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Comment by william_T | Hacker News Reader

What physician is saying no to preventative medicine paid for by the consumer? Why do doctors think we are visiting for their benefit? I would be very interested in the arguments against blood labs. For the doctor, they draw blood and review results, which is something they do every day. For the patient, you draw blood and review results and pay for it, which is something normal people are not greatly inconvenienced by. The money may be the thing, but why would your physician know your budget? If you want a zero risk preventative procedure, the doctor should tell you how much it is, not give financial advice.

What argument would a doctor have against order a wider range of tests? The blood is outside of your body, and the physician is not in the lab running the centrifuge or mixing chemical agents to react.

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Every Primary Care doctor visit I've ever had in my life (note: USA) felt like a cross between an assembly line and the DMV. It's all about rushing you through the visit as quickly as possible, spending as little time with the actual expensive doctor as possible, and getting you out the door so that other cu$tomer$ can get crammed through after you. Blood labs? They aint got time for that!

And nowadays, to make matters worse, I have to book an appointment for this delightful experience 2 months in advance for my existing doctor, and five months in advance for a "new patient visit" at a new doctor. Everything around Family Doctors says "go away".

> Every Primary Care doctor visit I've ever had in my life (note: USA) felt like a cross between an assembly line and the DMV.

Note that 'the DMV' is itself a bizarre American experience that a lot of the world doesn't put up with/find a need for.

It took quite a lot of references like this going straight over my head to look into this thing 'everyone [in the USA]' has to do and is familiar with and understand. (If I need a replacement driving licence or to change my address or whatever, I spend two minutes on a web form and it comes in the post. There just isn't 'a DMV' or equivalent office for me to (have to) go to.)

The reasoning I heard from a GP is: the more values you get back, the higher the chance of a false positive. A GP who has blood tested will do so based on your symptoms. Get the lab to do all the possible tests, and chances are at least one of them will be off but since you had no symptoms you’re going to have to test again since it might be a false positive. All this takes a lot of time and creates feelings of insecurity with the patient. So where I’m from, there are no ‘check-ups’ within insured or government funded health care, you strictly react on symptoms. There are only checks for specific forms of cancer and you’re invited for this specifically. Don’t know whether this is the best way, but it’s an explanation for the approach.

> What physician is saying no to preventative medicine paid for by the consumer?

its more common than you think; and many professionals resent the idea that its anything resembling a 'free market' where a 'consumer' (patient) can 'order services' without their provider's approval.

as you might imagine there are reasonable-sounding prima facie arguments for both sides of this discussion.

I have to fight with the doctor every time I want something he doesn't deem necessary.

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