Comments on: Why doctors order unnecessary tests http://www.kevinmd.com/blog/2006/05/why-doctors-order-unnecessary-tests.html medical blog Sun, 22 Nov 2009 14:15:05 -0500 http://wordpress.org/?v=2.8.4 hourly 1 By: Anonymous http://www.kevinmd.com/blog/2006/05/why-doctors-order-unnecessary-tests.html/comment-page-1#comment-109332 Anonymous Thu, 13 Aug 2009 09:14:33 +0000 http://clients.emmense.com/kevinmd/2006/05/why-doctors-order-unnecessary-tests.html#comment-109332 Because your problem is not a common one (which would have been found on those tests. The other thing is that you are not giving an accurate description of it. Your doctor continues to order tests because you continue to complain about it and they just want to find the cause of it and to treat it. Because your problem is not a common one (which would have been found on those tests. The other thing is that you are not giving an accurate description of it. Your doctor continues to order tests because you continue to complain about it and they just want to find the cause of it and to treat it.

]]> By: A.F. MELLO http://www.kevinmd.com/blog/2006/05/why-doctors-order-unnecessary-tests.html/comment-page-1#comment-96818 A.F. MELLO Fri, 26 Jun 2009 18:56:57 +0000 http://clients.emmense.com/kevinmd/2006/05/why-doctors-order-unnecessary-tests.html#comment-96818 RECENTLY WENT TO MY DOCTOR COMPLAINING OF SERIOUS ON TOP OF BOTH SHOULDERS. HE THOUGHT IS WAS ROTATOR CUFF. SENT MY FOR AN X-RAY, THEN AN MRI, THEN EMG. AFTER ALL THIS RUNNING AROUND AND "EXPENSE" I'M BACK AT GROUND ZERO. WHY DID I HAVE TO GO THROUGH ALL THIS SERIOUS EXPENSE, ONLY TO COME OUT WITH ZERO RESULTS. WAITING TO SEE WHAT OTHER SPECIALIST HE'S GOING TO RECOMMEND. THIS IS A LITTLE ABSURD. WHY ALL THE TESTS? RECENTLY WENT TO MY DOCTOR COMPLAINING OF SERIOUS ON TOP OF BOTH SHOULDERS. HE THOUGHT IS WAS ROTATOR CUFF. SENT MY FOR AN X-RAY, THEN AN MRI, THEN EMG. AFTER ALL THIS RUNNING AROUND AND “EXPENSE” I’M BACK AT GROUND ZERO. WHY DID I HAVE TO GO THROUGH ALL THIS SERIOUS EXPENSE, ONLY TO COME OUT WITH ZERO RESULTS. WAITING TO SEE WHAT OTHER SPECIALIST HE’S GOING TO RECOMMEND. THIS IS A LITTLE ABSURD. WHY ALL THE TESTS?

]]> By: Michaela http://www.kevinmd.com/blog/2006/05/why-doctors-order-unnecessary-tests.html/comment-page-1#comment-88575 Michaela Tue, 09 Dec 2008 22:31:00 +0000 http://clients.emmense.com/kevinmd/2006/05/why-doctors-order-unnecessary-tests.html#comment-88575 The chart I was talking about...<br/>http://www.mja.com.au/public/issues/176_11_030602/dic10690_fm.html<br/><br/>Women might also like to research the clinical value of breast exams and pelvic exams in asymptomatic women.<br/>I was surprised to hear most US women are "required" to have a pelvic exam every 12 months - that doesn't happen in Australia.<br/><br/>Self examination of your own breasts IMO seems to be the best protection from breast cancer. <br/>I attended a breast clinic when I was 20 & and was shown how to self examine - that way you become familiar with your own breasts.<br/>I'm currently researching the need for mammograms - they are being offered to women 50 and over...<br/>I'm afraid I don't trust the medical profession to make these calls for me - so I'll do my own research.<br/>I don't want to find they are of little clinical value or are in fact, harmful in 10 years time.<br/>If anyone is interested in some info on the clinical value & need for pelvic and breast exams in asymptomatic women, let me know...<br/>IMO the answer to taking control of our bodies is to be informed... The chart I was talking about…
http://www.mja.com.au/public/issues/176_11_030602/dic10690_fm.html

Women might also like to research the clinical value of breast exams and pelvic exams in asymptomatic women.
I was surprised to hear most US women are "required" to have a pelvic exam every 12 months – that doesn't happen in Australia.

