Are my doctors procedure happy?

[esquel]

I feel for the poster several down whose wife is scheduled for a CT scan without knowing what the doctor is looking for. Recently I've been wondering about the barrage of tests and findings I've been subjected to as I get older, and what feels more like the upselling you get at TGIFridays, rather than a medical practice.

DH and I have developed the usual array of aging issues, like higher blood pressure and receding gums. The doctor has been trying me on a number of blood pressure meds to see which works best. When we were tweaking the dosage, I saw him monthly, and every time I came in, the nurse would say brightly, "How about getting a flu shot?" I am not in a high risk group for flu, and declined it each time, until I finally told the nurse to please note in my record that if I want a flu shot, I will ask for one. He has been having DH get blood tests bimonthly to monitor prediabetes, which appeared briefly more than a year ago. First it was borderline sugar, then it was one type of cholesterol too high, then another type that was too low. I feel like they find a new problem whenever the last thing gets fixed.

I just saw my dentist today. It seems every time I come in, he has a new procedure he is recommending to all his patients. First it was cosmetic whitening. Last year, it was laser tooth cleaning, where UV light is used to kill off mouth bacteria, not covered by my insurance. Today it was fluoride tooth paint ($20) and prescription only toothpaste, which his office coincidentally sells for $20 a tube. I waffled on the toothpaste and said I would see if my prescription plan would cover it; a $5 copay is much easier to stomach than $20. The tech sighs and mutters something whenever I turn down the latest and greatest treatment; my teeth are in near perfect condition for my age.

Even veterinarians get into it. Our former kitteh had an unhappy stomach for a while, and prescription cat food! only from the vet office! was $25 per bag. What in the world is in cat food that requires a vet to dispense it?

Without medical training beyond what I can digest from Teh Intarwebz and read in library books, how can I decide if the treatments my doctors suggest really are worthwhile, or just a fishing expedition? If there's something that's the opposite of hypochondria, I think I've got it; I'm starting to hate going to see my medical providers.

 

[Goshawk]

Doctors aren't necessarily procedure-happy, but they are only human, and so enjoy using the new tools and "toys" that are made available to them. Also, the vast majority of them in my opinion are doctors and dentists and nurses and hygienists because they genuinely want to help people, and so are very glad to have those new tools and "toys" available to help them help you; flu shots really do help some people, as do fluoride treatments and prediabetes screening. It's not like they're pushing woo at you, in other words. They're just utilizing the bumper crop of tech stuff that comes at them from the pharmaceuticals and health care industry and research labs.

Also, in today's litigious society, health care professionals are more cautious than ever about potentially leaving any stone unturned in a patient's care, lest they find themselves facing "Why didn't you make my elderly mother get a flu shot?" or "Why didn't you tell me you had prediabetes screening available?" malpractice actions.

That said, if *my* dental hygienist was as rude as that when I turned down her offer, I'd either say something to her boss, or else find another dentist.

However, the whole "Kitty needs special expensive food that only the vet sells" is--in my opinion--a thinly disguised consumer scam, albeit one that is legal. I fully expect to be publicly pilloried for this opinion.

 

[esquel]

I'm pretty sure none of it is actually woo-ish. I just don't know how much of it is just upselling, like an offer to supersize at the Big M Supper Club. It won't hurt, and may help, but isn't really necessary. After being offered a new treatment so many times recently, it starts to feel like a fast way for the office to make an extra $20 per visit.

 

[Willowfrond]

I wish

I had your doctor.
Two years ago I had a hearing test, came out with good results but while I was there I asked the Audiologist about the tinnitus I have in one ear. I have had this since my teens and am now in my fifties. She told me it was pulsatile tinnitus and that I should tell my doctor.
When I told my doctor he said oh that, it's nothing.
Being a confused skeptic I googled...Nothing! there are lots of conditions it can be associated with most benign but some potentially life threatening.
We have a great 1800 health line here manned by Registered nurses so I called and asked, the nurse said right away to insist on a referral firstly to an ENT and so on through other specialities if nothing was found.
No go!
I am now up to doctor # 6, still being poo pooed.
This isn't ruling my life you understand, I just bring it up now and then and yes I have moved around a lot in the past two years and had change of doctor.

 

[casebro]

"Prescription only" pet supplies are a bit bogus.

