Physicians overuse diagnostic tests, urging structural changes to curb waste and antibiotic resistance

American medicine orders more than 14 billion diagnostic tests each year, but many are performed at the wrong time or on patients who will not benefit.

The author argues that while the industry has invested heavily in developing advanced tests, it has done little to teach clinicians how to use them properly. The discipline of diagnostic stewardship, which aims to match the right test to the right patient, remains unfamiliar to most doctors.

A common example is the overuse of urine cultures. Positive results often trigger antibiotics even when patients lack urinary-tract infection symptoms, contributing to unnecessary drug exposure and accelerating antibiotic resistance.

To address the problem, the article calls for structural reforms, such as integrating stewardship principles into hospital protocols. A pilot effort in Michigan involving 46 hospitals is cited as a step toward reducing inappropriate testing.