Growing up, for those who grew up in the days when the sound of shattering glass denoted the grand entry of Mr. Stonecold Steve-Austin, you probably know that the same night you would hear this familiar line, “If symptoms persist, seek medical advice.” A very good advice especially when there is an obvious anomaly with your health. Fast forward we are now in 2019. The question we should be asking ourselves and very crucial to our health going forward is this…
“How do I know when medical testing is appropriate? What is the information the medical practitioner has that warrants this kind of test and not another?”
Do not get this twisted. We are not all professionals. Yet we are required not to play ignorant. There exists those times when you think a certain test may be inappropriate depending on how you see the doctor interpret it. This is not an endorsement, but rather a suggestion to be alert and understand the context of medical testing for there is a chance, however slim, you might be right.
For instance, it is not always given that every time you have a headache, however severe it is, that you need a CT scan and or a spinal tap. A headache may be as a result of a number of factors that could include a hangover, lack of enough sleep and/or water and many others. But should you say no to a doctor? And how should you behave when a doctor orders a CT scan of the stomach when your blood pressure is borderline high and you are vomiting and diarhearing? Let’s find out…
Since those Raw is War eras (don’t get offended, it is only that those were the days we were born, so our history seems a little skewed), the rhetoric has been revolving around the dangers of inadequate health care. Physicians would get in a dilemma in emergency situations that needed attention that sometimes wasn’t available. Little access to care and a stream of successive misdiagnosis lead to many deaths. Therefore, many tests would be done in a bid to find out persistent problems to avoid the situation going out of hand.
While many people still lack access to care, there’s mounting evidence that many people also receive too much care. The prestigious Institute of Medicine estimates that close to a third of all medical tests and administered care are completely unnecessary. This is a huge misdiagnosis that is probably more dangerous and potentially harmful bearing in mind the risks and side effects inappropriate test and treatments may have on the patient.
In our earlier example, the CT scan administered to a vomiting patient exposes them to all the risks associated with radiation. This essentially means a possibility of cancer later in life. We have not even mentioned that a misdiagnosed test may lead to another test and another, henceforth accumulating more risks.
This is why you should not be ignorant about your health now and in the future. There are many reasons to over treat rather than under treat. Companies that process drugs anticipate more incentives when the population receive more care. Yes, I knew you would get shocked. And doctors, well meaning as they are, receive more financial incentives when they over test. Other times doctors are gripped with the fear of malpractice, thus they are forced to do more so that they are sure.
Are we only blaming drug companies and doctors? Not at all. Patients also carry a responsibility in over testing and over treatment. When you are a patient and you have a mindset that believes that more testing and/or treatment is better, you will lean towards idolizing more tests and the technology involved. So, back to our question, how do you know when it is appropriate to take a test and when in simple and sensible terms, it is too much?
We have no direct answer to these question. However, there are a set of questions you can ask your doctor, before you agree to any tests.
Considering the trend of the symptoms what are your possible diagnoses?
Every doctor has an idea of what could be ailing you even before the tests. Try find out your doctors thoughts on what could possibly be happening and what they think. A good doctor will explain the rationale behind every single test and treatment prescribed, their essence and the various possibilities. And yes, not all headaches denote a brain bleeding.
What is/are the assurance(s) that the test/treatment is beneficial?
How does the test improve the quality of life in comparison with what is there currently? If there is an evidence that suggests assured benefit, then go ahead and take the test or the treatment regimen. For evidence purposes, the doctor may be willing to pull out studies that show how the tests and treatment have improved quality of life in the past. If there lacks evidence, the doctor should explain to your satisfaction why he/she thinks you still need the regimen.
Potential risks and side effects?
Ask before every other test what you are up for because every test has side effects. Before consent, know what those side effects are. This will help you to out the benefits and the side effects on a lever to help you decide whether you really need the test.
Can I watch and wait? Is my situation unique?
Is my situation an urgent one or can I wait and see if symptoms more than what I already have will emerge? The doctor should be in the best possible position to advice on this since he or she understands the profile and progression of symptoms in particular anomalies.
Most of the times, your situation is not unique and the doctor might have dealt with such previously. This experience might be very valuable to your decision making.
Other treatment options?
It is possible that there might exist some other vital treatment options that do not only involve medical care. A good doctor would advice on other options including diet, physical therapy and exercise and many other treatment options. These treatment options may turn out to be just as effective as the medical treatment and may help you avoid the side effects.
Your situation may not be as hard as you may think. Even more friendly is a doctor you have built a relationship with and who you can comfortably ask questions.
Disclaimer; This article only seeks to give suggestions on how you can engage with your medical practitioner. It is not a medical advice or a replacement for medical care. Remember “If Symptoms Persist, Seek Medical Advice.”
Download the following attachment for the five questions you should ask your doctor before a medical test or treatment