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I’ve seen a lot of doctors over the past 20 months. A lot. Recently, I went to an endocrinologist for some routine blood work. While I was there the doctor decided she wanted me to get a thyroid sonogram and a bone density test. I asked her why. She felt a nodule on the thyroid, she said. Okay, I told her I would let her do the sono. But why did she want me to get a bone density scan? I was so thin, she said. So thin?!? I was incredulous.

What are the reasons to give someone a bone density scan, which is x-rays of the hip and spine? The National Osteoporosis Foundation suggests that the following list of folks should consider a test:

  • women age 65 or older
  • men age 70 or older
  • someone who has broken a bone after age 50
  • women of menopausal age with risk factors
  • postmenopausal women under age 65 with risk factors
  • men age 50-69 with risk factors
  • someone who had an X-ray of the spine showing a break or bone loss
  • back pain with a possible break in the spine  
  • height loss of ½ inch or more within one year
  • total height loss of 1½ inches from your original height

So no, I don’t fall into any of those categories. I turned down the test. The doctor was not pleased. I figured I probably cost her a few hundred bucks not to mention the opportunity to use the new toy in her office.

This happens over and over every day. Doctors, who are seeing less reimbursement from insurance companies, are looking for a way to raise payment-per-patient numbers. One good way: Sending patients for tests in their own offices.

Of course, most doctors are smart, thoughtful professionals who want to help and follow the “first, do no harm” principle. But as a patient, you need to be aware that you are not just a patient but a CUSTOMER. You are the one who controls your own health. You MUST be an advocate for yourself and for your family.

As for my experience: I probably won’t be going back to that doctor. Yes, she was nice, but I don’t completely believe she had my best interests in mind. Have you had a similar experience? I’d like to know.

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