In 1972 I worked for Walt before he put Petco together, when he only owned one store. He would buy some of these "prescription' items by having a friendly vet sign the order. There is nothing prescription about them, except that the maker wants to maintain exclusivity. The trade designation for that type of item was "ethical", meaning sold only to licensed vets.(Walt was the other kind of 'vet', a WWII Tarawa Marine)

If I had a cat, I'd feed it people food first. REAL meat. Or fish. Cheaper, better, less processed. My dogs are getting bag food, plus ham and rice. Hams were 99¢/lb this week. Ham & Rice costs 33¢/lb, cheaper than the bag food. I once figured those little bitty tins of cat food cost $12/lb. Toss Fluffy a raw chicken drumstick for 35¢ instead. She''ll love you for it.

 

[casebro]

My problem with medical treatments are that the Docs know that a given treatment will help a few percent delay a disease, but they act as if EVERYBODY will attain immortality of they accede to the treatment. It's a game of numbers, the more they treat the more people will gain- even if the chances any one person will gain anydamnthing are slight.

Study results are always in relative risk, where in cutting the disease from a 10% occurrence to a 5% occurrence is announced as a "50% improvement with our treatment", rather than "19 of 20 will show NO benefit". Charlatans.

 

[The Don]

"Prescription only" pet supplies are a bit bogus.

In 1972 I worked for Walt before he put Petco together, when he only owned one store. He would buy some of these "prescription' items by having a friendly vet sign the order. There is nothing prescription about them, except that the maker wants to maintain exclusivity. The trade designation for that type of item was "ethical", meaning sold only to licensed vets.(Walt was the other kind of 'vet', a WWII Tarawa Marine)

If I had a cat, I'd feed it people food first. REAL meat. Or fish. Cheaper, better, less processed. My dogs are getting bag food, plus ham and rice. Hams were 99¢/lb this week. Ham & Rice costs 33¢/lb, cheaper than the bag food. I once figured those little bitty tins of cat food cost $12/lb. Toss Fluffy a raw chicken drumstick for 35¢ instead. She''ll love you for it.

Feeding a cat "people food" may result in a shortage of some nutrients, depending on the amount of wild food the cat gets.

Here decent quality dried cat food (store's own brand) costs around £1 a kilo.
Decent quality canned food is just under £1 a kilo. I cannot imagine what advantage the fancy stuff gives.

Having said that, out two will only eat Felix As Good as it Looks at £3.50 a kilo, but that's because Mrs Don spoils them.

 

[Silly Green Monkey]

Mine throws up if he eats a mix that isn't heavy on the Walmart brand Special Kitty cat food. He *likes* other foods, but throws them up.

 

[Lolly]

My cat had incidents where his urinary tract got all blocked. He now eats the "prescription" diet to stop bladder clogging and he's been fine since he's been on it. If he gets all blocked up and it goes unnoticed, he can die, so I am a fan of his special dinner if it's helped him not have any incidents for years and years.

As for being offered treatments, I don't care, as long as they don't get all ****** at me if I say "no". As long as it isn't something completely bogus that (I think) no reputable practice should be offering, I don't care what they try to sell.

 

[JJM 777]

Recently I've been wondering about the barrage of tests and findings I've been subjected to
(...)
I feel like they find a new problem whenever the last thing gets fixed.

The coin has many sides.

Firstly, it is true that mere outward observation is not always enough to diagnose the health situation of a person. The more tests are made, the more reliable the diagnoses should be statistically.

Secondly, mere outward observation does not always give even a hint which tests are the ones that will discover the health problem. The doctor may sometimes feel that a test probably exists which would discover this health problem, but there are helluva many tests and no idea which of them will detect this particular problem. If the patient is extremely wealthy, you can go machine-gunning through all tests without bothering about the costs. But that is rarely the case.

Thirdly, tests cost money, and someone must pay them. The doctor may have negative or positive interests in prescribing tests for you:

a) In privately owned health care, where the patient is the one who pays the bills, the doctor (or his employer) earns a profit margin of every test, so they have an economical interest in assigning many tests for you. Isolated individual cases must exist numerously, especially in slightly corrupted countries like Russia, where a doctor uses unnecessary tests as means of "pumping money from the patients" and increasing his own personal income.

b) In health care that is paid by a third party, such as a state or insurance company, the third party who must pay the tests may put thumbscrews (or a yearly budget) on the doctors not to prescribe overly many tests, any more than is "very necessary", lest the third-party payer cancel the deal and buy the doctor services from some other doctors. In this case the doctors have an economical interest to sometimes refrain from prescribing a possibly helpful but pricey test for a patient, even if the patient begs for it on his knees (this really happens in state-paid health care), to ensure good business relations with the third party who budgets and pays it all, to keep the payer happy so the profitable deal will continue also in future.