Do Doctors Prescribe Too Many Tests

[HappyHiker]

I have simple criteria for seeing a doctor: uncontrollable bleeding, intractable pain, broken bone, difficulty breathing. I'm convinced that less is more where medical treatment is concerned, and my criteria haven't let me down so far. Every prescription has its side effects, every test has its downside. I know easily as many people who have been harmed by doctors as have been helped--especially in this age of (endlessly and profitably) treating the symptoms instead of actually healing the underlying problem. Like Cathy, I know I'm going to die of something, and I'd prefer it wasn't "standard of care."

Curious, Jane. Do you not get tests such as a mammogram or colonoscopy? I'm being bugged to get a mammogram as a year has passed...not sure I want to get this one...I hate exposing my body to more radiation...

[catherine]

I am on the light side when it comes to these tests, too. Some of it is rebelliousness, some of it is just procrastination. I've had two mammograms in my life and I've never had a colonoscopy. My reasoning is probably very fallacious, but, I'm not rushing for a mammogram because I have absolutely no history of cancer in my family. I've also read studies that say that sometimes mammograms find masses that would have worked themselves out over time. There are definitely two schools of thought on mammograms, but it's not definitive that yearly mammograms do anything for overall survival. However, the risk of mortality from breast cancer without having been screened does rise as one gets older.

As for colonoscopies, I don't eat red meat, I have no other risk factors for colon cancer, and I am simply playing the odds that nothing will come up. Again, I have zero relatives who have ever had cancer.

[JaneV2.0]

Curious, Jane. Do you not get tests such as a mammogram or colonoscopy? I'm being bugged to get a mammogram as a year has passed...not sure I want to get this one...I hate exposing my body to more radiation...

I get nothing. I used to get Pap smears occasionally. I suppose I might croak sooner, but I'm well on my way to a normal life span. I think everyone should follow their instincts in such matters.

[Yppej]

I have a family history of breast cancer and go for a mammogram every other year, not every year, based on the fact that Britons go less frequently than Americans with no worse outcomes. At 50 I went for a colonoscopy and polyps were found, which makes any future test diagnostic and coming out of a deductible or coinsurance, so in 5 years I am going to insist on stool cards instead. The one test I do not ever miss is the pap smear. I feel it offers good bang for the buck with no risks from radiation, perforation of the colon, etc. But cervical cancer is slow growing so at age 70 my doctor said we will discontinue the pap test.

[JaneV2.0]

I ...
As for colonoscopies, I don't eat red meat, I have no other risk factors for colon cancer, and I am simply playing the odds that nothing will come up. Again, I have zero relatives who have ever had cancer.

In my family, the longest-lived of us never turned down a steak. I prefer hamburger, personally. But i eschew sugar, as a rule, for the same reason you shun beef. No relative that I know of has ever had a cancer of the digestive system.

[pinkytoe]

At this point in my life, you would probably have to pay me to get some of these "preventative" tests. Last mammo was 7 years ago and I don't plan to get a colonoscopy unless I'm unconscious. Glad we all get to do what works for us.

[Gardnr]

What I've noticed over the years is that very few docs trust their clinical skills......and they resort to having tests that tell them what they haven't thought about or were willing to trust their judgement with. .

As a 30 year Registered Nurse I wholeheartedly disagree. The general population is highly litigious. once a precedent has been set, every other provider is held to that standard, feet to the fire. Patients demand certain tests. That accumulates into a new "standard of practice" and suddenly the provider can't say "I know you have (or dont have) X". They now have to prove it either way.

Example: I had a knee injury in May 2015. We were conservative. in Sept the pain had not subsided enough so an MRI was done. It showed nothing substantial. I continue the therapy. Feb 2016 I'd had it and asked for a knee scope. My surgeon agreed that was a reasonable request at this point. I had a HUGE defect on the joint surface of the thigh bone. MRI didn't show it. But the standard of care is to do an MRI.

Several years ago a local insurance company decided to do "report cards" on surgeons for standard of care. One of the best-ever surgeons got a B because he didn't MRI enough of his patients. Well hell's bells......he refused to order more.

There's nothing wrong with asking lots of questions about why and what if.....you have every right to make an informed decision. But please DO make an informed decision not a "I've had enough tests" decision.

[JaneV2.0]

I know lots of people who have suffered various injuries at the hands of doctors. I know no one who has sued. Maybe all these "frivolous lawsuits" are coming from the same small group of litigants. Or maybe insurers are fanning the flames.

[Yppej]

I know a family who sued but their daughter died and was not just injured. But I think malpractice lawsuits have been exaggerated by the right, which wants to claim that tort reform will make healthcare affordable and accessible, when the dollars involved are much too small to fix the country's healthcare insurance woes by themselves.

[JaneV2.0]

I know a family who sued but their daughter died and was not just injured. But I think malpractice lawsuits have been exaggerated by the right, which wants to claim that tort reform will make healthcare affordable and accessible, when the dollars involved are much too small to fix the country's healthcare insurance woes by themselves.

I forgot about the right's vendetta against trial lawyers, who apparently can be counted on to contribute to left-leaning political candidates, much like unions. Gotta bring 'em to their knees!