Self examination of your own breasts IMO seems to be the best protection from breast cancer.
I attended a breast clinic when I was 20 & and was shown how to self examine – that way you become familiar with your own breasts.
I'm currently researching the need for mammograms – they are being offered to women 50 and over…
I'm afraid I don't trust the medical profession to make these calls for me – so I'll do my own research.
I don't want to find they are of little clinical value or are in fact, harmful in 10 years time.
If anyone is interested in some info on the clinical value & need for pelvic and breast exams in asymptomatic women, let me know…
IMO the answer to taking control of our bodies is to be informed…

]]> By: Michaela http://www.kevinmd.com/blog/2006/05/why-doctors-order-unnecessary-tests.html/comment-page-1#comment-88573 Michaela Tue, 09 Dec 2008 22:15:00 +0000 http://clients.emmense.com/kevinmd/2006/05/why-doctors-order-unnecessary-tests.html#comment-88573 I have some additional information that expresses concern about the dangers of over-screening women...there is increasing evidence that smears should not start before 25 or 30 because of the tendency to treat minor changes that would have cleared up anyway (more likely to happen with very young women apparently)...leading to invasive and unpleasant procedures.<br/>Women should think carefully before agreeing to smears without an interval of 3 to 5 years (if they need them at all) - more frequent tests appears to provide little benefit to the woman, but increases the likelihood of unnecessary follow-up...<br/>The smear is an inaccurate test - only 60-70% reliable, also Doctors are ignoring new guidelines for less frequent screening for their own reasons.<br/>The fear of being sued is probably a factor - pathologists are now sending back smears that would previously have been called normal as inconclusive, to be on the safe side, after a few law suits has made them nervous - thus women are suffering as a result with increased anxiety and more unpleasant re-testing and unnecessary procedures like colposcopy.<br/>I was shocked to see the US required virgins to have pap smears from age 18 - I'd challenge anyone to show the clinical value of that sort of testing. <br/>It's so sad that this seems to happen to women - I'm not sure whether it's a result of the days when medicine was dominated by males and a "paternalistic" approach prevailed and women were not trusted to make their own decisions...<br/>I think women really need to look at the clinical benefit of this testing and forget about the standard patter trotted out by most Doctors.<br/>A comparative chart of screening shows that in the US many women are being tested every 12 months which is unsupported in the rest of the world and by many health organizations within the States.<br/>http://www.nytimes.com/specials/women/nyt97/22gilb.html<br/>findarticles.com/p/articles/mi_m0815/is_/ai_n18744631 I have some additional information that expresses concern about the dangers of over-screening women…there is increasing evidence that smears should not start before 25 or 30 because of the tendency to treat minor changes that would have cleared up anyway (more likely to happen with very young women apparently)…leading to invasive and unpleasant procedures.
Women should think carefully before agreeing to smears without an interval of 3 to 5 years (if they need them at all) – more frequent tests appears to provide little benefit to the woman, but increases the likelihood of unnecessary follow-up…
The smear is an inaccurate test – only 60-70% reliable, also Doctors are ignoring new guidelines for less frequent screening for their own reasons.
The fear of being sued is probably a factor – pathologists are now sending back smears that would previously have been called normal as inconclusive, to be on the safe side, after a few law suits has made them nervous – thus women are suffering as a result with increased anxiety and more unpleasant re-testing and unnecessary procedures like colposcopy.
I was shocked to see the US required virgins to have pap smears from age 18 – I’d challenge anyone to show the clinical value of that sort of testing.
It’s so sad that this seems to happen to women – I’m not sure whether it’s a result of the days when medicine was dominated by males and a “paternalistic” approach prevailed and women were not trusted to make their own decisions…
I think women really need to look at the clinical benefit of this testing and forget about the standard patter trotted out by most Doctors.
A comparative chart of screening shows that in the US many women are being tested every 12 months which is unsupported in the rest of the world and by many health organizations within the States.
http://www.nytimes.com/specials/women/nyt97/22gilb.html
findarticles.com/p/articles/mi_m0815/is_/ai_n18744631

