A simple question can greatly impact health care costs:
Millions of such conversations would be useful, given the tremendous amount of wasted care in American medicine. Patients get tests and treatments they really do not need because they don’t know better (resulting in antibiotics for viral colds, for example), because our physicians are paranoid about being sued (resulting in defensive X-rays and other tests), and because many physicians and patients ignore guidelines suggesting when some tests and treatments can be avoided.
Money is another key reason for unnecessary tests and treatments. The majority of patients do not pay for all of their health care, providing them some protection from the financial ramifications of unnecessary tests and treatments. Why shouldn’t I have an ankle X-ray just to be sure I don’t have a tiny fracture if it doesn’t cost me anything? Perhaps as important, no one providing health care gets any revenue when a test or treatment does not get done, which means the business model of health care benefits from all testing and treatments, regardless of the benefit to the patient.
Fear also plays a role. If a test or treatment is not done, the patient may be unhappy or be harmed by a missed diagnosis, and the physician might get sued. By comparison, a test or treatment that costs money but seems unlikely to cause harm is a small price to pay.
