Overscreened

I go to the doctor a couple weeks ago. No big deal, just the annual checkup and thyroid test (a test I’ve been getting since 1980). My regular doctor has somehow disappeared, I can’t seem to find out what the story is, so I go to the doc who’s taking her appointments.

A couple of odd things: (1) It was possible to get an appointment almost immediately. That alone doesn’t indicate a problem, but it does make me wonder, since other docs I called had a waiting period of as much as 8 weeks. (Also ridiculous, but another subject for another day.) (2) He calls when I was already out the door for the day to ask if I could get there 20 minutes early. Way too late to get a call like that; also makes me wonder.

He seems decent enough. He’s pushing a few more blood tests, as there are other things that can interfere with thyroid levels. OK, no problem. Then he’s pushing a colonoscopy. No. I’m over 50, “guidelines” recommend the procedure every 10 years for someone over 50. No. I really need to get this done. No. Why not? With no history of colon cancer anywhere in my family, and no signs that maybe this is a problem, no. Not gonna happen. He’s so insistent, I wonder what he gets out of doing this expensive, invasive, time-consuming, and unnecessary test.

This reminds me of the time my mom was diagnosed with cancer based on a single CA-125 test. From what I’ve read (and I read a LOT while this was going on), one CA-125 is about as predictive as throwing dice, with false positive and false negative rates running about 25%. Now, a series of CA-125s, done over a few months, that’s a much better set of tests. If it keeps coming out high, you might have something; on the other hand, if a second test drops, you probably don’t have something. It took another doc to do a second test. Anyway, the first docs insisted Mom had cancer, to the point that they said she had at most 6 months (3 years later, she’s still here), and should get her affairs in order. A biopsy came back negative; the docs said maybe they didn’t hit the right spot, so a second biopsy was ordered. #2 came back negative. I asked the docs whether they were open to the possibility that it might not be cancer; they said no, they had lots of experience, I didn’t, and I shouldn’t question them. Uh huh. Fast forward a bit, Mom had the mass removed, the pathology report (of which I read every word and looked up what I didn’t understand) came back 100% negative, and the docs still couldn’t admit she didn’t have cancer. So much for expertise.

Back to my story. Doc persuades me to do the mail-in test; it’s not invasive, a lot less expensive and time-consuming, and, while I believe it to be unnecessary, it’s not going to harm anything. Doc says, if they find blood in it, I have to have the colonoscopy anyway, so I might as well do the colonoscopy. I said I prefer to jump off bridges when I get to them, so, not gonna happen.

Other tests were back in a couple days. I get a letter a week later, saying TSH level is a little high (it’s actually kind of a lot high, at a point where other docs have adjusted the thyroxine dose to get it back down); he says I have to make sure I take my pill every day. He must think he’s dealing with a complete moron; either that, or he’s pissed that he’s not going to get whatever benefit HE gets from the colonoscopy. Either way, I see no reason to go back.

Here I thought, people are supposed to take more charge of their own health care. I do, and it ticks these guys off. WTF, docs?