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Doctors call for end to 45 common medical tests, procedures

  1. Man! I just went through my second colonoscopy this morning! Been 7 years since the first.

    The 45 tests and procedures considered to be overused include:

    • Repeat colonoscopies within 10 years of a first test

    • Early imaging for most back pain

    • Brain scans for patients who fainted but didn't have seizures

    • Antibiotics for mild- to-moderate sinusitis unless symptoms last for seven or more days or worsen

    • Stress cardiac imaging or advanced non-invasive imaging in the initial evaluation of patients without cardiac symptoms unless high-risk markers are present

    • PAP smears on women younger than 21 or who have had a hysterectomy for a non-cancer disease

    • Advanced imaging or bone scans in patients with early-stage breast or low-grade prostate cancer

    • Bone scan screening for osteoporosis in women younger than 65 or men younger than 70 with no risk factors

    • Routine cancer screening on dialysis patients with limited life expectancies

    • Chemotherapy for sickest cancer patients
    For the complete lists of "Five Things Physicians and Patients Should Question" go to: Choosingwisely.org

  2. I literally just a few seconds ago posted this on the same thread in another forum:

    It is not possible to give everyone every screening test.

    Therefore, it is important to develop a set of criteria which identify those people who are most likely (in a statistical sense) to benefit from a particular screening test.

    these doctors are saying (and I don't know if they're right or not, I'm just presenting their reasoning) that some screening tests are overused/not used on the right patients/don't measurably improve the outcome, therefore we should stop doing them except in patients who have X, Y, or Z risk factor.

    Pretty straightforward stuff. I'm not qualified to comment (medically) if they're right or not.
  3. Oh, the same story? I searched but nothing showed up. Maybe the mods can delete this one.
  4. Another forum that's not GT, you're fine
  5. The overuse of diagnostics is a direct result of malpractice lawsuits.

    Once again, nearly every societal ill can be traced back to lawyers.
  6. I thought I awoke briefly during my c-scope......... and I was a little uncomfortable with the smiles on everyone's faces. ???
  7. Imagine how uncomfortable a smile on your face would have made them.. ROFL! :)

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  8. :laughabove:
  9. More time on the golf course, I suspect....aahahah.
  10. Well that and the fact that so many clinics have purchased equipment that they need to pay off.
  11. This article is about "getting equitable access to health care." Can you say rationing?

    ChoosingWisely is a leftist propaganda group dedicated to promoting ObamaCare.

    Their partners (or should that be "comrades") are listed here:
    Choosing Wisely Consumer Communication Collaborators:

    ■Alliance Health Networks
    ■The Leapfrog Group
    ■Midwest Business Group on Health
    ■National Business Coalition on Health
    ■National Business Group on Health
    ■National Center for Farmworker Health
    ■National Partnership for Women and Families
    ■Pacific Business Group on Health
  12. That is exactly what this is----BS. I will rely on the doctors I trust to make the determination----the doctor who knows me and sees me regularly and not some panel of doctors. The rationing begins.
  13. Where does that doctor get his or her information? They read studies and they take the recommendation of groups of medical professionals and statisticians, right?
  14. True dat. Just give me and my family the same insurance and health plan as the U.S. Congress, the U.S. Senate and the President and I will be fine.
  15. Congresspeople, senators, and the President all get their choice of the same health plans as every other federal government employee. I think most of them get Blue Cross Blue Shield.

    My health insurance is probably better than that of most Senators.
  16. If we are going to socialized medicine. I want the same care as the President and every Senator and Congressman.
  17. Ya'll hiring? LOL!

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  18. I was totally awake for one of mine, and the doctor did NOT appreciate it when I said " you know, if anyone else tried to drug me and do this they'd be arrested"!

    At a quick glance, some of those seem fairly reasonable, but some do not.
  19. My dad jokingly demanded and kiss first, and asked if he would still be repected in the morning. :)

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  20. I was totally awake after the doctor's cocktail. He commented
    that I didn't feel a thing? (his drugs). It was no big deal the
    procedure, but he was pissed that he had too be there on
    a Saturday afternoon when his favorite ballgame was playing.

