Why More Medical Testing Doesn’t Always Make Us Healthier

Direct-to-consumer medical imaging tests are a huge and growing business worth billions of dollars. Over 100,000 Americans are already customers. But do these test results actually make us healthier? As a radiologist, a doctor specialized in the alchemy of turning information into health, I translate data hidden in images into words that motivate behavior to promote healthier, longer lives. Because it is central to what we do, radiologists have grappled for decades with the question of whether and how information improves health. It turns out to be surprisingly complicated. In order to make a difference in someone’s health, the test must accurately predict or diagnose a condition, resulting in a change in mindset and behavior, and that change in mindset and behavior must produce a better outcome than not doing the test. For example, whole-body MRI of the general public, a test not recommended by any medical guideline, medical society, or payer, creates information by taking a picture of your body. That information is accurate for some diseases but not others. It might change your mind by finding something you didn’t know about, like a small mass in your kidney or thyroid gland, whi...