When You Go to the Doctor

I wrote recently about talking with your doctor before accepting a prescription for antibiotics. Today, let's move on to testing with Nikki.

A couple of years ago, I went through a myriad of tests - blood and urine tests, endoscopy, MRI, CAT scan, ultrasound, etc. Through it all, the doctors learned I was "normal" and had no idea what was causing my unusual symptoms (which turned out to be caused by mold exposure). I was desperate for a diagnosis and assumed the doctors knew what they were doing, so I blindly accepted tests they recommended. My doctor briefly surmised that my symptoms could have been caused by an allergic reaction to something. Before sending me to an allergist, my blood was tested to see if I was having an allergic reaction at all. Now, I have moderate to severe seasonal allergies. When this blood test was done, it was Fall and I had sinus problems from multiple outdoor allergens. Ready for the surprise results from the blood test: my body was having an allergic reaction to something! The blood test couldn't show what I was allergic to, just that I was having a reaction to something. Well no kidding. I was already sneezing and sniffling from grass, trees, and other outdoor stuff.

That test was the biggest waste of money...my money. If I had've asked what they were actually testing for when my blood was drawn, I would have stopped it right then. And because of my learning experiences with multiple tests, here are some things to keep in mind next time your doctor recommends testing:

1. What are you testing for or what has led you to believe this test is needed? Sometimes, doctors are grasping at straws when they order a test. They don't know what else to do. Sometimes, a test is ordered to cover themselves from a lawsuit. In America, we are known to get sue-happy and want to take doctors to court for everything. To rule everything out and avoid lawsuits, they test. (Which is really sad, by the way. Yes, doctors make mistakes and some should be sued. But there are plenty of others who are great doctors but are scared to do what they know is best because of the threat of lawsuits.) And other times, one of your symptoms matches a specific disease that a test would rule out. Specialists have a tendency to look at one area rather than the whole person. While one symptom may match a disease, your other symptoms might possibly contradict it, which negates the need for that specific test.

2. Depending on the result, what will be the next step? I believe it's rare, but occasionally tests are ordered with no intention of doing anything about the result. This seems to occur most often when the patient needs to be pacified satisfied that the doctor is trying to figure out the cause of the problems. Other times, "the next step" will be recommended regardless of the test results. What's the point of undergoing the test if the treatment plan will be the same regardless of the results?

3. What is an estimate of how much this test will cost me? As the paying patient, it is your right to know the costs ahead of time. However, most offices can't give an exact amount because of the differences in insurance plans. If you're not sure if your insurance will pay, ask for the cost of a patient paying out-of-pocket. This will be the maximum amount you will spend on the test.

4. If the test is too expensive, too invasive, or involves radiation, ask if there are other alternatives. The test recommended by your doctor may be the only option or it may simply be the most reliable, most used, or most accepted by insurance companies. Don't hesitate to ask, particularly with exams involving radiation. They can be extremely detrimental to your health, so it's best to avoid them when there are other alternatives.

5. Finally, what is my blood pressure, cholesterol, etc.? Keep a medical file of your own. Note blood pressure, cholesterol, blood sugar, or anything else that is checked when you go for a doctor's visit. After any test or exam, request copies of the results and images for your file. This is particularly helpful if seeing specialists or requesting a second opinion. It reduces the need for many tests because you will already have results in hand.

Have any other questions to add? I'd love to hear from you!