestion. These can both be symptoms of gastroesophageal reflux disease (GERD.) However, many physicians are using them as the first step in their diagnosis. And that’s unnecessary.

Your diet could easily be the cause of frequent heartburn. Fried foods, citrus fruits, caffeine and spices can all trigger pain and indigestion. Especially if the bacterial flora in your gut is out of balance. That’s why I often recommend taking a probiotic on a daily basis.

And even if you have GERD, an endoscopy won’t change the treatment. Your doc will prescribe you a proton pump inhibitor (PPI) like Nexium or Prilosec. (I’m not crazy about these drugs, but I won’t get into that right now. Just make sure you’re taking plenty of extra vitamin B12 if you are taking one of them.)

And then there are the potential complications. These include the risk of poking a hole in the esophagus, bleeding and misdiagnosis. So it’s important to save this type of testing for when it’s really called for. For example, if you have heartburn combined with symptoms like weight loss, bleeding, vomiting and anemia. That’s when this type of testing can really provide useful information.

Thankfully I’m not the only one recognizing this disturbing trend. The American College of Physicians just released new recommendations for the use of upper endoscopy. This is what they had to say…

• Consider endoscopy to screen for Barrett’s esophogus in men older than 50 years with more than 5 years of GERD symptoms and nighttime symptoms, hiatal hernia, overweight, or tobacco use.
• Screening endoscopy should not be done in women of any age or in men younger than 50 years.
• If the initial screening endoscopy results are negative for Barrett’s or cancer, repeated endoscopy is not indicated.
• If Barrett’s but no dysplasia is present, endoscopy should be done every 3 to 5 years. More frequent endoscopy is indicated if dysplasia is present.

Ultimately, you are in charge of your health care. Don’t try to persuade your doctor to give you a test if he doesn’t think you need it. And if he does recommend a test or procedure, make sure you ask the right questions. Understand the risks and make the decisions that are right for you…

1. Do you REALLY need the test or procedure? Any test or procedure your doctor recommends should be necessary. He should explain exactly what it will do to treat your problem, how it will improve your health and any risks involved.
2. What problems could you encounter? Find out if the test is prone to false-positive results, and what further testing you should expect if that were to occur. Also, will the results change your diagnosis or treatment? If not, there’s no reason to take it.
   
3. Are there safer options? In many cases there are safer alternatives. Find out what they are. Also keep in mind that you can correct many health concerns with simple lifestyle changes. And believe me, it’s much easier – and cheaper – to make those changes than it is to go through many of these over-used tests and treatments.

To learn more about the healthy choices that can help you live longer and healthier, just visit the Advanced Natural Wellness  website at any time.

Resources:

Brenner DJ, Hall EJ. Computed tomography–an increasing source of radiation exposure. N Engl J Med. 2007 Nov 29;357(22):2277-84.

Shaheen NJ, Weinberg DS, Denberg TD, et al. Upper Endoscopy for Gastroesophageal Reflux Disease: Best Practice Advice From the Clinical Guidelines Committee of the American College of Physicians. Ann Intern Med. 2012 Dec 4;157(11):808-816.

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