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"Testing" is a part of the practice of medicine, always has been. Yes a doctor should have an idea of what they are looking for and use the testing to help confirm or rule out a suspected diagnosis...
In every case you have listed here and your other posts that seems to be EXACTLY what happened...
Very little question about it. And the treatments, at least initial ones, are well-knowsn.
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Originally Posted by bluedevilz
Apparently you feel you are "smarter" than your doctors and should be able to dictate what tests are performed....that isn't the way medicine works but you are always free to refuse testing and recommendations at your peril...
Maybe not smarter, but even with my IQ of 79 I'm far from stupid.
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Originally Posted by bluedevilz
If you really told the doc trying to find out the cause of your eye issues to "go jump in a lake" then you sound like a real peach...so maybe you should keep on trying to "limit your time with doctors"...probably good for both parties
I asked the doctor first what he was looking for and reluctantly said it was MS. Having a mother-in-law who was suffering from MS I knew that there was no "early-treatment advantage" the way there probably is for cancer and for that matter TIA's. I felt that further testing was useless and that my insurance carrier was being milked.
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Originally Posted by bluedevilz
You started this off talking about your "borderline" HBP which you may or may not be treating, then a few months ago you describe symptoms that certainly sound like a TIA or mini stroke...
I treat that by exercise and hopefully a healthier diet though what you read on diets really makes you wonder. I knew that I was going to be put on low-dose aspirin so why not start it myself?
Quote:
Originally Posted by bluedevilz
So to review, you likely have hypertension which left untreated or under treated can lead to a stroke....you recently had symptoms which were probably a TIA but who knows since you were able to avoid "unnecessary" testing by not seeing your physician...
Know that 1 out of 3 people who experience a TIA will later have a full blown stroke...
So yeah keep on your kick to avoid "unnecessary" testing....looks like it's working real well for you now
I actually talked to my doctor-to-be on the tennis court this morning. I told him I didn't want to ignore the situation but didn't want to be put through the wringer either.
What is your point? They should have just said "oh, he has rectal bleeding" - we'll just decide w/o testing what it is........ ?
Frankly he might as well have. What happened was an operation, a month of debility, and then a recurrence about a year later which ended in death about 18 months after diagnosis.
Are doctors "targeted and focused" or do they just order scattershot testing for – what? the fun of it? I'd say they test based on what you present with – and sometimes, those symptoms are pretty vague. Would you prefer they utilize a Magic 8 Ball?
It's easier to order tests and move on to the next patient than to design a treatment program.
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Originally Posted by CatzPaw
With all the other issues you mention, I'd be watching for that cancer thing, too.
That was my father, long dead.
Quote:
Originally Posted by CatzPaw
You really lost me with the "go jump in the lake" remark. I can't imagine what it would take for me to say something like that to a doctor but it would be a whole lot more than you detailed.
I calmly went through the treatable or curable diseases for which he could be searching. When he conceded he was looking for MS, which in males is largely untreatable, I felt as if I was being taken advantage of.
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Originally Posted by CatzPaw
But, by all means, keep on doing what you're doing. If you stroke out, you still avoided aiding and abetting the doctors and their willy-nilly tests, right?
I cannot in all honesty say a lot good about my experiences with GPs. Many seem to view me as insane and/or a total liar. So these GPs have many times applied the hocus-pocus "psychogenic" diagnosis to me. Yeah, walked around with a number of undiagnosed medical problems for years.....valley-fever, demyelinating peripheral-neuropathy, hiatal-hernia, helicobacter-pylori....to name a few. All were eventually diagnosed by specialists.
I think if you have a pressing medical-problem.........try to figure out what area that problem is best medically classed as and see the corresponding specialist, GPs many times seem like clueless witch doctors.