    His tech assisting was new, but excuse the pun, as the tech
    didn't know **** from shinola!

    Since it was done on an emergency basis the doc was pissed
    that he was missing his game. This doc was the best
    Gastroentologist in town, but it was obvious that he was
    pissed off that my rear end was disturbing his day.

    I'm really trying to end this politely, but Dr. Buck: Go ****

    Everything turned out fine as far as my colon, but you got
    payed to do your job. :wavey:
  21. I can see the avoiding getting sued thing. I had a colonoscopy and a simultaneous endoscopy last year because I had some digestive issues following severe food poisoning. Well, they found a little benign something and so now I have to go back in 5 years AND my sister has to get tested. (Parents already have.) I am nowhere near 50 and my sister is even younger. She studiously avoids anything having to do with the subject because she doesn't want to get it done. Can't say I blame her.
  22. Thats how doctors and hospitals suck the system. Its designed to be the way. Sorry folks.
  23. Won't be a popular thing to say on a gun forum, but lawyers are just like guns. People decide to file suit and they use lawyers as the tool to do it. A lawyer represents the client's interests, not their own. In fact, in modern law school classes suit avoidance and alternative dispute resolution are heavily emphasized.

    So I guess...lawyers don't sue people, people sue people? :D

    Never forget that it was a lawyer who won Heller for us. Got to meet Mr. Gura a few weeks ago. Nice guy. :)
  24. I disagree with the PAP screens under 21.

    Its a marker of high risk behavior too.
  25. He's got your approval. We're all sooo relieved.

  26. Are you insane, or just illiterate? Do they not say "you're fine" wherever you're from?

    The man thought I was informing him that he'd posted a duplicate thread, and I replied that I meant something else.

    Looks perfectly normal to me. You see, here in America, "you're fine" means the same thing as "no problem" or "it's all good." It's just something we say.
  27. Dont wory about teumessian_fox, I cant figure out if he hates everthing or just most everything. He is such a pleasant fellow.
  28. Yeah, and to be fair, I have been a bit touchy lately.

    My apologies, Mr. fox. Hate away.

  29. Nah, I love everybody. I just have zero tolerance for pretentious and pompous people.

    (Are your ears burning?)

  30. What a sensitive little child.

    It's called "sarcasm" dude.

  31. I cant hear you over the sound of how awesome I am.

  32. There you go dude. Just flow with it.

    And yes, you are awesome. As are we all.
  33. If that was your idea of sarcasm, you suck at it.
  34. Not too many years ago, I was a used car salesman who had flunked out of college. Since then I've done a few things, but none of them have made me pretentious.

    I posted this just yesterday:

    I know who I am. I may be an opinionated a-hole, but I have no illusions about being better than anyone else.
  35. OK kiddies, let's all take a deep breath. Recess is over, and it's time to get back to talking about adult stuff like doctors and insurance companies who tell doctors what to do.
  36. The no pap thing under 21 is already in effect. Makes a lot of sense. HPV related dysplasia and cancer is a very slow growing process and many many young women can clear the infection. They are advocating going to a 5 year cycle for women with a negative pap. These measures will drastically decrease costs and for guys like me, cost money (lost revenue).

    If folks can accept a slightly greater risk of a bad outcome we can trim a massive amount from costs of medicine. We are well past the point of diminishing returns per dollar spent. Fortunately evidence based medicine seems to be beating lawsuits so we are seeing progress in not just being knee-jerk reactionarys and CYA practicioners. The dowsnside is that we spend more time documenting everything we do than actually doing what we are paid to do :)
  37. Jason, what do you do?

  38. I was awake during my last one, just enough drugs on board to ease the discomfort. I needed to change positions a couple of times and was able to watch the whole thing on the monitor, it was neat.

