1. All About Medical Care

362. When to Refuse Tests or Surgery

It has been estimated that at least one-quarter of medical tests done each year are not needed. A study published in the Journal of the American Medical Association found that nearly 60 percent of the study’s 2,800 pre-surgery tests were not warranted because there were no symptoms indicating that the tests should be done. Just 22 percent of the tests studied yielded results, and even these played a very small role in treatment. Yet medical tests make up about half of the typical patient’s hospital charges, according to David Sobel, M.D., the director of patient education at Kaiser Permanente.

Be frank with your doctor and ask for an explanation of why a particular test is being done.

You’ll want to ask the following:

1. •Will the test results determine the treatment?
   

2. •Are there risks to the testing?
   

3. •Are there alternatives?
   

4. •Can outpatient testing be considered?
   

If your doctor recommends a hysterectomy, tonsillectomy, coronary bypass, or gallbladder removal, ask questions about alternatives. According to Eugene Rubin, M.D., of Stanford University, these procedures are among the surgeries performed excessively. Others that Dr. Rubin lists are:

1. •Dilatation and curettage (D and C).
   

2. •Cesarean sections.
   

3. •Pacemaker insertion.
   

4. •Joint surgery.
   

Find out about the following:

1. •Alternatives that are not as radical as surgery.
   

2. •If it would be risky to postpone the surgery.
   

3. •If the surgery is not effective, what treatment you should try next.
   

SOURCE: Adapted from Drs. David Sobel and Tom Ferguson, The People’s Book of Medical Tests (New York: Summit Books, 1987). Dr. Eugene Rubin, Matters of Life & Death: Risks Versus Benefits In Health (New York: Harper & Row, 1984).