What REALLY surprised me was the way medicine was practiced here down South.....
first, what's with that yearly comprehensive exam with all your clothes on? i mean, i can't see the back of me gosh darn it, what if a melanoma showed up?? plus, never had a doctor down here examine my finger nails, often a very good sign that you could be suffering from a host of maladies. It's just done, all the time, up north.
second, with drug costs spiraling out of control, your doctor, and not just specialists, but pretty much every doctor i saw, had a drug closet and monthly visits with drug reps who would help out a doctor's lower income patients with free samples of needed medications. Won't ever happen here in North Narrowlina, probably because there's a law that keeps us under the thumb of the drug companies who lobbied like hell under the guise that these laws supposedly "protect" us.
I loved the way i was treated at Duke, I had a say and could give reasons why I felt I wanted this or not that drug, treatment.... but after getting beaten, assaulted, robbed and car stolen in Durham, i don't feel comfortable going there now, exacerbates a still problematic PTSD...... I do not like UNC, it's like they have a "formulary" that all doctors MUST follow, and it really makes me feel like they jack me up with tests i don't need, but they can get reimbursement from medicare. and if i don't play ball? i'm hounded to death.
What REALLY surprised me was the way medicine was practiced here down South.....
first, what's with that yearly comprehensive exam with all your clothes on? i mean, i can't see the back of me gosh darn it, what if a melanoma showed up?? plus, never had a doctor down here examine my finger nails, often a very good sign that you could be suffering from a host of maladies. It's just done, all the time, up north.
second, with drug costs spiraling out of control, your doctor, and not just specialists, but pretty much every doctor i saw, had a drug closet and monthly visits with drug reps who would help out a doctor's lower income patients with free samples of needed medications. Won't ever happen here in North Narrowlina, probably because there's a law that keeps us under the thumb of the drug companies who lobbied like hell under the guise that these laws supposedly "protect" us.
I loved the way i was treated at Duke, I had a say and could give reasons why I felt I wanted this or not that drug, treatment.... but after getting beaten, assaulted, robbed and car stolen in Durham, i don't feel comfortable going there now, exacerbates a still problematic PTSD...... I do not like UNC, it's like they have a "formulary" that all doctors MUST follow, and it really makes me feel like they jack me up with tests i don't need, but they can get reimbursement from medicare. and if i don't play ball? i'm hounded to death.
As I understand it, at least some of the dermatologists around here do that annual cancer exam with the patient down to his/her underwear, and ask the patient if they know of any lesions or questionable spots that should be checked in their private areas- admittedly that might miss some cancers if a patient is not aware of anything like that and says so. Haven't heard nor experienced any doc I have visited check out my fingernails, that's true.
As for the drug samples, I think in general, the pharmaceutical industry has cut back in the number of drug samples they give to docs' offices, I've overheard comments by drug reps visiting docs offices to that effect anyway- and while they have to split available samples to all the docs in their territories who would prescribe the given drug, they tend to give the lion's share to the bigger practices with more patients who would give out more prescriptions for the drugs than a smaller practice. In any case, I don't think any practice gets enough samples to keep patients for whom they prescribe the drugs from having to buy the drugs themselves at some point, and that was never the point of samples anyway. But a check of the drug manufacturer's website (via Google search), will generally unearth a coupon or some program in which a patient can get financial help with a new prescription- often it's significant help. I know at least one practice, the eye clinic I go to, that uses a specialty pharmacy for opthalmic prescriptions, the patient has the option to use that, if they do, the docs send their prescriptions to this pharmacy, the patient calls with credit card information, the amount paid for the drugs is no more than a co-pay would be elsewhere with insurance, often it's less, and the drugs are sent via mail to the patient, any prescription insurance they have is not involved, or doesn't have to be.
In any case, prescription drug financial help is still out there, but one has to speak up and let their providers know they need help, and they have to be willing to do a little "legwork" in finding, and applying for the help. Or get someone to do it for them, I do this for my 91 yr old mother who has no prescription drug coverage ( her choice, but that's another story.)
