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[collegekidsmom]

They always call my house and tell the blood results over the phone. The big one in my area lately seems to be Vitamin D. If you any blood appt at all, they want to test for Vitamin D-it just seems out of the blue. They always want to push some kind of drug anyway, so they leave the message and say to call back. I usually don't.
Just yesterday, they left mammogram results for a family member on the house phone. You'd have to specifically tell them not to leave information or they will do it.

[scampster]

Yes, they did, kinda. The nurse (or whoever called me) mentioned that the cholesterol number (for which, as I said, I hadn't wanted to be tested) was problematic, but she wouldn't say exactly what the number was. Even more frustrating, she wouldn't tell me, or even hint about the results of the test that I did request, and am particuarly interested in (the hormone levels).

I can see getting other info while they have your blood (since I imagine some things are useful indicators), but all the cholesterol tests I have done have involved fasting ahead of time. It seems odd for them to do cholesterol if you didn't know that was being done (and consequently didn't fast before it).

[unspoiled]

They always call my house and tell the blood results over the phone. The big one in my area lately seems to be Vitamin D. If you any blood appt at all, they want to test for Vitamin D-it just seems out of the blue. They always want to push some kind of drug anyway, so they leave the message and say to call back. I usually don't.

From my own experience as a patient, I was diagnosed presumptively, then diagnosed positively, and successfully treated for vitamin D deficiency, all quite recently thanks to our family physician's concerns (due to my insistence based on family history he also tested for thyroid hormones and calcium which came back normal). It's not like vitamin D is some brand-new expensive drug, so unless I'm missing something big here I doubt that, in principle, it would further any doctor's personal agenda to "push" for it.  But then again, as a patient, I always call the doctor back, if nothing else than to double-check what the nurse (or whoever) said on the phone, and to ask lots of questions.  

[treehugger1]

Yes, they did, kinda. The nurse (or whoever called me) mentioned that the cholesterol number (for which, as I said, I hadn't wanted to be tested) was problematic, but she wouldn't say exactly what the number was. Even more frustrating, she wouldn't tell me, or even hint about the results of the test that I did request, and am particuarly interested in (the hormone levels).

I can see getting other info while they have your blood (since I imagine some things are useful indicators), but all the cholesterol tests I have done have involved fasting ahead of time. It seems odd for them to do cholesterol if you didn't know that was being done (and consequently didn't fast before it).

Yeah, I was going to mention the fasting issue earlier. That was one of the strange things about the whole deal. Like I said, I asked the Dr. for a blood test for the hormone levels (only). As he was preparing the script (order or whatever you call it) I mentioned that I was going to get the test done on the way home. So, I go to our lovely little blood testing establishment, wait for 30 minutes, only to have them tell me that I needed to fast before the test. I was surprised, since my Dr. never mentioned the fasting to me. But, I supposed it was something I had to do for the hormones. So, I went home, fasted that night then, made a special trip back the next morning (and waited -- I kid not -- 1 and 1/2 hour).

In any case, now I'm even more miffed: I wound up taking an entire morning "off" just to get a test I didn't even want?!?!
Wow!

[patchouli]

Treehugger,

It sounds like we're similar in seeking out the same kind of doctor/patient relationship.  I looked for a doctor who would communicate directly and openly and consider me as part of the overall dialogue in terms of my treatment.  I shopped around until I found a wonderful family doctor who did this after a straight-out-of-the-book horror experience with a prior gynecologist.  My present and wonderful doctor often calls me herself with many of my test results, or will call me if the nurse doesn't answer my questions.  Last time I was in I had a test for thyroid and she gave me a complete panel anyway, but I also trust her completely, and she knows that.  In fact, years ago when I was being resistant about a treatment for a female problem (she had sent me to a specialist), she called me herself, out of the blue, to talk about it with me and offer her advice. 

And Frogfactory, I've had most of my test results with my family doctor given over the phone, and she often will discuss treatment options with me that way.  I wouldn't want to have to go back in person, unless the news was of the very bad kind.

But Treehugger, I think think the issue is larger in your comfort level with your doctor, and your trust, and maybe that is the bigger issue for you and that is what you are sensing?

I'm sitting here attempting to calm an intense annoyance, so I thought I'd sollicit others' opinions on the matter at hand.

