Incidental findings lead to more costs than benefits

Sep 16, 2017

A chest X-ray ordered by your doctor for the cough you have been dealing with may not reveal anything about your cough, but an entirely different problem. This is called an incidental finding. While these findings can occasionally lead to something good, they can also cause unnecessary worries and costs. Joining us this week to discuss incidental findings is Dr. Robert Shmerling.

Shmerling is the clinical chief of rheumatology at Beth Israel Deaconess Medical Center, as well as faculty editor of Harvard Health Publications and an associate professor in medicine at Harvard Medical School.

An incidental finding is a result you weren't expecting -- information you don’t necessarily know what to do with. While it may be good to find something you didn't know was there, a majority of the time it leads to unintended costs.

There are cases where an incidental finding has led to a lifesaving discovery, but in most cases what is found ends up being benign or nothing to worry about at all. Patients can go their entire lives without knowing there was an abnormality and it would not bother them at all.

Causing more worry than good

These findings could have damaging results on the person. Getting a call that something was found could lead to unnecessary worry and anxiety. When faced with something unknown it could cause not only the patient, but the doctor distress as well.

"That discovery well obviously will make you worry, makes your doctors worry and sometimes lead to additional testing, maybe even a biopsy or surgery" says Shmerling, "Again, in the end those are the things that aren’t going to be helpful to you."

Why tell you in the first place

While these extra findings are causing more distress than necessary, it is in the best interest of the doctor or technician reading test results to disclose the information anyway, no matter how small the abnormality may be.

"That you have an obligation to mention any abnormality, not only because it could be in the best interest of the patient, but also to cover yourself as a practitioner," says Shmerling. "So if it does turn out, in the unlikely event it turns out to be something important you can’t be criticized for having missed it or not mentioned it."