The more you treat, the more you get sick, doctors claim

The more you treat yourself, the sicker you get: this is the conclusion reached by American doctors who have found that some tests and treatments do more harm than good, writes Newsweek. "There are many areas of medicine where refusing tests, X-rays and treatments ultimately has a better effect on health," the newspaper cites the opinion of Rita Redberg, a professor of medicine at the University of California.

"For many otherwise healthy people, one test leads to another, which in turn can lead to interventions for a supposed problem that may resolve on its own or turn out to be harmless," the paper notes. "From prostate-specific antigen tests to diagnose prostate cancer (which 20 million men in the U.S. undergo each year) to surgery for chronic back pain and antibiotics for sinusitis, many tests and treatments turn out to be either harmful or as useless as a placebo."

Experts say the U.S. government spends hundreds of billions of dollars each year on medical procedures that provide no benefit or even pose serious health risks. They say Medicare could save money and lives by stopping paying for some common procedures.

And while the tests may save lives for some patients by catching the disease early, they can be harmful or even devastating for others. Large studies that looked at the effects of various cardiac surgeries on otherwise healthy patients with only mild chest pain found that the procedures did not improve life expectancy or quality of life any more than noninvasive treatments like pills, exercise, and a healthy diet, despite being much more expensive. Studies have also shown that blockages in arteries, long thought to cause heart attacks by CT scans and other X-rays, usually do not cause heart attacks, but that treating them can. That's because surgically removing these blockages releases debris into tiny blood vessels and can trigger a heart attack or angina, said Nortin Hadler, a professor of medicine at the University of North Carolina at the time. Many of the 500,000 angioplasty surgeries performed each year were performed on patients who would be better served by pills, exercise and diet, he said.

New technologies can sometimes even make the problem worse. CT angiography, which can see the heart and coronary arteries in 3D, is "extremely good at giving us the ability to see things we haven't seen before, but our ability to understand what we're seeing and whether we should intervene hasn't kept pace," says Dr. Lauer of the National Heart, Lung, and Blood Institute.

A study conducted by Johns Hopkins Medical Institutions found that 1,000 low-risk patients who underwent CT angiography had no fewer heart attacks or deaths over the next 18 months than 1,000 patients who did not undergo the test. However, they took more medications, had more tests, and underwent more types of surgery, all of which carry the risk of side effects. CT angiography itself has the side effect of exposing patients to high doses of radiation, increasing the risk of cancer.

Dr. Steven Nissen of the Cleveland Clinic discourages asymptomatic patients from undergoing CT scans, echocardiograms, or even treadmill stress tests because studies show they often yield false positives and can lead to dangerous interventions. Even the best test results can lead to worse health if they lead people to believe they can now eat whatever they want and skip exercise.

The same applies to expensive CT scans of the spine. They can help identify diseases that can be cured by surgery. However, they are no more effective than light exercise and a gentle regimen, but they carry serious risks and do not necessarily eliminate pain.

"There is a common misconception among doctors that if you find something different from what you consider 'normal', then that is the cause of the patient's problems," the newspaper quotes Hadler as saying. In addition, some doctors believe that if a treatment, such as a pill, helps a severe case of the disease, it will also work for a milder case, but this is not necessarily true, the newspaper emphasizes.

Sometimes, traditional tests should be avoided, too. In the Archives of Internal Medicine this month, a group of doctors published a list of tests and treatments that some patients should avoid entirely: antibiotic treatment for sinusitis, X-rays for low back pain, osteoporosis screening for women under 65, electrocardiograms and other cardiac tests for low-risk patients, and even complete blood counts for healthy adults.

And although studies show that some treatments are no more effective than placebo, many doctors do not give up on useless and even harmful health care that costs taxpayers so much, the publication notes.