The "Is Testing Really Necessary?" Story

It was an ordinary day.  Talking with a friend about having an MRI on my back a few weeks ago.  He was wondering about how it is done and if it hurts or is uncomfortable to have done.  Gave him my impressions, which were all positive as far as he was concerned.  Then he told me about an article he read about the 10 tests that you should avoid.  Said that the MRI on your back was one of them, since it can't always tell anything about the pain and that those who had an MRI during the first month of back pain were 8 times more likely to have surgery which didn't correct the pain any faster than those who didn't have the surgery.  I told him he must have read that wrong, since my MRI showed exactly what was wrong and that it wasn't going away unless I had surgery to correct it.  Then he told me that my PSA scan for prostate cancer is another test to avoid.  What?  My doctor counts on them to compare to my baseline PSA I had years ago to see what changes are happening with my prostate.  He said the article said that the PSA test causes more harm than benefit.  As a result of the test many men often have ultrasounds, repeat lab tests and even biopsies for a problem that may not be there, since 76% of high PSA readings turn out to be false alarms.  My reply to him was that an experienced and skilled doctor knows when a false reading is obtained and although he may request a repeat test, he more than likely will not do a biopsy unless it is really needed.  One time my doctor suspected something was amiss, but after an ultrasound, which is less invasive and certainly not painful like a biopsy, he determined that size and shape of the prostate was normal.  Then I asked him if anything was said of the colonoscopy which I have had twice already.  He said they recommend you get one every 10 years or every 5 if something is found, but after the age of 75 you don't need to have them anymore, since the test after that age can cause more problems than it can detect.  Some of the other tests that are to be avoided are: (1) Nuclear stress test and other imaging tests on people that have no symptoms of heart disease.  "Just to make sure" is not a reason to spend all that money.  I agree;

(2) Yearly electro- cardiogram or exercise stress test on people who do not have any symptoms of heart disease is another one.  It is said that it is much better to check blood pressure and cholesterol with maybe a one-time electrocardiogram as a base test for comparison; (3) PET scan to diagnose Alzheimer's disease even though the test can tell if you have a specific protein in your brain. It still can't tell if that protein will lead to the disease.  (4) Yearly Pap tests, since cervical cancer generally takes 10-20 years to develop and if you have the test every 3 years you should be fine.  Those over 65 who have had a few good yearly tests probably don't ever need another one. (5) Bone density scan for woman before 65 or men before 70 really isn't needed, since the medicine prescribed for that ailment is linked to throat and chest pain, difficulty swallowing, heartburn, muscle pain, bone loss in the jaw and thigh-bone fractures.  Think they need to do some more research on these medicines. (6) Follow-up ultrasounds for small ovarian cysts aren't necessary, since many woman have cysts and only those that are 1 centimeter in diameter or greater need to be rechecked. (7) And, the yearly physical.  Many of the tests that doctors order for a yearly physical aren't necessary unless you have a reason to suspect a certain problem.   So, we talked a bit more and kind of came to the conclusion that perhaps  the insurance providers may have had some say in what was written for this article he was telling me about.  How about you?  You get these tests on a regular basis?  It was another extraordinary day in the life of an ordinary guy.