Comment by maxxxxx | Hacker News Reader

Comment by maxxxxx | Hacker News Reader

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This sounds familiar. I have watched now quite a few people go through serious diseases. One pattern I saw was tests, tests and more tests. A lot of them very expensive, time consuming and painful. But when you ask what they will do with the test results there often is silence. To me it looks like they are doing something because “we need to do something”.

Reminds me a little of data collection practices at companies. Sucking up more data feels like you are doing something. But using the data is much more difficult and often doesn’t happen.

As a patient (or a patient advocate for a loved-one), anytime a test is proposed it is important to ask what actionable information can come out of it. Basically look 2 steps ahead.

Some tests will help confirm a course of treatment, or propose a new one. But what if that treatment is something you've already decided you won't do? For example in an older patient too old for a surgery or a baby that you've already decided you'll keep.

But you are right, some tests are ordered out of a desire to show that "something is being done". It's important to talk with the doctor about the cost (not just money but pain & recovery) and benefit. Everything is a tradeoff.

"Some tests will help confirm a course of treatment, or propose a new one. But what if that treatment is something you've already decided you won't do? For example in an older patient too old for a surgery or a baby that you've already decided you'll keep.

"

I had the impression that a lot of doctors go through the same test protocols independent of patient situation. They are more deliberate with the actual treatment but there seems less thought about the necessity of testing.

It also varies by doctor. Some like to order more tests than their peers. That's why it's important to have a doctor with whom you can openly discuss these tradeoffs. The vast majority are open to that, but some will give you the stink eye if they interpret that as you questionning their algorithm.

> But when you ask what they will do with the test results there often is silence.

With chronic and serious conditions, like in oncology, some tests are pretty much the only way to see if there's any progress with the treatment and how the general health levels of the patient are (bloodtests).

Cancer runs pretty deeply in my family, and I had read the same about breast cancer screenings years ago, re: false positives causing more harm than good, so it'd make sense to see the same trends for other cancers as well.

As far as breast cancer screening goes, the recommendations are for the general population; woman with a family history or other specific risk factors may benefit much more from screening than the general population and/or have different intervals than the general population. This is why communication with physicians is so important.

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