]]> By: Michaela http://www.kevinmd.com/blog/2006/05/why-doctors-order-unnecessary-tests.html/comment-page-1#comment-88539 Michaela Mon, 08 Dec 2008 05:09:00 +0000 http://clients.emmense.com/kevinmd/2006/05/why-doctors-order-unnecessary-tests.html#comment-88539 Diora - I think that's right...patients do need to be informed and demand to be treated as an individual. I don't have smears at all (gasp, horror)...<br/>Try mentioning that to any Dr and the hysterics start...<br/>The simple fact is...I refused to be treated like a sheep...<br/>The current screening system does not differentiate between high and low or no risk women.<br/>My husband & I were virgins when we met and have an exclusive relationship - I have never been exposed to HPV, so don't need smears. (confirmed by senior female gynaecologist to get the GP's off my back!) <br/>The tiny risk does not warrant 2 yearly invasive tests in my opinion and I'm the person paying for the testing - it's my body.<br/>If I wanted to cover every tiny risk, I'd be having my brain scanned and bowel examined as well...<br/>Thankfully, for the rest of you - there is a blood test on the way (the CSA test) that will replace smears - almost 100% accurate as opposed to about 70% for the smear test - a simple blood test. I can hear the shouts of joy from here...<br/>Search Medicine & Man and Cervius Pty Ltd for information about this Test.<br/>My advice - read up and find a Dr who will listen..not lecture, frighten or intimidate - we're women, not children. Diora – I think that's right…patients do need to be informed and demand to be treated as an individual. I don't have smears at all (gasp, horror)…
Try mentioning that to any Dr and the hysterics start…
The simple fact is…I refused to be treated like a sheep…
The current screening system does not differentiate between high and low or no risk women.
My husband & I were virgins when we met and have an exclusive relationship – I have never been exposed to HPV, so don't need smears. (confirmed by senior female gynaecologist to get the GP's off my back!)
The tiny risk does not warrant 2 yearly invasive tests in my opinion and I'm the person paying for the testing – it's my body.
If I wanted to cover every tiny risk, I'd be having my brain scanned and bowel examined as well…
Thankfully, for the rest of you – there is a blood test on the way (the CSA test) that will replace smears – almost 100% accurate as opposed to about 70% for the smear test – a simple blood test. I can hear the shouts of joy from here…
Search Medicine & Man and Cervius Pty Ltd for information about this Test.
My advice – read up and find a Dr who will listen..not lecture, frighten or intimidate – we're women, not children.

