PSA stands for Prostate-Specific Antigen. It’s a blood test used to screen for prostate cancer.
Doctors used to recommend an annual PSA test for men over 40. But now we know that the PSA is not a good screening tool. It results in a high number of false positives, and not all forms of prostate cancer need to be treated.
Too many men have received unpleasant, expensive treatment they didn’t need.
In an excellent YouTube video, Dr. Mike Evans explains more:
In 2012 the United States Preventive Services Task Force (USPSTF) recommended against … Continue reading
I read two articles yesterday that complemented each other:
In Kaiser Health News (KHN) Heavy Use Of CT Scans Raises Concerns About Patients’ Exposure To Radiation
And on KevinMD two radiologists posted The financial costs of treating CT-induced cancer
Each underscores the fact that CT scans are significantly overused in American healthcare.
Although CT scans are an essential diagnostic tool, the Food and Drug Administration reports that an estimated 30 to 50 percent of imaging tests are believed to be medically unnecessary.
Considering we spend tens of billions of dollars every year on diagnostic imaging, that’s a lot of wasted … Continue reading
When my son was about 10 years old he got an infected blister on his foot. I took him to the pediatrician to have the abscess drained, and then he was given a prescription for Augmentin, a fancy and expensive form of amoxicillin.
(If I knew then what I know now, of course, I would have 1) questioned whether an antibiotic was really necessary, and 2) wasn’t there a cheaper alternative to a brand name drug?)
Within 24 hours of taking the Augmentin, my son developed a terrible case of hives starting on his infected foot and eventually running up … Continue reading
I’ve spent most of the holiday weekend happily engaged in reading through a pile of health care books.
And the one I absolutely have to recommend to everyone is The Patient’s Playbook: How to Save Your Life and the Lives of Those You Love by Leslie D. Michelson.
Michelson is not a physician, but has worked in the health management field for more than 30 years, helping individuals and companies navigate our crazy health care system.
Based on his experience, he has organized his book into three sections. Each chapter ends with a helpful “Quick Guide” of the most crucial … Continue reading
A few months ago I posted about CYA—Cover Your Ass—medicine being one reason why too many diagnostic tests are ordered and health care costs are high.
CYA medicine is when the doctor or doctors are pretty sure what your problem is, but they order extra scans and x-rays and blood tests anyway because “failure to diagnose” is one of the leading causes of medical malpractice suits. They aren’t going to take any chances, and who can blame them?
Related story from KevinMD: This is why doctors practice cover your ass medicine
Besides, they don’t pay your resulting medical bill, so … Continue reading
October is Breast Cancer Awareness Month, so I can’t let it pass without commenting on the American Cancer Society’s (ACS) recently updated screening mammogram guidelines.
Before, the ACS recommended annual mammograms starting at age 40.
Now they recommend annual mammograms for ages 45 to 54, with screening mammograms done every other year after age 55.
But, they add, women should still have the choice to start screening at age 40 and have yearly mammograms thereafter.
The confusion arises not only because the ACS is a bit wishy washy on its guidelines, but because the American College of Obstetricians and … Continue reading
I’ve written several posts about Choosing Wisely, an initiative launched in 2012 by the American Board of Internal Medicine (ABIM) with the mission of decreasing the use of unnecessary health care.
Overuse of diagnostic tests, screening tests, surgeries and drugs is rampant in our health care culture, and it’s costing billions of dollars every year, not to mention that some patients are actually harmed by overtreatment.
It’s a noble goal, but the burden is on the consumer—the patient—to read and use Choosing Wisely’s lists of inappropriate treatments because a recent analysis shows that physicians are not paying enough attention … Continue reading
When you go to the grocery store is your cart full of “free” foods, such as soy-free, dairy-free, egg-free, gluten-free, nut-free, peanut-free, etc.?
With so many of these products being heavily marketed, and poor health information being widely spread on the internet through Facebook, blogs and other social networking sites, it’s easy to make assumptions about food allergies for your and/or your children.
Common symptoms that everyone gets occasionally—nausea, diarrhea, acne, fatigue, weight gain, rashes, and sinusitis—are frequently misdiagnosed as food allergies or intolerances.
I have had many friends over the years who have told me they or one of … Continue reading
A friend of mine sent me a link to this story: Left in the Brain: Potentially Toxic Residue From MRI Drugs
Most MRIs, a common diagnostic imaging test, require you to be injected with a “contrast agent” that allows the images to be more defined and therefore more useful.
It’s been known for some time that these agents can be harmful to people with impaired kidney function, so in those cases radiologists will use a more kidney-friendly agent or do without.
But now it appears that some of these contrast agents, specifically the gadolinium agents (that just sounds toxic, doesn’t … Continue reading
“Cover-your-ass health care” or “save-my-ass medicine” are terms used to describe all the extra diagnostic tests (blood tests, CT scans, MRIs, etc.) ordered by physicians to rule out possible (but unlikely) life-threatening conditions.
Such as going to the emergency department with a headache and getting a CT scan to rule out an aneurysm or a brain tumor.
Or, as in this video example, being worked up for a heart attack when the most likely diagnosis is a simple case of heartburn. (Warning: video contains some bad language!)
The ER physician in the video is certainly … Continue reading