When should physicians disclose incidental findings to patients?

Traditionally, medical practice calls for physicians to inform patients when an unrelated, but suspicious lesion appears on a CT scan or MRI — but a group of researchers from NYU Langone Medical Center in New York want to challenge that practice.

The researchers, led by Stella Kang, MD, assistant professor of radiology and population health at NYU Medical School, wrote in a paper published by the Journal of the American College of Radiology that such incidental findings, when low-risk, often lead to unnecessary additional testing, invasive procedures and overtreatment.

Radiologists and other physicians feel obligated to remove, test or treat incidental lesions to ensure the patient is OK — which can be life-saving in some cases. However, the researchers challenge that more often than not, the additional treatment associated with incidental findings can also drive up costs and create additional clinical issues. It often makes more sense, both clinically and financially, not disclose incidental findings with patients — but is it ethical?

The researchers suggest more dialogue is necessary, but that radiologists might look to the field of genetics to sort out these dilemmas. In particular, the researchers called for more research into how patients feel about low-risk incidental findings, how patient preferences can be applied to uniform recommendations for decision making, and how physicians can approach care if patients do not want to discover low-risk incidental findings.

 

More articles on integration and physician issues:

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