First, do no harm.  Sounds easy enough, but have you ever ordered a “screening CT?”  Have you ever been “better safe than sorry?”  We’re all aware of the nebulous risk of radiation from the imaging we order, we know that getting stuck for blood hurts, and sometimes medications have side effects, but what happens when the results of tests themselves are the things harming patients?

This article does a great job exploring this question.  I’ve also found patients much more receptive to my explanations as to why I’m not ordering the thing they think they need since reading this and spending some time thinking about it.  There are definitely times when my honest indication for ordering that Head CT is “patient wants it…” but in general this article has pushed me a little closer to the minimalists’ corner.

Overkill – Atul Gawande