How to Talk to Speak Your Doctor's Language

A woman should get her first Pap smear at age 21, and every year afterward.

Every man needs a PSA test.

A child who gets conked on the head should have a CT scan, “just in case.”

If a generic statin is good, then a brand-name one is better.

Not necessarily so, says Dr. Nancy Van Vessem, clinical director of Tallahassee’s Capital Health Plan. Research shows some medical testing and treatments that have become routine can be unnecessary and wasteful — and, at times, lead to medical interventions that are unhelpful and even dangerous. “The science is showing us we’re probably doing things we shouldn’t be doing,” she said.   

Take the PSA test, once used as an early warning system for developing prostate cancer. 

“Now, PSA testing for prostate cancer is basically out. It’s a test that never was meant to screen for prostate cancer,” said Van Vessem. “It was a test you used in following men who already had it to see if the therapy (was) working. Even the guy that developed the test doesn’t think it should be used for screening, but it was put into practice that way.”

The American Board of Internal Medicine Foundation asked the professional societies of several medical specialties to each come up with a list of “Things Physicians and Patients Should Question” when providing or receiving health care.

Twenty-six specialty groups have developed lists and more, including dermatology, surgeons and orthopedic surgeons, are scheduled to provide their lists this fall. In addition to the lists, which can sound a little like “doctor-speak,” the site also includes patient-friendly write-ups with the imprimatur of Consumer Reports.

The site, say its creators, does not dictate hard-and-fast rules, but is designed to open a dialogue between patients and doctors. 

The lists and information can be found at choosingwisely.com.

What the Doctors Say

Here’s a sampling of the suggestions made by doctor/specialist groups:

» From the American Academy of Pediatrics: Cough and cold medicines should not be prescribed or recommended for respiratory illnesses in children under four years of age.

» From the American Geriatrics Society: Don’t recommend percutaneous feeding tubes in patients with advanced dementia; instead offer oral assisted feeding.

» From the Amercian College of Obstetricians and Gynecologists: Don’t perform routine annual cervical cytology screening (Pap tests) in women 30–65 years of age.

» From the American Academy of Family Physicians: Don’t do imaging for low back pain within the first six weeks, unless red flags are present.