First published on October 21, 2011, I think reading this again is necessary!
In “Doc, Do I Need That Test?” (http://livewellthy.org/2011/02/10/doc-do-i-need-that-test.aspx), I attempted to define what is “necessary” from a medical point of view. Necessary is one of those ambiguous words, defined differently by patients, their spouses, docs, insurers, and Medicare.
When I began practicing medicine 30 years ago, my patients trusted me to know what was necessary. As I matured as a doctor, I began trusting my patients and included them in the process of deciding the necessity of any given treatment, procedure, or medication. In recent years, my patients and I have lost our right to define necessity to a clerk who answers an 800 number and follows a computerized protocol as well as to the news media.
The problem is that I always know what was necessary after the fact. The magic “retrospectascope” is an all knowing tool. If only we had one. Since we don’t, the best my patient and I can do is to look at all sides of an issue and go with our best judgment.
What defines “Unnecessary” care has become a great point of contention in society and in every day practice. Dr. Darrel White’s article on KevinMD looks at the necessary/unnecessary debate through his lens, http://www.kevinmd.com/blog/2011/10/unnecessary-care.html. It is well worth reading. Hopefully, your vision is good enough to enjoy it!
I think I just saw a white Crown Vic drive by. I better go out and check on my dogs. If you don’t understand this comment, read the article.