mandatory screenings

Jennyisbusy

My friend needs to take thyroid medication daily so that her body doesn't shut down and die. In order to get this medication a yearly doctors visit is required and usually a blood test is done to verify that the medication is at the appropriate dosage. Ok enough I guess.

The past few years though the doctors office tells her that she MUST get a mammogram, bone density, cholesterol profile. I know it is for her health but I also feel that she should have the right to choose if she would like to have these tests done.

Should doctors make health screening mandatory by holding an important prescription hostage?

Grimmerick

I am not sure about this because I don't know what medications she is taking, but they might be mandatory tests because of possible side effects of the medication, and they want to regularly check to make sure the medication is not negatively affecting her body. But if they can't give a reason for the link between the tests and the medications then I would say she then has grounds to question them and a right to refuse. My dad is on a new rosacea medicine for his face and they regularly test his kidneys because the medication has been known to cause side effects in some people.

jamk1446

I think it depends on the screening but just in general no. My doctor’s office wants me to get yearly mammograms beginning next year but I’m going to tell them no. I’ve had 2 done 5 years apart and both times they’ve told me there’s absolutely nothing suspicious. I don’t have a history of it in my family nor do I have a lifestyle that increases my risk factors so I’m going to tell her not until another 5 years. If she refuses to continue treatment over it, I will seek out another doctor but knowing our history together and when I remind her of the above facts, I hope she won’t try to make me do it just for the sake of doing it. I just don’t see why you should be forced into procedures if there’s no obvious reason to have it. If you have risk factors, yes, it’s a good idea to follow through with whatever they are recommending.

On the other hand, I do know that doctors face patients who are not compliant in following orders- they don’t take medications as directed, they don’t follow through with appointments, labwork, don’t take ownership of their health. It’s hard to treat a patient who won’t work with you. And in those cases, I think it’s fair for the doctor to say, “unless you become compliant, I can’t take the liability for your health and I won’t treat you anymore.” But this sounds like it’s just a blanket “do it or else” policy. That’s not ethical in my opinion if that’s really enforced that way.

TheRoadDog

If you don't agree with your Doctor, get another Doctor. One that you feel you can work with.

On the other hand, sometimes certain exams are mandatory. Especially when my wife recommends it. She was on me to get a colonoscopy for 10 years. Couldn't stand it anymore, so I scheduled it. After a couple drinks and a few meds, it was just like any other Friday Night.

mayerel

I think, as Emmy pointed out, sometimes there are side effects to medications or complications that could occur with a known health problem thus making the tests more important.

I know when I was on cholesterol medication I had to have a liver function test every year to make sure there was no adverse effects. In order for my doctor to prescribe my BC she requires I have a pap every other year. I think the docs need to do this in order to keep you as healthy as possible and to cover their *kitten*. As Jamk pointed out there are people who are non-compliant with medications or don't take them properly and there could be adverse reactions and the doctor would be held liable.

Yes, you should have the right to choose your medical treatment, but part of that is finding a doctor willing to work within your parameters.

Jennyisbusy

The blood workup is related to the medicine and reasonable. The other tests are just the standard 'based on your age and gender' type screenings.
In this particular case, if she didn't need the medicine they wouldn't really have a way to 'force' her to have the tests. I just find it absurd, almost that they are hinting that she is not capable of deciding what is best for her, or possibly have found an easy way to squeeze a few more dollars.

debloves2ride

If it is to safeguard againse medication side effects then the doc has the right to say "you must have this". In general I don't think they should demand that you get certain test, treatments etc. I usually go with what the doc recommends, after all he is a doc. Many times I think the doctors are doing just for CYA - to many people are sue happy and if the doc didn't order a mammogram and then a patient got cancer (as an example) many people would blame it all on the doc and sue the pants off him. (or her)

aliciagetshealthy

First off, mandatory by whom? Is it the doctors who are requiring it? Or, is it a requirement through the insurance carrier, who is responsible for the bills, and then requires the doctors to perform said tests on schedule?

I think it should totally be up to each individual if they want to submit to a test or not. But, if you are in effect asking someone else to bare the cost for your health choices, should they not have some say in what you are required to do to stay healthy and reduce their cost risk?

macpatti

I had an OB/GYN once that would drop patients if they didn't follow his orders regarding regular exams. We were free to find another doctor if we didn't like his policies. He would say, "I don't want any of my patients dying on my watch because they didn't take the necessary precautions". So, I'm fine with a doctor refusing to refill a script becasue the patient won't follow orders.

mayerel

I think another reality is that the doctors don't always know how a medication or condition might effect other parts down the road, so they do need to cover their *kitten*, but it also acts as early prevention. We simply don't know everything the human body is capable of and we, as a society, hold doctors responsible.

If someone didn't do the tests and got cancer they would (could) argue that their doctor didn't make them take the test. There is little sense of personal responsibility these days. On the flip side, I choose, after I did my own research, to get off my cholesterol medications, my doc threw a fit, guess what, I got a new doc. And if I have a heart attack, it's only my fault.

LuckyLeprechaun

Where is this situation taking place?

In a country with socialized medicine, it makes perfect sense, because the public is footing the bill for her health care costs.

In the US (so far) we don't work that way, so there would be no way to enforce such a thing.



This kind of reduction of personal liberty is just one of the reasons I do not think socialized medicine is a good or feasible idea in the US.

UponThisRock

Doctor might just be trying to cover himself. More diligence = harder to sue him.

Jennyisbusy

First off, mandatory by whom? Is it the doctors who are requiring it? Or, is it a requirement through the insurance carrier, who is responsible for the bills, and then requires the doctors to perform said tests on schedule?

Good point. I am pretty sure the doctor is the voice behind the order. In here case she has one of those health accounts and actually writes out a check for each procedure and only keep major medical insurance. Maybe if she had insurance to 'write the check' she would have never even flinched?

Lucky - I am talking about the good ol' US of A!

LuckyLeprechaun

Then isn't it just a matter of changing doctors?

I was imagining you might be British, under their National Health plan, or something similar.

aliciagetshealthy

First off, mandatory by whom? Is it the doctors who are requiring it? Or, is it a requirement through the insurance carrier, who is responsible for the bills, and then requires the doctors to perform said tests on schedule?

Good point. I am pretty sure the doctor is the voice behind the order. In here case she has one of those health accounts and actually writes out a check for each procedure and only keep major medical insurance. Maybe if she had insurance to 'write the check' she would have never even flinched?

Lucky - I am talking about the good ol' US of A!

In that case, I'd find another doctor. I think they can make recommendations, and talk about risk factors associated with age, but to withhold known needed medication is unacceptable. If she's the one writing the checks, then in my opinion, it's entirely her choice whether she wants the tests done after the doctor has given his reasoning for wanting the tests.

As an aside, I feel that if the doctor has given the talk and the patient declines the testing, they should have zero recourse against the doctor in case of illness/disease that could have been prevented or caught early if the tests had been done.

my $.02

Jennyisbusy

As an aside, I feel that if the doctor has given the talk and the patient declines the testing, they should have zero recourse against the doctor in case of illness/disease that could have been prevented or caught early if the tests had been done.

Absolutely!

PlanetVelma

I have Kaiser, so they are VERY big on preventative medicine, they basically forced me to have my last pap smear (yay). I'm a huge procrastinator so I was kind of annoyed because I had to do that before I could talk the dr about anything else.

I WISH they would've done that with my husband's mom. She ignored her notices for her colonscopy....guess what? Yup, she was diagnosed w/ colon cancer, had emergency surgery, etc... She's been going through chemo, surgery, radiation, etc...since July of last year.