this post was submitted on 31 Jul 2023
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I've never tried this, but advice I've seen online is if your doctor won't order testing, ask them to note in your chart that they are declining testing. Apparently the implicit threat of a lawsuit if they're wrong is enough to kick at least some of them into CYA mode.
That's terrible advice. I don't know if any doctor that is "out to get you" by not ordering tests. Tests are not harmless. Improper testing can kill you. For example, you have a headache with no red flag symptoms. You keep pushing, some doctor orders an MRI and now you have what we call an incidentaloma. Some incidental mass that isn't going to cause you any issue and is unrelated to your headache. Now you latch on to this abnormal thing, you worry about it, it affects your life. More scans and tests are done to figure out what this is. Eventually a biopsy is offered. Good news, it's just some normal cells that happen to look funny on MRI, but completely benign. Bad news, the biopsy had complications and now you're wheelchair bound for the rest of your life.
It's thoughts like this where the "advocate for yourself" has turned into the "threaten the person that dedicated multiple decades of their life to help others to get what you want" that has lead to the insanely piss poor defensive medicine in the United States.
Tldr: refer every patient and order every tests until someone dies of bankruptcy or an unecessary complication because webmd.
FYI, finding an incidentaloma and doing another scan 3 months later to see that it's disappeared is also life saving. My mother had a lung problem, got some imaging done, they found a lump in her lung, and instead of going directly to poking it for a biopsy or surgery, they checked 4 months later, and saw that it resolved on it's own. If it was cancer, they would have seen changes in it, and known it was something to be investigated further at the time of the second scan. Doctors need to manage expectations and refer people for therapy if they have anxiety around their health.
Oh for sure, my comment is more towards people that won't accept the diagnosis of everything is fine and no further testing is needed. Those people tend to yell, sue, go find some other doc, try chi blocking and crystals before they will talk to a therapist about their anxiety.
My comment about incidentaloma is more when you find something that wasn't causing any true issue. Now what. You have to get another scan. But before that, there was no indication that anything was wrong because nothing was wrong. Now you're stuck working and monitoring something that ends up being benign and would have been that way if you never look.
Same with any tests, there's a rate of false positive to be aware of. When your suspicion is high, it outweighs it, but when it's low and the test comes back positive, your stuck now and are often obligated to do unecessary work to prove that it was a false positive.