Unnecessary Medical Tests

Seems to me that doctors are starting to think like insurance companies.

And it seems to me they are making decisions for the wrong reasons.

No.  This is the wrong way to think.

I have heard critiques on television and radio about tests that doctors order that should not have been ordered.  Why?  Because they cost money.  Oh, and they probably do not do the patient any good.

There is a horrible disease in America and it is called “Cheapness.”

And it has ruined medicine and killed countless people.

That is one of the reasons I started the SuperPac – One of many reasons.

Too many reasons.

Listen to the voice of experience, of countless hours of training, of common sense.  That would be me.

I do not give a damn how much a test costs.  I do not give a damn if I will “look better” if I order it or not.  I only give a damn if it helps the patient.

I am not talking about CYA (“cover your ass”) medicine.  You know, the kind where a doctor decides to order a test to look better in a malpractice case should there be a bad outcome.

I have heard such opinions day after day in the doctor lounges of a large number of states and a couple of countries. They are worried about the doctor’s needs (or the hospital’s) rather than the patient’s needs.

A doctor needs to CYA because everyone is out to get him/her. As they say, we live in a “litiginous society.”  That’s a fancy term for “Everybody wants to sue and get a windfall.”

Such thinking may or may not have something to do with high malpractice premiums.  It certainly seems not.

The smartest thing I ever heard about ordering tests for patients came from – maybe you should sit down – a French female malpractice lawyer.  She had a penchant for tying richly colored silk scarves around her pretty neck and avoiding ex-husbands.

“You will order a test if and only if the result of the test will make a difference in what you do to the patient.”  Simple.  Brilliant.  I wanted this woman to be my friend back then.  She was very popular, though.

“Think it through.  If most doctors would have thought of it, and others would or would not have ordered it, document.  Document, document, document.  Clearly and beautifully.  Legible handwriting is important.  Write each word expecting it to be projected in letters twenty feet high to a jury in a court of law.”

“Nothing is routine, everybody gets it.  Show in the chart, with footnotes to articles if you need to, why you decided what, and how hard you thought about it, and everybody will love you.”

So far — by the grace of God — everybody seems to love me. Over 30 years practicing medicine without a black mark on my record.  No malpractice suits, no insurance fraud claims, no disciplinary actions by a medical board or a hospital staff.

In one case, an X-ray or MRI may be precious but in another, useless.  It is not just “nobody needs one of these.”  Everything — including the patient’s family history, personal fears and concerns — should be taken into consideration when a test is ordered.

One question that has been raised is the use of chemotherapy in cancer when a patient is “near” death.  Closeness to the end of life on earth should not be a statistical input into what to do.  How badly does the patient want to live?  Personal motivation might put them at the upper reaches of the bell curve.  They might not want to die until they pass some milestone.  Or, they might want to give up and feel the pain is not worth the trouble.  You do not treat someone at one end of the bell curve as if they were at the other.

A doctor who ignores the above should not treat humans.  They should not treat animals.  Maybe they are capable of treating robots, but I am not even convinced of that.

The soulless and spiritless doctor should not be a doctor.

What a doctor should be, however, is a guardian of human life and hope.