Check everything

06/20/2010 at 5:58 AM Leave a comment

One of the hardest times for me to keep my mouth firmly shut is when a patient comes in and wants his blood drawn to check for ‘everything’. I have tried to discover what they think they want, but really they generally have no idea. They just want a clean slate so they can stop worrying about all health related matters.

Uh, folks. This is not Star Trek. We don’t have that cool gizmo that they wave over you while I stare into the tricorder and tell you everything that could be wrong with you. Not by a long shot. On top of that, our tests, in general, are not as sensitive as our own bodies. We use blood tests as confirmatory tests, with several exceptions of course. Are you tired? thyroid, iron and hematocrit. Have a serious infection? white count. Etc. In addition, insurance companies are not keen on paying for ever increasingly expensive blood tests simply because the patient requests them and we have to have a diagnosis that justifies that particular blood test. And no I can’t make the up the diagnosis.

Besides, people do not comprehend the scope of available blood tests. The book that describes all regularly used blood tests  is a phone book. There are literaly thousands upon thousands of tests that can be run. I probably only understand a minute fraction of them, most of them being super specific and rare tests.It would take gallons upon gallons of blood to run everyone of them.

I usually understand that the patients want the typical screening blood tests. That they have finally accumulated enough gumption to come to the doctor and they don’t want to waste the experience simply talking to me, they want the real stuff, the blood tests that are printed out by a computer and therefore much more accurate and useful.

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Entry filed under: Doctor's Rants.

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