2265 North Clybourn Avenue    Chicago, IL 60614    P: 773.296.6700     F: 773.296.1131

Doctors and Lab Tests

When I was in pre-med (back in the Pleistocene Era, to many of you), I worked as a lab technician in a small hospital. All those blood and urine tests you’ve had whose results are now fully automated were once processed slowly and painstakingly by hand (mine among them). The so-called metabolic profile of about 20 tests that today takes a few seconds to complete would have occupied me for nearly a full workday.

Because of high labor and time costs, doctors back then ordered tests very carefully. In fact, to emphasize the labor involved, during my years in medical school doctors had to learn how to process blood tests, perform blood counts (manually, with a hand counter), and interpret blood smear slides and Pap tests. Today doctors are taught the chemistry behind these tests, but since it’s all automated they don’t learn the mechanics.

The concept of “labs” was relatively new back then. Physicians ordered tests primarily to confirm a diagnosis they’d already made by listening to their patient’s medical history and performing a physical exam. For a doctor to order reams of tests to see what might emerge as abnormal was considered the sign of a lazy clinician.

Over the past several years, the medical profession has been taking itself to task for allowing lab tests (and x-rays and CT and MRI scans) do their thinking for them, and they’re quite uncomfortable with what they’re finding.

Far (far!) too many tests are being done on patients, often with little return.

• First, as you might imagine, tests of any stripe are extremely expensive. Most of the results you see on a typical lab report are unnecessary, but the doctor can’t not order them because they’re part of a bundled package. I can’t say to the lab, “I want only four tests out of that package of 20,” because they deliberately price the four I want to exceed the price of the 20 in the bundle. And because we don’t have comprehensive shared electronic medical records in the US, the duplication of tests is simply astonishing.

• Second, all this ordering of tests may not be that good for you, the patient. We’re only now beginning to appreciate the high radiation exposure from CT scans. Women have undergone unnecessary breast biopsies–and men unnecessary prostate biopsies–for the most minimal of lab abnormalities. And, sadly, when an abnormal result (often on an unordered test) pops up, doctors feel compelled to order even more tests to follow up on it, or refer you to a specialist for another bevy of tests. By the time you hear, “Well, it turned out to be nothing,” you’re a nervous wreck.

In medical school we were endlessly warned “Treat your patient, not her lab test,” but too many doctors seem to have forgotten this, starting patients on a lifetime of meds to lower a slightly high cholesterol reading that could easily be handled by diet changes or labeling patients with serious illnesses based on a blood tests that have high percentages of false-positive test results. During the decades that a nearby university center “didn’t believe in fibromyalgia,” I saw dozens of women diagnosed (wrongly) with lupus and started on potentially dangerous medications because doctors treated their lab test, not them.

• Third (and this is not an original thought), I believe that having access to literally thousands of tests–and having a third party (health insurance) pick up the tab–makes doctors intellectually lazy. When new patients arrive at WholeHealth Chicago with enormous stacks of medical records, it’s obvious that doctors ordered many multiples of the same tests, with costs spiraling to thousands of dollars. As I read through piles of test reports, almost all of them completely and repeatedly normal, I have to wonder: Were all these tests ordered because the doctor didn’t have anything better to do with his or her mind?

If you’re thinking doctors do this for the money, you’d be wrong. The dollars for these tests go to hospitals and the lab testing facilities. Does a physician order all these tests fearing a malpractice suit? Yes, according to surveys that’s behind some of it. But ultimately, all this test ordering came about because it’s what the conventional health care system limited itself to. Chiropractors, naturopaths, acupuncturists, and homeopaths don’t order endless tests and yet they manage to make an astonishing number of people well without bankrupting them.

The answer, of course, is balance. Once your doctor has ordered the few tests needed to rule out some serious condition that might be causing your symptoms, or ordered some simple tests to screen you for diabetes or cholesterol problems, rather than ordering more tests, he or she should consider listening to you more carefully and perhaps suggesting you see an alternative practitioner for relief of your symptoms.

Don’t ever be afraid to question your physician when the only suggestion is “Well, let’s get a few more test results and see.”

