Please do not let our crazy systems prevent needed preventive testing for
you or for anyone.

Sadly I get 2 or 3 calls a month regarding absolute strangers in huge need
of health care, as identified by tests that I did not order, and even the
physician ordering the test not uncommonly dumps giving the bad news on my
doorstep.

Such is the collapse of primary care and a non-system where people are left
out while others call their own shots and both suffer not having a
coordinator of some sort.

New wrinkle is ultrasound screenings at churches and other organizations.
Head to toe ultrasound is about 20 different tests. Of course probability
in much of our testing is that for every 20 tests, one will be positive
anyway.

Just had a patient with a screening that indicated a spot on the liver.
What does this mean? Largely unknown. We have never screened all humans for
ultrasound, only symptomatic ones. Same problem when we starting massively
increasing CT and MRI scans and had less clue about normal variants.

So who does the patient call, you guessed it, me. Probably nothing but...
so we do some blood tests

Guess what, more anomalies in the blood that might match up to liver.

So we do a CT scan and again, probably nothing but fatty tissue confluence,
but....

Fortunately I repeated the blood tests at the same time and now they are
normal. This of course presents the dilemma of which set of tests was wrong
by the same lab in only a few days difference.

At this point I pulled the plug because I had no real indication of a
consistent problem by ultrasound, CT, or lab tests. Also the next step was
painful and dangerous liver biopsy on what was probably fatty tissue.

Sadly she will need some other costly testing in the future, at least lab
and possibly scans if she gets too nervous.

A "free" screening ended up costing nearly $1500 (my estimate) and could
have even killed her.

Just makes you want to line up at your local screening, doesn't it?

Robert C. Bowman, M.D.
[log in to unmask]

-------------------
Problems/Questions? Send it to Listserv owner: [log in to unmask]


To unsubscribe, send the following message in the text section -- NOT the subject header --  to [log in to unmask]
SIGNOFF SDOH

DO NOT SEND IT BY HITTING THE REPLY BUTTON. THIS SENDS THE MESSAGE TO THE ENTIRE LISTSERV AND STILL DOES NOT REMOVE YOU.

To subscribe to the SDOH list, send the following message to [log in to unmask] in the text section, NOT in the subject header.
SUBSCRIBE SDOH yourfirstname yourlastname

To post a message to all 1000+ subscribers, send it to [log in to unmask]
Include in the Subject, its content, and location and date, if relevant.

For a list of SDOH members, send a request to [log in to unmask]

To receive messages only once a day, send the following message to [log in to unmask]
SET SDOH DIGEST

To view the SDOH archives, go to: https://listserv.yorku.ca/archives/sdoh.html