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?