]]> By: Anonymous http://www.kevinmd.com/blog/2006/05/why-doctors-order-unnecessary-tests.html/comment-page-1#comment-87420 Anonymous Thu, 25 Sep 2008 16:04:00 +0000 http://clients.emmense.com/kevinmd/2006/05/why-doctors-order-unnecessary-tests.html#comment-87420 To: Anon @ 2:48<br/><br/>I am also in the process of fighting with my soon to be ex doctor's office about the same problem. I have never had an abnormal Pap Smear in 10 years, been with my husband for over 7 years, I waited 2 years in between tests because I have not had any abnormal Pap smears and my doctor before this one said I could and it would not hurt anything, and both me and my husband were tested for STD's when we first got together.<br/><br/>This is a new doctor because we moved to a new state. She was actually recommended to me as someone the nurses in the city go to. So I went in for a Pap Smear, a pregnancy test, and a prescription for birth control. That's it. She never asked me to do the STD screening and never even brought STD's up. If she would have I would have told her it was unnecessary because both me and my husband had previously been tested and we knew the results. I didn't find out until my insurance agency refused to pay for the tests. Thankfully mine is only $105, but still. It is money that is needed for groceries that should not go for unauthorized tests. I go see her tomorrow (I had to make an appointment because she refuses to return my calls or even talk to me on the phone) to see how she can fix this or else I will be taking her to small claims court. I am not sure what else I can do. I had already decided to switch doctors when I saw she did this a few months ago. I am sorry, but I refuse to pay for tests that I never requested...that's fraud. I feel kind of violated that they ran these tests without my knowledge and it makes me wonder what else they are going to do. It also makes me wonder if she is getting kickbacks for tests. I thought she was a great doctor during my visit and this is really disappointing to know she did this. How she handles tomorrow will decide what path me and my husband will take. To: Anon @ 2:48

I am also in the process of fighting with my soon to be ex doctor’s office about the same problem. I have never had an abnormal Pap Smear in 10 years, been with my husband for over 7 years, I waited 2 years in between tests because I have not had any abnormal Pap smears and my doctor before this one said I could and it would not hurt anything, and both me and my husband were tested for STD’s when we first got together.

This is a new doctor because we moved to a new state. She was actually recommended to me as someone the nurses in the city go to. So I went in for a Pap Smear, a pregnancy test, and a prescription for birth control. That’s it. She never asked me to do the STD screening and never even brought STD’s up. If she would have I would have told her it was unnecessary because both me and my husband had previously been tested and we knew the results. I didn’t find out until my insurance agency refused to pay for the tests. Thankfully mine is only $105, but still. It is money that is needed for groceries that should not go for unauthorized tests. I go see her tomorrow (I had to make an appointment because she refuses to return my calls or even talk to me on the phone) to see how she can fix this or else I will be taking her to small claims court. I am not sure what else I can do. I had already decided to switch doctors when I saw she did this a few months ago. I am sorry, but I refuse to pay for tests that I never requested…that’s fraud. I feel kind of violated that they ran these tests without my knowledge and it makes me wonder what else they are going to do. It also makes me wonder if she is getting kickbacks for tests. I thought she was a great doctor during my visit and this is really disappointing to know she did this. How she handles tomorrow will decide what path me and my husband will take.

]]> By: Anonymous http://www.kevinmd.com/blog/2006/05/why-doctors-order-unnecessary-tests.html/comment-page-1#comment-85022 Anonymous Tue, 15 Apr 2008 17:35:00 +0000 http://clients.emmense.com/kevinmd/2006/05/why-doctors-order-unnecessary-tests.html#comment-85022 Also, in addition to my post of 4-14, 2008 about my doctor demanding unnecessary tests and refusing to continue to treat me for my high blood pressure if I did not submit to them, he wanted to check for heart enlargement and I asked him what he would do if he found that it was enlarged, would he give me another kind of pill? His answer was, "I am already giving you the same medication for your blood pressure that I would give you for an enlarged heart." So I ask you, why then the test for the enlarged heart if I was already taking meds he would give me for it? Unnecessary test? You bet.<br/>Do the math. Also, in addition to my post of 4-14, 2008 about my doctor demanding unnecessary tests and refusing to continue to treat me for my high blood pressure if I did not submit to them, he wanted to check for heart enlargement and I asked him what he would do if he found that it was enlarged, would he give me another kind of pill? His answer was, “I am already giving you the same medication for your blood pressure that I would give you for an enlarged heart.” So I ask you, why then the test for the enlarged heart if I was already taking meds he would give me for it? Unnecessary test? You bet.
Do the math.

