In the immortal words of the great philosopher Michael Corleone: “I keep trying to get out, but I keep getting pulled back in.”
That describes healthcare too. One thing leads to another, and you end up in the “treatment trap.” This is my own personal tale of (narrowly avoided) massive overtreatment woe. This incident bothered me for a long time…and ultimately was the inspiration for Quizzify. I thought, if this could happen to me, it could happen to anybody.
Some variation of this has happened to me not once, but many times. If I got all the scans that doctors have advised me to get, I’d be glowing by now. In the oh-I-know-it-sounds-crazy-but-it-just-might-work department, I do have a solution to help reduce the number of CT scans in this country, which is: Stop calling them scans.
You see, the word “scan” by itself is quintessentially non-threatening. For instance, after you “scan the horizon,” the horizon is none the worse off for wear. Most people approach medical scans with the same nonchalance. Most patients are not cautioned in advance about the radiation (100 to 1000 times that of an x-ray) and sometimes the referring physician doesn’t bother to mention the IV with the dye in it. If a doctor says, “I’d like to order a CT scan for you,” most people say “fine.” Or, at worst, “What’s the cost?” (Many people even demand one before the doctor proposes it.)
However, if the doctor says: “I’d like to order an intravenous dye-assisted radiation scan for you,” people might start asking the questions they should have been asking in the first place.
Please see Ann’s comment below. She makes the excellent point that often the doctor is not the instigator of these scans. The patient is. I’ll let her take it from here…
“MANY people even demand one before the doctor proposes it”, and even after the doctor (this doctor anyway) discusses the dye, radiation…provides handouts explaining it because so many look at me with disbelief, so figure they can hear it from me and see it from someone else…and I explain that I think the chances (if this is the case) of it giving us a finding that we can (and should) act up are low…they STILL DEMAND the scan. Then, when I don’t do it, because I don’t feel that getting the scan meets the “first do no harm” criteria, I get patient complaints (survey driven medicine then ensues). I think the take home message is shared decision making. Have the discussion. You can instigate the discussion too, it doesn’t HAVE to be the doctor. The fact of the matter is, that many physicians have been so badgered for studies and z-packs and heart scans etc that we forget that once in a while, there is actually someone who doesn’t want it if it is not going to help. This is not making excuses or being defensive, it is just telling it like it is so people can be empowered to understand what is happening and take part in making the right things happen.
Thanh you for this comment, Ann. Yours is a perspective that should absolutely be more than a comment. I’ll tweak the original posthaste to direct people here.
THats Michael, non Sonny, Corleone. MIstakes like that are unforgivable. Botching Godfather quotes puts you below Wellness scammers.
Yikes! Well, the difference with us — indeed, perhaps the key difference with us — is that when we become aware of a mistake, we allow a bright line to be shined on it (your comment) and then we apologize (sorry!) and fix it. The Wellness Ignorati either double down on mistakes (examples: Wellsteps, Koop Committee), thus turning them into lies (using Confucius’ definition that a mistake not corrected once it is pointed out becomes a lie), or quietly remove them (ShapeUp, Bravo) with no apology to the employees or employers they harmed.