My doctor's office just called saying that, according to the blood test I had done Monday, my cholesterol level is iffy, and that I should make an appointment for a follow-up.

But here's the thing: I went to the doctor's last week, -- with no health complaints whatsoever -- merely to request a blood test to determine whether or not I was menopausal. I did not request any other blood work to be done. Nor do he or anyone at the lab tell me what they were conducting tests for other health issues. Yet, apparently they did.

Is this normal? Should someone at least have mentioned what (else) was being tested?

Why am I annoyed (aside from the lack of communication/consent)? I have some reason to believe that my Dr. is a kind of drug/medical procedure pusher. (Example: On my SO's first visit, he was asked -- out of the blue --- if he had "erectile disfunction"!) I'm concerned that when I do go for the follow-up (which I need to do to get the results about the hormone levels) he'll urge me to start taking medication for this new "problem."

[unspoiled]

It's not like vitamin D is some brand-new expensive drug, so unless I'm missing something big here I doubt that, in principle, it would further any doctor's personal agenda to "push" for it.

Correction: I meant to write "my" doctor, not "any", and tried to correct it at the time but managed to go over the editing time limit again.  I was referring solely to my own experience as a patient so obviously please do not construct this as medical advice of any kind as it was not intended that way.

On-topic: Treehugger, hugs and health wishes despite the lack of really relevant contributions. 

[onion]

I had an endocrinologist who always ran a cholesterol test whenever he pulled blood, and I didn't think about it or even care until my health insurance company stopped paying for it--and it turns out it was hundreds of dollars.  I complained to one of the techs in the office, and she confided in me that the doc got "kick backs" for requesting this particular kind of cholesterol lab work.  When I then went in for my consult with him, he started pushing statin drugs.  I told him where to shove it and got a new endo.  I was about 25 years old at the time and was in very good health, with the exception of the very peculiar disorder he was treating me for, which does not present "high cholesterol" as a side effect or even matter of concern.

Find a new doc.

[treehugger1]

I had an endocrinologist who always ran a cholesterol test whenever he pulled blood, and I didn't think about it or even care until my health insurance company stopped paying for it--and it turns out it was hundreds of dollars.  I complained to one of the techs in the office, and she confided in me that the doc got "kick backs" for requesting this particular kind of cholesterol lab work.  When I then went in for my consult with him, he started pushing statin drugs.  I told him where to shove it and got a new endo.  I was about 25 years old at the time and was in very good health, with the exception of the very peculiar disorder he was treating me for, which does not present "high cholesterol" as a side effect or even matter of concern.

Find a new doc.

Interesting story. Do you have any more detailed info about the "kick backs?" How the system works, etc.
I have a hunch something like this is going on in my doctor's case.

I've decided to set about finding a new Dr. I also just called the office of my current Dr. and requested that they simply mail me the results. The receptionist put up a fight on the phone, but I got her to at least look into the possibility for me (asking the Dr.'s permission).

After having spent about 5 hours yesterday reading up on Cholesterol and statins, I can pretty much see where this is leading. Three troubling things I learned:

1) According to John Abramson, a truth-telling Harvard Med School prof, the pharmaceutical industry has so corrupted the medical establishment that even articles in top journals now show clear signs of bias (and hence are no longer to be trusted).

2) These -- shall we say -- not entirely disinterested researchers are now suggesting that statins may benefit even healthy patients -- people who have normal cholesterol levels as well as

3) children, although there have been no studies done on the long term effects of these drugs.

I am so not going there.

[onion]

I had an endocrinologist who always ran a cholesterol test whenever he pulled blood, and I didn't think about it or even care until my health insurance company stopped paying for it--and it turns out it was hundreds of dollars.  I complained to one of the techs in the office, and she confided in me that the doc got "kick backs" for requesting this particular kind of cholesterol lab work.  When I then went in for my consult with him, he started pushing statin drugs.  I told him where to shove it and got a new endo.  I was about 25 years old at the time and was in very good health, with the exception of the very peculiar disorder he was treating me for, which does not present "high cholesterol" as a side effect or even matter of concern.

Find a new doc.

Interesting story. Do you have any more detailed info about the "kick backs?" How the system works, etc.
I have a hunch something like this is going on in my doctor's case.

