How Perils Can Await the

How Perils Can Await the 'Worried Wealthy'. Hordes of consumers are flocking to centers around the country to have their bodies scanned by three-dimensional computerized X-rays. By Jane E. Brody. [New York Times: Health]

This is a compelling article that I'll print out for the office.  Too much testing CAN be a bad thing.  The article clarifies how false positives on screening tests can lead to serious problems .. and great expense and hardship. 

Today I saw a 53 year old man for a "annual physicial."  Unfortunately, the common misperception is that a physicial examination is the conerstone of this annual visit.  It's not.  As a primary care physician, my job is to assess risk, and prevent disease.  I always ask patients if they wear seatbelts, since automobile accidents are more likely to contribite to their death or illness than anything I hear when I listen to their lungs.   Testing always comes up too.  "Do the all of the bloodwork" I often hear …  "I want to be sure everything is OK"  Hmm … How do I respond?

Of course, I can't do "all of the bloodwork."  Doing so would be both impossible and irresponsible.  I need to help my patients make careful, informed decisions about which screening tests are appropriate and indicated.  I often make use of the USPSTF screening guidelines to guide the disucssion.  To some, "It's just a blood test" and the risk of a false positive or ambiguous result isn't appreciated.  I don't want to talk my patients OUT of getting a PSA.  ? or do I?