top of page

Repeat tests? More tests? The Why and what to do

By Martine G. Brousse

"The Medical Bill Whisperer"

Patient Advocate, Certified Mediator


October 24, 2023

Every Dr you see orders duplicate tests, labs, and even scans, and at close intervals.

You may even feel like a pincushion.

Why this trend? Can anything be done?

Let's explore reasons and solutions.

First, a reminder:

· Your treating physician always is your best source of advice

· This blog does not provide or promote any medical advice

· This blog offers general information for educational purpose only

A. The concern

· The healthcare system is clogged with repeat services, such as labs, tests, and scans

· It seems that every medical provider orders their own labs, tests, scans

· Patients do not always understand why they must repeat or undergo so many of those

. It's costing you money

B. Two main reasons

1. Clinical

a) Fear of Malpractice

· Malpractice, or medical errors, has been on the rise. According to some studies, it may be one of the leading causes of death in the US

· “Better safe than sued” become an underlining mantra

· Taking every precaution, reducing any potential risk of missing something, ruling out any possibility however remote translates in a huge number of tests that may not have been needed or that may even cause harm (and often stress)

b) Focus on own Specialty

· Patients are referred or self-determine which specialist to consult, with deeper knowledge and experience with one part of the body.

· However, specialty implies focused attention at the exclusion of other systems, or body parts.

· A specialist will tend to order tests, labs and scans that focus on that body part, even if the symptoms or condition are not related to his area of expertise, or are better treated by another medical provider

· Actions, courses of treatment and options will also be limited to this scope of expertise, further leading to tests, scans and labs that may not be useful or needed. If nothing is found, you then would likely be referred to another specialist to repeat the process.

c) Miscommunication

· Emergency conditions may prevent timely exchange of medical information regarding your health, prompting duplication or new tests that were already performed, or would not be needed

(i.e you are tested in the ER for diabetes but your yearly physical last week ruled it out, your endodontist took a CT scan of your teeth, but your dentist wants to do X-rays the following month)

· Unless the patient mentions it, the physician may not be aware that you just had blood drawn or that imaging reports are available

d) Lack of Trust between medical providers

· Yes, it exists. Some physicians even look down on “lower” specialties like PCP or Dr of Osteopathy

· A medical opinion or judgement is too often disregarded or dismissed unless issued by someone of a similar or higher level of expertise, or by oneself

· Example: many medical directors at insurance companies will not allow for a peer-to-peer call to discuss authorizing a treatment or procedure, unless the “peer” is a MD or PhD. Yet they have never seen the patient.

· There is a reluctance to trust an unfamiliar provider or unknown source. Many physician will prefer to repeat a test or scan at a facility or by a provider they have come to trust.

2. Financial

a) Back to malpractice

· Premiums are expensive and have been increasing dramatically the past few years

· The one way to reduce premiums is not to be sued. Refer to above mantra: “better safe than sued”

b) Fee-For-Service model

· The prevalent payment model is for medical providers to be paid for every service, treatment, item they provide

· Hence, the more services, the more $

· While it is definitely incorrect and unfair to say that every medical provider adds as many services as possible for financial gain, this model does not encourage restraint or careful use of resources

· Results, quality of care, clinical need may fall second to the bottom line

· More tests, scans and labs mean larger share of cost even with insurance, more stress and wasted time on your part

C. Some Solutions

1. Get a PCP

· A PCP can coordinate care, gather all medical records, easily respond to requests for copies of records by insurance or other providers, encourage better communication between physicians

· Avoiding duplication of services, lowering the risk of errors, and maximizing services ultimately saves you $

2. “Value-Based care”

· Newer payment system introduced a good decade ago to provide better care to the population at a reasonable cost

· Providers are paid based on quality of the care (and results) they have rendered to you

· This move from Quantity to Quality is encouraged at the federal level and expanding

· There are many advantages: streamlined medicine, improved overall care management, lower costs to your insurance and therefore to you

· But: more profits may mean less care for an OK result instead of more care and less $ for an optimum result, increased scrutiny by insurers to lower costs, reporting values may be difficult to qualify, providers may neglect a patient’s personal needs to keep “value score” high, some specialties (oncology, brain surgery) may be penalized because of high levels of bad outcomes they encounter.

D. Tips

1. Question your medical provider:

· what is the need?

· can a recent or older test be used?

· has the Dr seen a recent report?

· will the insurance cover it?

2. Keep track and communicate:

· Get copy of records and reports, or have them forwarded to your PCP

· Provide your PCP contact info before any appointment with another provider, and ask the office to get a copy of your medical records ahead of time

· Keep your Rx list current or ask your pharmacist for a printout

· Have your pharmacy and lab info handy, especially the ones that are In Network with your insurance

· Update your insurance info as needed

In conclusion, being involved by gathering reports and/or keeping copies with your PCP can go a long way to avoiding duplications of tests or labs.

Asking a physician the exact need for a test or scan that seems “too much” will ease your concerns, and possibly enable your physician to take a more conservative or observation approach to a situation which may resolve itself or not require aggressive action at this time.

As always, your physician - and a second opinion if needed - is the best source of medical advice.

Martine Brousse was a long-time Billing Manager for Physicians before switching to the side of patients in 2013. The move has allowed her to apply her deep expertise and vast experience of the intricacies of resolving all types of medical bill and claim payment issues in ways that directly and positively impact her clientsʻ finances.

(424) 999 4705 - F (424) 226 1330

@martine brousse 2023@ the medical bill whisperer 2023

Repeat tests? More tests? Why and what to do
Repeat tests? More tests? Why and what to do

5 views0 comments

Recent Posts

See All


bottom of page