When a panel of leading medical experts concluded this spring that patients were receiving too many medical tests – often to their detriment – it was another reminder of the fallibility of the medical profession and a wake-up call that we all need to take charge of our own health. "Doctors don't know everything," says Dr. Emily Rubenstein Engel, a physician at San Diego's Scripps Clinics.
The age of the family doctor is over. There was a time when physicians had only a handful of patients, rarely farmed them out to specialists, and didn't make decisions influenced by pharmaceutical incentives, insurance policies, or the constant threat of malpractice suits. These days, managing your own health care is largely up to you – no matter how eminent your physician or how much you're paying. More doctors are specialists, reluctant to diagnose or treat beyond their field, and are overbooked and overwhelmed by patient quota, hospital demands, and insurance-company red tape.
You have to be your own health advocate – to ensure that you see the best physicians, get enough time with them, ask the right questions, and are given the right drugs and tests, so that you can make lifestyle changes to treat and prevent problems. "Optimizing your health is not something you do at your doctor's office – it's something you do with yourself every day," says Dr. Jacob Teitelbaum, an integrative physician and national authority on men's health issues. "You learn about your health, you learn about medicine, you learn about medical tests, and you become your own damn expert."
Here are a few hard and fast rules to help you take control of your health care. Launch Gallery >>
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Be wary of tests.
Medical tests like MRIs, CT scans, and X-rays can be helpful. But the problem with them – and the reason a task force recently recommended that doctors limit the number of tests they order – is that medical screening often finds abnormalities that aren't the root of a patient's problem.
In the case of many complaints, such as lower-back pain, medical tests offer little insight, and the prescription remains the same: rest. If a doctor orders you an X-ray, then a CT, and then an ultrasound, all in his own lab, you should run the other way, says Mordkin, because it's likely that physician stands to profit from the tests, and you can't be sure whether he's operating with his or your best interests in mind. On the other hand, "If we're concerned you have something serious, like a kidney stone, and you're in a lot of pain, that's a good time to get a CT scan of your kidney. It depends on your symptoms and presentation."
Bottom line: Ask your doctor why you need that test, what he hopes to tell from the results, and how it will affect your treatment.
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