One issue with "over testing" is where do you stop?
I mean from a malpractice standpoint.
Young chest pain with no risk factors. CXR, EKG. Do you get a trop? If you do, full r/o and stress test?
Some med mal guys will say if you start the workup you need to finish it.
Same with vertigo. I see some people getting CT scans and d/c.
We all know the CT scan will probably not show a posterior lesion.
If you are looking for central cause, why didn't you get an MRI?
Would you be better with H&P and d/c if nothing points to central cause?
Based on odds, young people are less likely to have anything serious, but those missed are a disaster from med mal.
I try to do what I think is best for the patient, and I think most patients like when we get tests.
If the patient doesn't want something, I have a conversation and document refusal and capacity.
If i'm really concerned they may get an AMA, which I'm not sure really helps.
I am at the beginning of my career.
I probably order too much stuff.
That may change, it may not.
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Least Shocking Study ever
