We often read, talk and hear about the rising costs of health care. but how did we get to this point? Greed? Corruption? Liability? A complete lack of caring? Perhaps these reasons hold partial truths to the matter. But in my observation, a large part of why things happen is because few people ask the simplest of questions before ordering or undergoing a test - WHY?

One of my earliest medical rotations as a medical student was in Internal Medicine. The Director made a simple, yet profound comment, that I have always since carried with me: "Ask WHY before you order any test."

It seems straightforward, yet it does not seem to be the main focus behind usual decision-making that occurs between doctors and patients.

If there is no definite reason for a given test or procedure, then what might be the benefit of the results? Fishing expeditions are rarely fruitful.

This simple admonishment allows me to think more clearly when I try to figure out a patient care question. It is essential that doctors and patients alike ask WHY before any test or procedure. After all, it is your body we are talking about. You have a vested interest in this game, even if you do not directly (yet) see the costs associated with the questions being asked and e tests or procedures being performed.