Unnecessary Tests

[QueenofAllThings]

This is not so much an etiquette question as a 'what would you do?' No medical advice please - let's not lock the thread.

So I went for my annual routine mammogram today. No family history, no worries. After two sets of photos (normal for me) and 20 minutes of waiting for Dr. to review the photos, Nurse comes in and says in a low whisper "Doctor requires an ultrasound"  . 20 more minutes of waiting, during which time every horrible scenario is running through my head. Dr finally comes in and informs me that my photos were fine, no concerns, and that they 'just like to do an ultrasound every few years'.

OK

So forget my 20 minutes of hyperventilating panic.  It didn't occur to me until later that this was simply running up the bill for insurance. It's hard for me to say 'no' to a doctor - what do I know, after all? - but in hindsight I feel like I should have refused.  A breast ultrasound is messy and uncomfortable. 

Thoughts? Would you have gone along with it because Doctor knows best? Complained? Refused? Or not been concerned at all?

[oogyda]

Because I know what it costs, I would ,at the very least, make the doctor convince it was the best thing to do.

My primary insurance did pay 80%, but it still would have a couple hundred out of my pocket if my secondary insurance didn't have such a low "allowed amount".  Mine was done because there were areas of concern that even I could see on the films.

[Slartibartfast]

If your doctor (or any medical professional) tells you to do something that doesn't feel right, exercise your right to ask questions.  "Why do you suggest this procedure?  Is this routine?  What are you looking for?  Is there an alternative?  Does my insurance cover this?  How much will I have to pay out of pocket?  If we skip it, what are the risks I'd be taking?  Could those risks be reduced by doing something else?  Can I call back and make an appointment for the procedure after I've had some time to research this on my own and come to my own decision?"

In general, it's good to err on the side of trusting your doctor - but that assumes you trust him/her and he/she doesn't have a habit of questionable advice.  Some doctors are better than others about accurately presenting which procedures are medically necessary and which are merely medically expedient.

[mmswm]

I agree with the advise to ask him to justify the ultrasound.  Make him list the reasons why he wants to do it and what are the realistic potential consequences of not doing it.  Let him know upfront that the cost is a factor.  If he can't come up with a convincing reason, or you're on the fence, you wouldn't be out of bounds to seek a second opinion.

[jpcher]

I do not think that the tests were unnecessary. I think that, at times, further tests need to be taken in order to confirm a suspicious diagnosis.

I've had one of those where further tests (ultrasound) needed to be taken, but I had to go to a specialist . . . a few weeks of worrying later . . . but there is now a baseline for this concern so when I get my annual the regular Dr.'s know that this is not a major problem.

[bonyk]

I would have handled it the way you did.  I'm not an expert, but the idea of an ultrasound every few years sounds reasonable (but extremely uncomfortable!).  However, if you have a feeling that the doctor was less than honest, you could ask around to see how normal this is.  If it bothers you, switch to someone you can potentially trust.

[Winterlight]

I think it's reasonable to get the test, but also reasonable to ask why it's needed.

[Outdoor Girl]

Nothing wrong with questioning why a test is needed, and deciding that you don't want the test if they don't give you a good enough reason.

My dentist always tries to take x-rays every other appointment, which is more than I'm covered for in my insurance.  I ask what they're for - cavity detection.  Ummm, guys?  I'm 44 and I've never had a cavity.  Ever.  So I think I can hold off on the x-rays for a while.  They rarely give me a hard time.

[Sharnita]

I am not sure I agree with your take on motivation. That being said, I think it is perfectly polite and reasonable to ask when a test is mentioned why they want it, what it might show that pther tests can't/won't, etc.

As far as what I would have done:  I definitely would have asked why.  If the nurse said the doctor liked to do an ultrasound every few years I would have politely indicated that I was not famliar with the use of ultrasound as a routine and asked for more information about why it was used and what it showed as compared to a mammogram. I think if I wasn't comfortable after that conversation I would have asked to schedule it for another day and done research on my own.

[Deetee]

It is reasonable to ask why any tests are being done and it is good practise for any doctor to let you know why the tests are being carried out.

But I think you need to talk to the doctor and/or do some research before you deem any test unnessesry. Just because it is done every three years instead of every one year doesn't mean there is no value.

I generally just go along with whatever tests are suggested, but being in Canada, I never have a concern about costs (there is no co-pay on anything)