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Be informed – PSA screening tests — 5 Comments

  1. I sometimes wonder if the healthcare system avoids pragmatism. By encouraging the PSA, in the name of best practice, a doctor/hospital has the potential to make a lot of money. This video highlights that statistically speaking, there is very little benefit outside of the highest risk population. Pushing a slew of tests on a patient may just increase the amount of follow up care whether it is required or not. I agree with your response to Ray, knowing what tests are being performed and what you may want to do with the data is the key to taking control of your health care!

    • Hi Nathan, there is no doubt in my mind that many less-than-helpful screening tests are being ordered because they generate more income. Doctors don’t get paid much to just talk to a patient. They get paid to “do” something; the bigger the better. That’s why urologists are still dependent on the PSA as treating prostate cancer pays their bills. Our system is not practical, and it is full of perverse incentives and conflicts of interest. Thanks for your comment! FN

  2. Every year, a PSA screen, at this point I don’t think it’s going to change in my lifetime. Seems to be a “package deal” for routine blood analyses. The only thing that has changed is how I would respond to a PSA increase beyond that due to BPH for a man my age.

    • Hi Ray, you’re right. A lot of unnecessary screening blood tests are routinely bundled together and the patient bears the burden of knowing what is being ordered, asking why, and saying no. Sometimes the physician doesn’t even know every test that is being done–he or she just orders a pre-designed package for your gender and age. I’ve learned to ask for a printed out list of ordered lab work before going to the lab so I can strike off the tests I don’t want.

      Thanks for the comment! FN