My sister called today . . .

My younger sister, aged 48 years (sorry, sis), called this morning.

"I'm going to my doctor today. What labs should I tell him to draw?" she asked.

"Why do you have to tell him? Can't you just ask him what he thinks should be drawn?"

"No," she said. "He just draws what I tell him to."


Maybe my sister is bossier than most. But I've heard this from many patients, as well. They go to their primary care physician and end up requesting this or that test. Sometimes their doctor complies. Often, they resist and refuse to do so.

I've heard many complaints from patients about doctors refusing to order even fairly benign tests like a vitamin D blood level or lipoproteins, even a C-reactive protein.

The number of these sorts of complaints seems to be growing. Ten years ago, it rarely happened. Today, I hear this nearly every day.

I think it is symptomatic of the growing discontent we all have with the status quo in healthcare. We are all expected to submit to the paternalistic, what-can-you-possibly-know mentality that still rules the day in medical offices. Only 40-50 years ago, if you wanted to look at a medical book, you'd have to ask the librarian for special permission so that they could make sure you weren't just a pervert trying to look at naked bodies. Today, every manner of medical and health information can be found online. Quite a contrast.

We are entering a new age, one in which people are far better informed, have surfed the internet and read media reports on health topics, have been exposed to drug company advertising, and know a fair amount about nutritional supplements. I think the system needs to change to accommodate this rapidly growing hyper-knowledgeable society.

In past, when a health problem turned up, you'd turn to your doctor first. I predict that,in the next few years, we will use the doctor as a place of last resort, the person we turn to when all else has failed, after you've exhausted your information sources.

I hope that the Track Your Plaque process will become one of the engines of change, an information resource that provides empowering tools that don't replace your doctor, but provide many information tools that are superior and may minimize your reliance on a health care provider.


Copyright 2007 William Davis, MD

Comments (5) -

  • traderfran2001

    9/28/2007 2:16:00 AM |

    Ditto on having to struggle with Doctors to order tests. My Doctor thought that my lipid profile showed I was not in great danger until I showed him the results of my CT scan.He simply refuses to order tests like vit d levels. I have given up trying and simply get the tests myself.

  • Anne

    9/30/2007 3:23:00 AM |

    Ditto to having difficulty getting my PCP to run tests. I was low in Vitamin D and got it up by the end of last summer. I asked for a check after last winter and he refused because my vitamin D is now "good". In the summer I was getting some sunlight. I wanted to know if it had dropped during the winter months.

    There are online places that offer all the blood tests. I guess that is one alternative when the doctor refuses.

  • Dr. Davis

    9/30/2007 3:33:00 AM |

    Anne-

    You echo a repeated complaint we get: It is a frequent stumbling block  requesting laboratory tests (or other test, for that matter) that are clearly beneficial, but beyond the comprehension of your doctor.

    We are searching for solutions. Our collective efforts will, given sufficient time and inventiveness, lead us all to a practical answer.

  • Anna

    1/21/2008 8:40:00 PM |

    I think you have hit the nail on the head.  I used to think I was fairly well informed on health and that my doctor was giving me excellent care.  But over a few years I realized I had a lot of "not sick but annoying" health problems.  My *former* primary care doctor (I had seen her for a decade) was willing to prescribe for some of the symptoms but didn't seem interested in the "big picture" and even dismissed my theories.  She missed or dismissed so many things (hyperglycemia, hypothyroidism, relaxed pelvic ligaments), even when I asked about these conditions.  It was a rude awakening for me and I found other doctors who treated me with the appropriate treatments (rather than just Rx for symptoms) or at least listened to my ideas and I am much improved.  Now I am a much more informed patient and I don't hesitate to question, re-question, and learn on my own.  

    And while I don't like the idea of "shopping around" for a "puppet" doctor who will just do as I say, I have learned it is a good idea to get additional opinions (even if it means paying out of pocket) or try a new PCP, even within the same network (my HMO lets me see any PCP in the same network).   I made a huge mistake thinking that my former doctor couldn't have been wrong or that a long history with a doctor was better than starting all over with a new PCP.   I now realize that I am part of the team for my healthcare, even the leader sometimes, not just a passive observer.

  • Anna

    1/24/2008 12:14:00 AM |

    I think you have hit the nail on the head.  I used to think I was fairly well informed on health and that my doctor was giving me excellent care.  But over a few years I realized I had a lot of "not sick but annoying" health problems.  My *former* primary care doctor (I had seen her for a decade) was willing to prescribe for some of the symptoms but didn't seem interested in the "big picture" and even dismissed my theories.  She missed or dismissed so many things (hyperglycemia, hypothyroidism, relaxed pelvic ligaments), even when I asked about these conditions.  It was a rude awakening for me so I found other doctors who treated me with the appropriate treatments (rather than just Rx for symptoms) or at least listened to my ideas; two years later and I am much improved.  Now I am a much more informed patient and I don't hesitate to question, re-question, and learn on my own.  

    And while I don't like the idea of "shopping around" for a "puppet" doctor who will just do as I say, I have learned it is a good idea to get additional opinions (even if it means paying out of pocket) or try a new PCP, even within the same network (I now know my HMO insurance lets me see any PCP in the same network).   I made a huge mistake thinking that my former doctor couldn't have been wrong or overlooking anything or that a long history with a doctor was better than starting all over with a new PCP.  

    Now I am part of the team for my healthcare, even the leader sometimes, not just a passive observer.

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