Parents/Patients demanding investigations

[15isto2]

I am from the UK and was reading a thread on a US disney forum where a parent stated that he "demanded they do a CT" on his son. Just wondering how common demanding investigations was and if patients get them given that they may not be indicated (in the case in question an ultrasound would have been more appropriate if any investigation was to be done)

[ZippyGBR, BSN, RN]

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I have heard that in government run medical areas that tests may not be run unless "justified". (Not sure)

in the case of the UK it's nothing to do with funding for medical imaging it's because of the radiation protection legislation and the nationally agreed standards of care (RCR purple book ) i.e. where Ultrasound gives adequate diagnostic information CT will not be performed, it's increasingly rare to demand plain films before a CT where the plain films will make liittle difference.

path lab tests it's the ' will this result make a difference to patient management ?' rather than blindly doing every test an analyser can do on a sample just because...

Anyway, I remember recently getting a call from the Cardiologist at the base hospital. He didn't understand *why* and echocardiogram was ordered on me. (I am youngish, asymptomatic, BP 90/58, resting P 48-55.) I *asked* to have it done. [My father has CHF. My older sister and younger brother were recently diagnosed with cardiomyopathy. Looked clearly genetic to their cardiologists!] Anyway....my EF is 45! I may have ended up like my dad...undiagnosed CM that is asymptomatic and ending up a CHF instead.

this is intelligent screening, and it's the cardiologist that is the dubious link there, I presume he was satisfied once the familial link was explained to him , who wrote the referral ?

In the US, docs ordinarily try to play it safe and run the extra tests. It does drive up the cost of medical care. It is unnecessary in some cases, true. But, when a life is saved....one thanks God for that freedom.

is there any proof that randomly irradiating people actually saves lives or that using tests with poor specificity is of any benefit other than the fee for service providers advocating them , tests should aid or confirm clinical diagnosis.