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What Regularly Recommended Medical Tests and Procedures Do You Get?
Which Ones Do You Avoid?
But first, a necessary disclaimer:Everything I say here is my own personal opinion and not intended as medical advice for anyone. All your decisions must be made in partnership with your doctor and with your own medical history in mind.
Several years ago a nearby town got a full-body CT scanner. For the first time you could get a full body scan without a doctor's referral. People thought this was a great idea. I was appalled. Why expose yourself to all that needless radiation for the sake of mere curiosity? Why go looking for trouble? What if a false positive or an imaging artifact freaked the person out or led to further risky testing or surgery?
What if (as I suspect) your immune system is continuously resolving issues that you'll never even know you had? So now you have a new scary thing to monitor -- with even more radiation. Not good.
Decades of working in and with hospitals has left me (perhaps excessively) wary of medical diagnostics and intervention. If there's a worrisome symptom (like that sudden neck lump that paradise50 sprouted three years ago) then by all means investigate it. BUT-- I also try to balance my avoidance tendencies with common sense.
So I was happy to run across a medical resource called Choosing Wisely, that encourages consumer directed health care through discussion between patients and doctors about recommended tests and procedures.
Choosing Wisely® aims to promote conversations between providers and patients by helping patients choose care that is:I was pleasantly surprised to find myself in agreement with many of the site's guidelines. For example, several times now I have declined a bone density test. Why? Because I wouldn't take any of the current bone-building medications based on my current status. Why get a test if it won't change your treatment plan or behavior? I have none of the risk factors. There's no family history of osteoporosis or fractures, I have larger than average bones via wrist measurement, I'm physically active and fortunately don't have to take any medications like prednisone that cause bone-thinning. So I keep saying no to this particular test.
- Supported by evidence
- Not duplicative of other tests or procedures already received
- Free from harm
- Truly necessary
United States health care provider organizations representing more than one million providers developed lists of Things Physicians and Providers Should Question in recognition of the importance of conversations to improve care and eliminate unnecessary tests and procedures.These lists represent specific, evidence-based recommendations providers and patients should discuss together in order to make wise decisions about the most appropriate care based on their individual situation. Each list provides information on when tests and procedures may be appropriate, as well as the methodology used in its creation.
As a healthy person I also don't get annual physicals. I do see a primary care doctor once a year to get my thyroid prescription refilled and I do pay attention to physical changes. I can actually tell when my thyroid is off in either direction by how I feel, and when this happens I get a TSH test which always corroborates my symptoms and we adjust the dose. And while I can't prove it, I'm reasonably certain my malfunctioning thyroid is the result of long-term exposure to low-level radiation as no one else in my family has thyroid issues.
How about Colonoscopy? I'm entirely in favor of Choosing Wisely's suggested guidelines. While not without risks, a colonoscopy is one diagnostic procedure that can also be therapeutic, in that polyps along with small adenomas and other abnormalities that could turn cancerous can be snipped off as part of the procedure.
Right now I'm feeling terrible about a 57 year old friend of mine, one of the biggest, strongest and healthiest guys you'd ever meet who was just diagnosed with advanced (but hopefully not fatal) colon adenocarcinoma. This is a slow-growing cancer that has likely been there for many years. I asked him if I'd remembered to nag him about getting a colonoscopy when he turned 50. He said no, but his doctor had. He'd even made the appointment for the procedure but canceled. Two years later his doctor ordered it again, and again something came up and it was put off. If he'd asked my advice back then I would have pushed him to get it. I regret now I didn't.
If you're over 50 and haven't gotten a colonoscopy I now ask you to read this and seriously consider it, ok?How about treatments? More and more we're finding that antibiotics usually don't help sinus infections. Avoiding unnecessary antibiotics is always a good thing.(And yes, we've both had ours, and it's really not that bad)
This undeniably dorky video, set to the tune of Happy, emphasizes your role as patient and consumer in having these discussion with your doctor. It was not made by the a Choose Wisely folks but led me to them and reflects their guidelines.
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