Be well,

David Edelberg, MD

Leave a Comment


  1. Patrice says:

    Each blog entry covers an important topic and the case
    study examples bring the issue alive. Thank you so much for taking
    the time and putting in the effort each week to share. I’ve passed
    on several of your entries to friends and family.

  2. gene goldring says:

    hi david,
    loved this newsletter, which arrived at good time for me. my internist ordered parathyroid ultrasound because my PTH was 66, above normal range by “1”. calcium was 9.1, absolutely normal. yes, i have osteopenia so i understand the rationale but how do you have parathyroid disease with a normal calcium ? i asked him if i really needed the test, told him i would sign a disclaimer stating that not doing it was my choice and against his advice, and he asked me to please do the test, that he would be more comfortable. i did so, even though i have a high deductible blue cross policy and knew it would be out of pocket. test was normal, and i haven’t gotten the bill yet…………best, gene

Join our Newsletter

Get health recommendations, delicious and time-saving recipes, medical news, supplement reviews, birthday discounts, and more!

BIRTHDAY

Health Tips

Dr. Edelberg’s Health Tips contain concise bits of advice, medical news, nutritional supplement and pharmaceutical updates, and stress relief ideas. With every Health Tip, you’ll also receive an easy, delicious, and healthful recipe.

When you sign up to receive Health Tips, you can look forward to Dr. Edelberg’s smart and very current observations arriving in your in-box weekly. They’re packed with helpful information and are often slightly irreverent. One of the most common responses to the tips is “I wish my doctor talked to me like this!”

Quick Connect

Get One Click Access to our

patient-portal

The Knowledge Base

Patient education is an integral part of our practice. Here you will find a comprehensive collection of staff articles, descriptions of therapies and nutritional supplements, information addressing your health concerns, and the latest research on nutritional supplements and alternative therapies.

Join our Newsletter

Get health recommendations, recipes, medical news, supplement reviews, birthday discounts, and more!

Upcoming Workshops

**Pain Relief with Myofascial Balls
Tuesday, October 29, 6-8pm
With Renee Zambo, C-IAYT Yoga Therapist

Course Fee: $65.00
(includes WholeHealth Chicago Myofascial Release Kit, $40 value)

Does that same spot in your neck, shoulders, back or hips seem to bother you every day? Do you have joint aches and pains in the hands and feet? Would you like to learn ways to alleviate that pain and tension?

Join WholeHealth Chicago’s Yoga and Movement Therapist Renee Zambo for an evening of muscle tension release with myofascial therapy balls.

Space is limited and registration is required.
Please register online.
Call the Center for additional information at (773) 296-6700
More>>

Recent Health Tips

  • Dandruff, Fungi, and Cancer of the Pancreas

    It’s an eye-catching title, I’ll admit. But the links are quite real and further research may guide medicine in new directions of cancer prevention and treatment. It all starts in your gut microbiome, the totality of microorganisms–bacteria, viruses, protozoa, and fungi–present in your gastrointestinal (GI) tract, mouth to anus. Until recently, researchers and clinical physicians alike paid virtually no attention to the microbiome and the Read More

  • New Hope For Sinus Sufferers

    When osteopath Dr. Rob Ivker moved to Colorado in the 1980s to set up his family practice, he had no idea that when he stepped off the plane he’d succumb to symptoms of chronic sinusitis that just wouldn’t go away: stuffy nose, thick mucus, pressure behind his cheekbones and above his eyebrows, dull aching headache, and thick goopy drainage in the back of his throat. Read More

  • Director of IV Therapies Katie McManigal, BSN, ANP

    Most people at some point in their lives have had an intravenous (IV) line. An adept nurse warned you about the tiny pinch of the needle as it was smoothly inserted and taped in place.  Then the  fluid dangling above your head slowly started making its way through a tube and into your body. IVs are all over the place in hospitals. They’re seen in Read More

October Sale – Save 20% off UltraMeal Rice

UltraMeal RICE is a tasty, non-dairy, nutritionally fortified, powdered meal replacement for those who want to support healthy body composition but may be sensitive to soy.

Click here to take advantage of this month’s promotion!