I understand the feeling you're being hounded by the docs office in regard to some of that Medicare screening testing. If you don't out and out refuse it in no uncertain terms ( and you have to say the words), they'll keep contacting you till you consent to whatever it is. They do this as part of the Medicare mandated "quality of care", and unless they meet those "quality goals" ( ie, having all or high percentage of their patients screened for conditions for which they're deemed to be at risk, or even answering all those inane questions Medicare wants answers to), their reimbursements will be cut, and those reimbursements are not great to begin with.
So if you waffle over whether or not you will get that testing done, procrastinate or just ignore their notifications, they'll tend to "hound" you till you consent. But it's your right as a patient to refuse any testing, and if you do so, that should be it. Although depending on your health history, findings, risk for conditions, your doc may try and persuade you to get those done.
Tests fall into two broad categories: screening and diagnostic.
A screening test is used when it has been shown that doing the test for someone with no symptoms has benefit in finding a potentially serious condition at a point when treatment could prevent a more serious condition later. Example: colonoscopy.
A diagnostic test is done when there are symptoms. Example: colonoscopy for someone with rectal bleeding.
Each test should have an indication. For a screening colonoscopy, that could be simply age over 50 years. For someone with a family history of colon cancer the age for the first test could be lower. It has to be individualized for the patient.
Anyone is free to decline any test, but it is best to be sure you know the reason the test is being offered before you refuse to have it, particularly if you are having symptoms that generate concern for a serious problem.
When the testing is being done because of symptoms, doctors do want to zero in on a diagnosis in the most expeditious fashion. They will choose the battery of tests that is most likely to find a cause for a particular set of symptoms. That some of those tests are normal does not mean they were not indicated. You cannot know they will be normal until after they are done.
Yes, some testing is for CYA reasons. Go to an ER with a headache and you will almost certainly get your head scanned, because you made the decision that your headache was bad enough to need emergency care.
What REALLY surprised me was the way medicine was practiced here down South.....
first, what's with that yearly comprehensive exam with all your clothes on? i mean, i can't see the back of me gosh darn it, what if a melanoma showed up?? plus, never had a doctor down here examine my finger nails, often a very good sign that you could be suffering from a host of maladies. It's just done, all the time, up north.
second, with drug costs spiraling out of control, your doctor, and not just specialists, but pretty much every doctor i saw, had a drug closet and monthly visits with drug reps who would help out a doctor's lower income patients with free samples of needed medications. Won't ever happen here in North Narrowlina, probably because there's a law that keeps us under the thumb of the drug companies who lobbied like hell under the guise that these laws supposedly "protect" us.
I loved the way i was treated at Duke, I had a say and could give reasons why I felt I wanted this or not that drug, treatment.... but after getting beaten, assaulted, robbed and car stolen in Durham, i don't feel comfortable going there now, exacerbates a still problematic PTSD...... I do not like UNC, it's like they have a "formulary" that all doctors MUST follow, and it really makes me feel like they jack me up with tests i don't need, but they can get reimbursement from medicare. and if i don't play ball? i'm hounded to death.
Yep, you should be undressed for the exam. If you are not told to do it and given a gown, ask for it.
As Travelassie explained, many drug companies no longer give samples to doctors. They may give a coupon good for a few free months or a discount. That may not work if you have prescription drug coverage with your insurance or Medicare. Formularies are insurance driven, including Medicare.
For any tests recommended, ask why. If the doctor is getting reimbursed by insurance for ordering the test, it is because the insurance company expects to spend less money overall by getting patients tested. That is usually through an incentive program and the amount of money is small. No insurance company is going to pay for a test it deems to be medically unnecessary. That includes Medicare.
my point is that doctors usually know what the problem is without the benefit of endless tests.
If I have a really sore throat that is not getting better it might just be a virus or it might be strep, the only way to know for sure is to check for strep. If I get winded easily it might just be because I don't engage in enough aerobic activity, or it might be that I have a heart condition. I prefer not to go to doctors who try to "guess" at what's wrong with me.
And that incident with slurring your words and problems typing, as someone else said that sounds like a TIA which is definitely not something you should try to treat on your own.
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