Hello.
I was wondering if I am the only one witnessing a very strange phenomenon from my mother's general practitioner: endless requisitions for tests and scans.
I know that my mother's health is frail, but she is managing to live on her own with assistance from a weekly PSW. She is stable and functioning to the best of her ability.
Within the past year, her general practitioner has become more interested in sending her for many tests: pulmonary function, heart 'stress' tests, mammograms (at 74?) and ultrasounds.
In my opinion: if you look long enough for anything, a problem (that may or may not need intervention) is likely to appear.
With her 'Medicare'-style health insurance, her GP and specialists are able to bill the government for each visit, test and scan.
Is 'overdiagnosis' a risk for senior citizens? Or am I just paranoid that some medical professionals are out to make a buck?
Thanks for listening.
I also have bone density tests so I'll know if I'm getting osteoporosis and can take calcium supplements to bulk up my bones so that I'm at less risk of breaking a bone if I fall, thus ending my life after a broken hip and the follow-ons to that horrible end. So far, so good.
Lab tests tell me if there's blood in my urine, high cholesterol, diabetes, or other things that could kill me before I finish my caregiving of my beloved husband, who has dementia and needs me.
Because I've taken care of myself by getting tests and scans where needed, I am not a burden on others, as perhaps you are thinking your mother is to you. I am here to help others and hope to do that for some time. Like now, with my input to you.
The usual complaints here are about what tests ARE NOT being conducted on seniors thanks to huge waiting lists, a shortage of doctors, and tests being scheduled 6 months or more out.
Your mom can always say no to any test that's recommended. I won't undergo the bone density test, for example, because I would never be able to tolerate the calcium meds that are prescribed if required. Instead, I take a daily normal dose of calcium that doesn't disagree with me and that's that.
This is YOUR CHOICE and up to YOU to discuss thoroughly with the MDs. They aren't your boss. The patient is the boss about what he/she wants or doesn't want. This is entirely up to you about what should be done for you, or for your loved one who cannot make these decisions. As my dad's doc said to him when he was weakening "We can do all sort of tests, Fred, to see if you have some blood cancer, or whatever. But if we get a diagnosis, would YOU want to TREAT it?" and my dad replied he would NOT and his doc said "We can save ourselves the testing then!"
Again, this is in YOUR HANDS. Don't give away your rights and your powers over your own choices for your own body, or the body of the person entrusted to you.
GPs make (a little) money for each office visit. And most are booked full, so no financial incentive to over-use visits for any one patient. There would be someone else to see in that “slot” .
So though it may be unnerving and can’t known if appropriate , I don’t think there’s any financial conflict of interest driving it, at least.
My SIL told me the other day that he had ordered a blood panel for a patient and the guy refused to have it done b/c he was 'sick of lining you rich doctors' pockets." SIL just laughed and told the patient "I am on SALARY and I don't get a DIME from any tests that I order for you. And your insurance is covering any and all visits you make to me. I'm not a penny 'richer' caring for you."
This is USUALLY the case. Also, ordering more tests, etc., makes MORE WORK for the Dr.
Checking heart and lung function, and basic cancer screening don’t seem excessive, especially if she all right mentally.
For anything billed to Original Medicare, all are preset negotiated terms for payment based on the ICD-10 code submission for billing or whichever Part D prescription drug coverage your mom signed up for. Whether her doc, or an NP or a PA spends 15 minutes with her or takes 90 minutes, the Medicare reinbursement rate is fixed by the code for that visit. Ditto for Medciaid as health insurance. The other health insurers do the same but can adjust upward if it is done outside of the “network” of providers affiliated with the health insurer (Blue Cross, Humana, Advantage Plans, etc).
Imo @ 74 & living on her own, she is “young”.
So often it is question of quality vs quantity.
I am exhausted just taking my husband to every possible specialists followed by tests, procedures, shots, several surgeries, rehab, PTs and endless follow ups. I think he is exhausted and cancelled some lately. Enough, in absence of cure for Parkinson all alternatives offered no improvement, it is progressing faster than ever.
Guess what? Now hubby and I are those folks going to their primary doctor every 3 months, we extended it to every four months. I was thinking what are the chances of something major changing in 4 months. So far zip.
Our primary doctor has one heck of a physical. It includes a hearing test, eye test, BMI test, respiratory output test, EKG, walking test. And that fun filled 30 question memory test where one draw a clock and sets the time... copy a picture of a box... identify the three animals pictured... remember sentences and repeat back... remember numbers and repeat back... remember numbers and repeat back backwards... remember 6 words and repeat back 15 minutes later... subtract 9 from 93 and continue subtracting... say as many words that begin with "M" (that changes each year)... comparison test.... what day is it... what is today's date... year... place... city. I think that is all. Are we having fun yet?
one situation that pissed me off the other day was I took my girlfriend to the dentist for very specific work. But the dentist fought me about first have a cleaning then an exam then come back more times to address the reason you went. I can’t tell you how many times a similar situation has happen with my doctors. I have almost gotten rude with my doctors who are just milking the system. The only way to stop it is to be informed and vocal.
Sample, I totally agree with you