Diagnostic test overuse is a structural problem, not a willpower problem

A STAT News opinion piece by Daniel Morgan argues that the medical industry has prioritized developing advanced diagnostic tests without investing equally in understanding when and how to use them appropriately. Morgan contends that reducing unnecessary testing requires systemic redesign, not simply asking individual clinicians to exercise more restraint.

Why it matters

The argument is not new, but Morgan states it plainly: the problem is not that doctors lack knowledge about appropriate test use, it is that the system does not make appropriate use the default. Order sets are broad, liability fears push toward more information rather than less, and there is rarely a structural penalty for ordering an unnecessary test compared to missing a diagnosis.

For clinician-educators and department leaders, this matters because training the next generation of physicians to practice with restraint while placing them inside systems that reward volume and penalize omission is a setup for failure. The fix Morgan calls for is structural, which means it requires people with institutional authority to act, not just people with clinical expertise.

What to watch

Whether health systems actually redesign order sets, prior authorization workflows, and liability frameworks, or settle for another awareness campaign that changes nothing.