In spite of some medical professionals’ claims to the contrary, cancer patients rarely request unnecessary tests or treatments according to a study cited in the JAMA journal Oncology.
The study was completed at three Philadelphia Hospitals, and included a survey of oncologists, oncology fellows and nurse practitioners, who were interviewed after visits with cancer patients. The purpose of the study was ” to assess how frequently patients demand or request medical tests or treatments, what types they demand, the clinical appropriateness of their demands, and how frequently clinicians comply.” (Goginini et al; JAMA Oncology, published online February 12, 2015)
Of the 5,050 visits involving 3,624 patients, only 440 (8.7%) included requests from patients for tests or treatments. Healthcare providers complied with 365 of the clinically appropriate requests, and of the 50 demands for unnecessary tests, providers only complied with seven of those requests. Only one percent of the requests were considered clinically inappropriate.
The University of Pennsylvania team found that about 50 percent of the requests were for medical imaging tests, 14 percent for laboratory tests, and about five percent for genetic tests or chemosensitivity tests.
Cancer patients were chosen in this study, as oncology is a setting where there are life-and-death choices for patients, and the stakes are high.
Results are contrary to expectations
According to Dr. Ezekiel Emanuel, chair of the department of medical ethics and health policy at the University of Pennsylvania School of Medicine, Philadelphia, one of the authors of the study, “We found, contrary to expectations, that patient demands are low and cannot be a key driver of increasing health care costs.”
Although it has been claimed by many healthcare professionals that patient demands are contributing to rising health care costs, this study shows that few patients insist on unnecessary tests or treatments.
