How to Save Money on Medical Tests

Asking the right questions and deciding which diagnostic tests you want to take can help you reduce your medical costs.

| September/October 1983

Despite its exalted rank in modern society, the practice of medicine is not, and never has been, immune to the whims of fashion. In 1860, for example, it was "stylish" to bleed patients who were suffering from a wide variety of ailments. Turn-of-the-century doctors (with the best of intentions of course) regularly applied leeches to their clients, and also ladled out doses of strychnine, mercury, arsenic, creosote, and hydrochloric acid. And, as late as 1945, many surgeons were still—with the blessing of medical fashion— removing tonsils, adenoids, appendixes, gall bladders, and uteri in attempts to cure arthritis. 

Today, computerized machines stand in spotless laboratories, waiting to spew out numerical data at the touch of a button, and they hold much of the same magical lure for many modern physicians as the leech can and the bleeding basin did for their predecessors. Patients, too, may be fascinated by these marvels of medical science, but we mustn't be too dazzled to ask responsible questions when our doctors suggest that we subject ourselves to such powerful, hazardous, and sometimes extremely expensive technologies.

How Much Are Diagnostic Medical Tests Costing Us?

About a quarter of all medical costs incurred in this country stem from tests. In 1977, five billion laboratory tests were performed in the United States. That's an average of more than 20 per person! In 1981 alone, $21 billion (according to the most knowledgeable estimates) was spent on lab tests and X-rays, many of which were very likely unnecessary. That figure doesn't even include the diagnostic procedures performed by physicians!

Worse yet, the stunning amount of money being spent on tests is far from the only price exacted by push-button medicine: Radiation exposure, inaccurate diagnosis as the result of laboratory error or an incorrectly interpreted set of figures, and possible infection (or even death) can all—on occasion—be added to that cost!

Is This Test Really Necessary?

Many people are surprised to learn that a doctor can't order any tests without his or her patient's consent. Most simply assume that lab exams are routine, required procedures, and therefore don't exercise their right to ask questions. Nonetheless, the decision to undergo, or refuse, medical tests is really up to you, and we suggest that you stand on your patient rights.

If your doctor wants you to have a cardiac catheterization, for instance, you'd be well advised to read up on the test in some detail and to prepare an extensive list of questions for him or her to answer, before you submit to such a drastic procedure. On the other hand, when dealing with relatively minor tests, you need only to assure yourself that they're necessary, safe, and inexpensive.

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