Push for transparency in lab test costs
For many clinicians, lab test costs are a bit of a black box, as labs do not make this information readily available. However, if clinicians knew that a panel of tests for four different Candida pathogens could be quite costly, they might be less inclined to order such granular-level tests at the outset.
Clinicians and their patients have a right to know lab test costs and should push for more transparency from their labs, including encouraging them to post this information on their websites.
Address the problem more broadly
Ob.gyns. also can take the lead in addressing the overtesting problem at a broader level. For example, they can use proactive education, such as through seminars or grand rounds, to help minimize unnecessary testing and inappropriate referrals from family practitioners, emergency room physicians, or other clinicians who may be less familiar with current cervical cancer or STI screening guidelines. Education also should be reactive, such as gently educating clinicians when they perform unnecessary tests and make inappropriate referrals.
Technology also can be used to address the overtesting problem. As more practices implement electronic health records, their systems can be tailored to guide clinicians to order lab tests based upon evidence-based medicine. This will not replace clinicians’ need to be knowledgeable about current guidelines and testing options, but certainly can complement this ability.
The bottom line is that women’s health clinicians need to take charge to help reduce unnecessary lab testing for women. It may be easy to avoid addressing the problem, especially if insurance companies are paying for extra tests. However, even when insurers pay for tests that are not needed, remember that, ultimately, we all pay – through reduced reimbursements to clinicians and labs, and higher premiums and deductibles for patients. More importantly, though, curtailing unnecessary testing is the right thing to do.
Dr. Pan is an ob.gyn. at Santa Clara Valley Medical Center in San Jose, Calif. She has served as a consultant to BD Diagnostics.