]]> By: Anonymous http://www.kevinmd.com/blog/2006/05/why-doctors-order-unnecessary-tests.html/comment-page-1#comment-85004 Anonymous Mon, 14 Apr 2008 19:14:00 +0000 http://clients.emmense.com/kevinmd/2006/05/why-doctors-order-unnecessary-tests.html#comment-85004 Doctor, thank you for your honesty. I just left my doctor's office this morning ending the professional relationship because of his insisting upon unnecessary testing for everything you can think of. He decided he could no longer treat me because I refused these unnecessary tests. I went in with high blood pressure which did not take long to correct with medication. I had no symptoms of anything else and my blood test came back with his stating how surprised he was at how good everything looked on it. Then he starting looking for things he could try to find wrong which had no basis in fact and from there the thing mushroomed into his taking offense because I would not follow his instructions for testing. Well so be it. I hope I can find a doctor as honest as you to take his place but I really doubt it.<br/><br/>My husband was terrified by what he thought I should be tested for and thought I might be really ill. I am showing him your article to ease his mind.<br/><br/>You are one in a million. Thank you. Doctor, thank you for your honesty. I just left my doctor’s office this morning ending the professional relationship because of his insisting upon unnecessary testing for everything you can think of. He decided he could no longer treat me because I refused these unnecessary tests. I went in with high blood pressure which did not take long to correct with medication. I had no symptoms of anything else and my blood test came back with his stating how surprised he was at how good everything looked on it. Then he starting looking for things he could try to find wrong which had no basis in fact and from there the thing mushroomed into his taking offense because I would not follow his instructions for testing. Well so be it. I hope I can find a doctor as honest as you to take his place but I really doubt it.

My husband was terrified by what he thought I should be tested for and thought I might be really ill. I am showing him your article to ease his mind.

You are one in a million. Thank you.

]]> By: Anonymous http://www.kevinmd.com/blog/2006/05/why-doctors-order-unnecessary-tests.html/comment-page-1#comment-75268 Anonymous Sun, 20 May 2007 19:48:00 +0000 http://clients.emmense.com/kevinmd/2006/05/why-doctors-order-unnecessary-tests.html#comment-75268 My daughter went to a gynocologist for a routine pap smear, then got a bill for $l500. for extra tests she never would have requested (mostly for veneral diseases). She's in a monogamous relationship with her husband of several years. They claim she signed a form o.k.ing the added tests. But it was only a form agreeing to pay her bill in a timely manner. Her insurance will not cover these unnecessary tests. Is there any recourse? Also the statements submitted to the insurance say she has seen the doctor, when it has always been a nurse practioner. 2:45 pm My daughter went to a gynocologist for a routine pap smear, then got a bill for $l500. for extra tests she never would have requested (mostly for veneral diseases). She’s in a monogamous relationship with her husband of several years. They claim she signed a form o.k.ing the added tests. But it was only a form agreeing to pay her bill in a timely manner. Her insurance will not cover these unnecessary tests. Is there any recourse? Also the statements submitted to the insurance say she has seen the doctor, when it has always been a nurse practioner. 2:45 pm

]]> By: Anonymous http://www.kevinmd.com/blog/2006/05/why-doctors-order-unnecessary-tests.html/comment-page-1#comment-68232 Anonymous Fri, 27 Oct 2006 15:33:00 +0000 http://clients.emmense.com/kevinmd/2006/05/why-doctors-order-unnecessary-tests.html#comment-68232 One source of overtesting that's overlooked here: information bias, the human tendency to want to collect more information even when we already know all we need to make an informed decision. It's the tendency of a teacher to give another test over the same material, of businesspeople to postpone travel arrangements until they receive confirmation of ALL meetings at a particular venue, and of doctors to order more diagnostic tests when the data needed for diagnosis is sufficient. One source of overtesting that’s overlooked here: information bias, the human tendency to want to collect more information even when we already know all we need to make an informed decision. It’s the tendency of a teacher to give another test over the same material, of businesspeople to postpone travel arrangements until they receive confirmation of ALL meetings at a particular venue, and of doctors to order more diagnostic tests when the data needed for diagnosis is sufficient.

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