One in 10 shy of asking doctors if tests are necessary

3 April 2019

One in 10 New Zealanders uncomfortable asking doctors whether a test or treatment is necessary

One in 10 Kiwis don’t feel comfortable asking their doctor about whether a treatment or test is necessary, a survey by Consumer NZ and the Council of Medical Colleges has found.

The annual survey was carried out as part of the organisations’ Choosing Wisely campaign, which encourages people to ask their health professional four questions when a test or treatment is suggested:

1. Do I really need this test, treatment or procedure?
2. What are the risks?
3. Are there simpler, safer options?
4. What happens if I don’t do anything?

Consumer NZ chief executive Sue Chetwin said people should feel able to question health care treatment options.

“Understanding why your doctor is considering a test – and weighing up the benefits and risks – is every patient’s right,” Ms Chetwin said.

“Ask what is likely to happen if you do – or don’t – have a test or procedure.
Are there potential side effects? What are the chances of getting results that aren’t accurate? Could that lead to more testing or another procedure?

“By having these discussions, you and your doctor will be clearer on what’s the best thing to do for your health and wellbeing.”

The survey also found 21% of consumers felt their doctor had recommended a test or treatment that wasn’t necessary. Of those, 24% said they went ahead and had it anyway. Eighteen percent ignored the doctor’s recommendation.

Thirty-five percent of consumers agreed or strongly agreed that some tests or treatments did not benefit the patient.

While most felt their doctor always (40%) or often (30%) involved them in decisions about their care, one in five thought this only happened sometimes.

Choosing Wisely medical director Dr Derek Sherwood said there was mounting evidence that more tests and procedures did not always equal better care.

“While modern medicine has given us more ways than ever to diagnose and treat illness, sometimes, the best option may be to do nothing,” Dr Sherwood said.

“Tests, treatments and procedures have side effects and some may even cause harm. For example, CT scans and x-rays expose you to radiation; overuse of antibiotics leads to them becoming less effective; a false positive test may lead to painful and stressful further investigation.”

As well as encouraging patients to ask their doctor about tests and treatments, the Choosing Wisely campaign has comprehensive information for health professionals about which tests, treatments and procedures to question.

Choosing Wisely sponsors are the Council of Medical Colleges, Southern Cross Health Society, Pacific Radiology and PHARMAC. Consumer NZ and the Health Quality & Safety Commission are Choosing Wiselypartners, and there is wide health sector support for the campaign.

See the Choosing Wisely website for more information.
Survey results
1. When you visit a doctor, do you generally expect them to send you for a test or provide you with a prescription?
• Yes - 57%
• No - 31%
• Unsure - 11%
2. Has a doctor ever recommended a test or treatment that you did not think was necessary for your health, or the health of your children or other people under your care? For example, prescribing antibiotics when you had a cold.
• Yes - 21%
• No - 66%
• Can’t recall - 13%
3. Which of the following best describes how you responded to the recommendation? (Asked to respondents who answered “Yes” to question 2.)
• I asked my doctor further questions about why the test or treatment was necessary - 54%
• I followed the advice of the doctor even though I didn't think the test or treatment was necessary - 24%
• I ignored the advice, but did not discuss it with my doctor - 18%
• Something else - 3%
4. How do you feel about asking your health practitioner whether a treatment or test recommended by them is necessary?
• Not comfortable - 11%
• Neutral - 18%
• Somewhat comfortable - 31%
• Very comfortable - 39%
• Unsure - 2%
5. How strongly do you agree or disagree that some tests or treatments that are done do not benefit the patient in any meaningful way?
• Disagree - 33%
• Neutral - 21%
• Somewhat agree - 21%
• Strongly agree - 14%
• Unsure - 11%
6. Would you say your doctor …?
Involves you in decisions about your care
• Always - 40%
• Often - 30%
• Sometimes - 20%
• Rarely - 6%
• Never - 1%
• Unsure - 3%
Allows enough time for your consultation
• Always - 35%
• Often - 29%
• Sometimes - 21%
• Rarely - 10%
• Never - 3%
• Unsure - 2%
Explains things in a way you understand
• Always - 42%
• Often - 35%
• Sometimes - 17%
• Rarely - 4%
• Never - 1%
• Unsure - 1%
DATA are from a nationally representative survey of 1069 New Zealanders aged 18 years or over, carried out online in December 2018. Responses may add to +/- 100% due to rounding.

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