Quote:
Originally Posted by retiredguy123
When a doctor recommends a test or procedure, how do you know that he/she is not just trying to protect against a possible malpractice lawsuit? Also, I don't think that some doctors fully understand the harm to the patient caused by worry and anxiety regarding medical tests and procedures. I think the patient needs to use some judgement when deciding what recommendations to follow.
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You can't be serious. But to answer the question, you don't. The more litigation in a geographic area and the higher risk of a specific specialty, the more likely a test will be ordered. This is a huge problem, costing anywhere from 300 to 750 BILLION per year just for the defensive practice of medicine.
Patient A comes to my office with 1 day of a headache radiating from his occipital region to his forehead. He has no neurologic signs, he gets temporary relief with Tylenol, he has been under stress lately, and I have a 25 year relationship with him. I tell him he has a muscle tension headache, continue Tylenol, use some gentle heat on his neck and some ben gay, and call me if it isn't gone in 3-4 days. My malpractice risk is close to 0.
Patient B has exactly the same presentation, but goes to the ER. He has no relationship with the ER physician, this is viewed as a single, isolated encounter, and he is a high malpractice risk specialty. That patient is going to have a CT scan or MRI. Is this the "wrong" test? No, but it is not necessary to make the diagnosis. The scan will show nothing, and in the unlikely case that there is an abnormality, it has absolutely nothing to do with his headache, just an incidental finding.
Now let's say that patient B went to the only ER physician that does not order a scan in this situation. Four months later the patient develops some loss of vision in his left visual field. A MRI show he has a 4 cm astrocytoma of his right occipital lobe. Do you think this patient goes back to the ER doc and thanks him for saving his insurance co. a few dollars? Or do you think he finds a lawyer? Even though this brain tumor had nothing to do with his headache 4 months earlier, this is pretty much a guaranteed losing case for the ER doc. No physician ever won an award for
NOT ordering a test!
Now, everything above is just a medicolegal argument, driven by a lack of tort reform and frankly too many lawyers. But this is not the argument that you and another poster has put forth. Your argument is that YOU have the education and judgement to know whether a test is TRULY necessary, whether it is ordered for legal protection or to make $$$ or if the doctor is just weak. If you have that ability, great---proceed at your own risk. Maybe we don't really need the doctor, we could just put out a Chinese Food menu of tests and treatments and you can choose one from column A and two from column B.
I know what you were saying, but ignoring professional medical advice is a dangerous game. If you don't trust your physician to order those tests that are in YOUR best interests, not HIS, perhaps you need a new MD.
End of rant.