Why Do Physicians Pursue Cascades of Care After Incidental Findings? A National Survey

Excerpt

Screening and diagnostic tests often reveal incidental findings, prompting cascades of further testing and treatment that are of uncertain value and can cause financial, physical, and psychological harms.^{1, 2} Like medical decisions writ large, the decision to pursue equivocal incidental findings may vary across physicians—informed not just by clinical need but also by physician factors such as training, fear of liability, discomfort with uncertainty, cost-consciousness, and perceived patient demand, or by health system factors such as malpractice laws and community norms.^{1, 3} Understanding how often and why doctors make these decisions would help to mitigate harms from cascades. Therefore, we surveyed a national sample of generalist physicians to explore variation in, predictors of, and motivations behind the decision to pursue equivocal incidental findings. …