June 5, 2012--Medically Confused

Among the things we do while in New York City are catch-ups with friends, keeping the search going for the perfect morning coffee (by far the best are the cortados at The Smile on Bond Street), and checking in with our corps of doctors. 

Thankfully, all our vitals appear to be working; but, while waiting for test results we have become increasingly confused about how best to monitor and take care of our health. 

This is because there is increasing evidence that in the absence of symptoms many of the tests we have routinely submitted to may in fact be more harmful than helpful.

Here is a summary of concerning things from Sunday's New York Times:  

Imaging for common headaches A careful medical history and neurological exam usually

are sufficient.

Imaging for lower back pain of short duration In most cases, with no sign of nerve

damage, scans bring no improvement in outcomes.

Bone scans to detect osteoporosis for women under 65 These often result in patients’

taking unneeded drugs rife with side effects.

Pre-operation chest X-ray Many hospitals do this, but it is a largely wasted effort unless

patients have signs of heart or lung disease.

Prostate specific antigen test A government panel no longer recommends this, saying its

harms far outweigh its benefits.

Annual Pap smear This test, for early detection of cervical cancer, is needed only once

every three years after a normal test.

Annual cholesterol test Adults need these only once every five years after having a test

with normal results.

Annual blood work Routine blood tests are no longer recommended for people who feel

well. Again, false positives are common.

Annual EKG For healthy people with no symptoms of heart disease, the electrocardiogram

is more likely to mislead than to identify early disease, leading to further needless tests — like

CT scans with their accompanying radiation — and perhaps unnecessary drugs or surgery.

Annual physical For healthy, asymptomatic adults, it’s an inefficient gauge of health, more

likely to find false positives than real disease

While struggling to figure this out, and hearing that coffee is a good source of antioxidants, I think I'll order another cortado.