    The only bad thing was, I told the hawt redheaded nurse, what I would like to do with her :embarassed:
  39. I think these are two reasons for 50% of the unnecessary spending.
    Patients demanding tests and treatments without a good understanding of the health and cost considerations is another.
  40. There are other forums? Someone told me there are other sub forums on GT besides this one once. Hahahahaha
  41. I've been selling in the medical areana for 30 yrs and we are definitelly over screening which is adding big bucks to the overall healthcare costs. But I'm good with that, I make big bucks when doc's screen annually even though their professional guidelines say to screen every 3 years! How else could I afford my boat and diesel pusher????

  42. Some still use their instincts, trust their gut, and weigh all that against what they know about the patient's insurance company.

    My ex's doc dismissed her out of hand, and her own father urged her to ignore it. But I wouldn't let it go...

    I dragged her to my doctor.

    It was cancer. And it took considerable surgery to remove it. That was 1984, and she's alive and well, and meaner than hell today...

    I see what others see here, RATIONING.

    By the bye, last night we watched one of the features on a Horatio Hornblower DVD (outstanding stuff!)... Many Brits were interviewed, including a current Royal Navy ship's captain... My God, his teeth were awful! As were the teeth of most of the older gentlemen interviewed! I see SOCIALIZED MEDICINE, I see RATIONING...

  43. I dont think orthodontics are rationed in the UK, they either don't place the same value on straight teeth as we do here or they can't afford it (i.e., they CHOOSE to spend their money elsewhere). What health care plan over here covers braces aside from medical necessity? My folks ponied up the cash for us. I ponied up the cash for my wife.

    BTW, I work in the lab so about 99% of all "Screening" medical therapies involve me in some way, be it screening pregnant mothers for fetal birth defects, screening babies for blood abnormalities like sickle cell, screening adults for colon polyps or cervical dysplasia, or breast biopsies after mammographic screening.

    I would MUCH rather make my money on "pointless" screening than diagnosing patients with end stage disease. Is it expensive? Sure. But you can pay for a lot of screening tests with the money you would spend taking care of one terminally ill person. Which would you rather be?

    Find me a bunch of folks who never go to the doc, live their lives, and then happily kick off when they get struck by a potentially preventable disease.
  44. Jason - If you have a young girl turn sexually active at 13, go through a few partners and have an ASCUS PAP at 18, is that good information to know? What does it tell you?
  45. Keeping in mind that many doctors are the partners in the clinics... at least around here. Talk about double dipping... :whistling:
  46. You forgot to add this :rofl:. Geez for a moment I thought you were serious. Thanks for the laugh.

  47. You inferred orthodontics... Let me elaborate...

    This Royal Navy captain's teeth were chipped, broken, and brown... The US Navy folks interviewed in the features of last night's DVD (we're working through the Hornblower series) had no such awful teeth. I'm thinking regular dental care for our people and none for the Brits, if I choose to trust my eyes... :freak:

  48. Why wouldn't I be? It's true. The company I work for regularly comes in #2 on the list of "Best Companies to Work For" and my benefits are spectacular. Congressfolk buy their health insurance through the same group plan that any other federal employee does. They have to pay, too.

  49. Still hard to fathom how naive people are:

  50. ASCUS at that age is pretty insignificant, it could be inflammation or an infection she will probably clear. The lab should do a HPV test to confirm the presence of high risk HPV. At that point (if it is positive) her GYN may go ahead with a colposcopy and take samples of suspicious areas but will probably just observe. HPV progresses very slowly and is often cleared. This is why they are recommending screening at 21, anything earlier just isn't clinically significant, particularly with the teens now getting the vaccine. In 20 years we may not routinely do paps at all, relying only on the HPV test, which would put a lot of cytolotechs and cytopathologists out of business. Of course the pap smear still screens for certain infections and endocervical and endometrial lesions so they may keep it around even though cervical cancer may be eradicated.