<snip>

This came from the tech, but my former doc was receiving cash-- a percentage of the fee paid for the test.  I had to pay his office directly for the cholesterol tests because my insurance company deemed them not medically necessary (I don't know all the details, but it was a more involved, expensive, and experimental kind of cholesterol test, not the basic cheap-o one that any GP can order.).  He was also one of those docs who would go on junkets to the Caribbean on the pharma rep's tab, sit through the two hour "seminar" on the benefits of whatever statin drug they were hawking, and then spend the rest of the week playing golf and frolicking.

The bigger issue for you, as I see it, is that you don't feel comfortable with your doc, and if I'm remembering some of your older posts correctly, you have some longer-term health issues.  Find someone you are comfortable with.  FWIW, the endo I found to replace the creep would email me my lab results if they had changed significantly and therefore necessitated a change in meds or a follow up visit, and always sent the lab report through the mail.  At the very least I think that getting your labs in the mail is SOP.

Good luck.  Finding a new doctor is agonizing.

[sikora]

Hi everyone! I just wandered by and read this  thread, and felt I had to answer.  

Specific test aside, and speaking generally, there is such a thing as too much testing; sometimes less is more. No diagnostic test is perfect, and there is always the chance for false positives, which can lead to further (costly) testing and unnecessary treatment.  I understand that the blood lipid panel is fairly specific, but still.  If the last test was normal, was done within a certain time frame, and nothing else has changed, there is no need to do the test "just because."   I don't know what the practice guidelines are for the lipid panel, but I don't think is something that has to be done whenever blood is taken for another reason.  

There are these things called practice guidelines, which suggest when and how tests should be done, based on findings from health services research on outcomes, efficacy, and cost effectiveness. Much of that research funding by the NIH (I was an NIH postdoc in health services research and public health). The findings of that research is what Obama is in part referring to when he speaks of reigning in the cost of ineffective and wasteful treatment, stuff that we pay for but that doesn't contribute to well being (ike unnecessary laboratory tests). I think that some people don't understand this. Culturally, we place the authority to determine medical need in our individual doctors, not in practice guidelines, and thus practice guidelines seem like rationing and bureaucracy "coming between you and your doctor."   Insurance companies apply them when it's in their best interests. Pharmaceutical companies may have a vested interest in not supporting conservative practice guidelines.  Just another contradiction in the US health care "system."

People watch too much House.  House is very bad medicine.

The other thing:  I want to know what I'm being tested for; there's this thing called informed consent.  This could be construed as unwarranted medical surveillance.  

[unspoiled]

People watch too much House.  House is very bad medicine.

Welcome back!

[collegekidsmom]

I wonder if the tens of millions of Americans taking statins will realize all of the supposed benefits. They are pushing statins like crazy here-yes, even for people with normal numbers.  I wonder how people survived without Lipitor in years past. They were talking about treating children even when my kids were younger-maybe 10 years ago. As for Vitamin D, when they called and left that message for the test I didn't ask for, they said on the phone "your vitamin D levels are fine, so continue taking whatever supplements you are taking for Vitamin D- because they are working!" Of course, they assume that you are taking all kinds of stuff already-even without asking you about that.

[spork]

If you don't feel comfortable following a physician's recommendations then the physician either

hasn't effectively communicated the rationale for those recommendations to you

or

is wrong

or

both.

Whatever the case, the solution is to find a new physician.  Someone in the physician's office should have explained why he (I'm assuming a he) was ordering a cholesterol test and that that's why you needed to fast.  Then you could have consented or rejected the test.


The vitamin D issue is different.  Recent studies indicate that over half of the American population may be vitamin D deficient.  There's a reasonable chance that a deficiency will be found in anyone who is tested, and vitamin D supplements are over the counter and very cheap.

[glowdart]

If they won't send you a copy of your test results, then send them a letter with your name & information requesting a full copy of your medical file.  (Actually, I'd do that anyway.)

[t_r_b]

He was also one of those docs who would go on junkets to the Caribbean on the pharma rep's tab, sit through the two hour "seminar" on the benefits of whatever statin drug they were hawking, and then spend the rest of the week playing golf and frolicking.

My mom was right: I should have gone into medicine.