“The tendency to over-test is amplified when the doctor who recommends the tests has a financial interest in the screening or imaging facility that he or she refers people to.”
This is certainly one of the reasons imaging for low back pain has gotten so over-prescribed. But Ehrenreich is referring to a much broader issues in medicine, in this very interesting article: “Why I’m Giving Up on Preventative Care: How Contemporary American Medicine Is Testing Us to Death.” I’m not necessarily endorsing it (not sure I’m qualified to), but it’s certainly an intriguing read. For instance:
Once I realized I was old enough to die, I decided that I was also old enough not to incur any more suffering, annoyance, or boredom in the pursuit of a longer life. I eat well, meaning I choose foods that taste good and that will stave off hunger for as long as possible, like protein, fiber, and fats. I exercise—not because it will make me live longer but because it feels good when I do. As for medical care: I will seek help for an urgent problem, but I am no longer interested in looking for problems that remain undetectable to me. Ideally, the determination of when one is old enough to die should be a personal decision, based on a judgment of the likely benefits, if any, of medical care and—just as important at a certain age—how we choose to spend the time that remains to us.
If there’s any obvious problem with that, it’s that “pursuit of a longer life” isn’t actually most people’s goal: we’re chasing a better life, one with less disease and disability. And by far the best way to do that is with exercise (and therefore at least some suffering, annoyance, and boredom, though usually less than people fear).