The LA Times has an interesting article detailing the cost of medical procedures and their (sometimes) lack of value. It’s clear that in the developed world there are many medical tests that can be performed for a variety of reasons. Physicians are under pressure to make sure that they provide the best medical care possible and stay in line with the standards that the medical community has outlined (and not get sued for malpractice in the process). There is some debate surrounding what medical procedures are needed and when. In-fact Choosing Wisely.org has a nice list of physician recommended procedures, and when not to have them. The Christian Science Monitor reports that we waste $750 billion in the US on unneeded care, fraud and paperwork! If we can reduce this waste we can give better care and more of it. The ability of physicians to have the latitude to treat the patients as they see fit may be at the root of this issue. Most doctors are very good at figuring out how to treat a patient, including what tests are needed and when. A team of physicians in the UK have found a very cheap way of ruling out appendicitis. It’s called the speed bump test. On average 42% of diagnosed appendicitis attacks turn out not to be appendicitis. Even with modern imaging and testing protocols the likelihood of having appendicitis surgery and not appendicitis is higher than it should be. Could a test as simple as asking whether or not there was pain associated with the speed bump your patient drove over on the way to the hospital be as accurate or more accurate than the current standard of care? The physicians at Stroke Mandeville Hospital seem to think so, but only to rule out appendicitis… Their research was published here in the British Medical Journal, December of 2012.