The content here is not a substitute for professional medical advice, diagnosis, or treatment.
Through my interactions with doctors, I’ve noticed that I was sometimes given suboptimal advice. I’d like to share a few examples that highlight why it’s important for us, as patients, to be informed about different conditions.
Exercise Stress Testing
There is a test in cardiology called stress test, where patient basically walks on a treadmill, which makes the heart work harder and an electrocardiogram (ECG) monitors heart's electrical rhythms. It is done to detect a narrowing or blockage in one or more coronary arteries. The idea is that when the heart works harder, the narrowed vessel may not be able to handle the extra rush of blood needed by heart - and this should be detected by the test. This test is often recommended when the patient has chest pain.
I have done such test myself. And on one of the visits, cardiologist also mentioned I could have done it routinely if I liked.
Now, here comes the problem. As far as I am concerned, routine stress tests are not recommended already for more than a decade:
The U.S. Preventive Services Task Force, an independent panel that makes recommendations to doctors, urges physicians not to routinely offer exercise stress testing to people without symptoms or strong risk factors for CAD. Physician groups like the American College of Cardiology support this recommendation.
One of the reasons likely is the following. As noted stress testing can be helpful to detect blockage in one or more coronary arteries. However, it detects those cases, when there is 70% or more blockage. Heart attacks on the other hand often happen when smaller blockages (less than 70%) rupture and form a clot. So doing routine stress tests could give you a false sense of security. Now, I would like to point out that this test can be still useful when someone has chest pain. The presence of chest pain, if caused by a blockage, suggests there may be a significant blockage of the arteries, so doing a stress test at that point can be more useful.
Another reason why doing unneeded stress can be harmful is that this test (like many tests) can give false positives (this happens roughly in 10% of cases). When this test gives false positive result, patient usually has to perform an invasive procedure called coronarography, which comes with its own risks.
Gallbladder Polyps
Once I went for a repeat abdominal ultrasound for a gallbladder polyp because I was interested in certain features of the polyp. However, I found out the doctor performing the scan was not willing or able to assess those features. Anyway, they mentioned that if there is a polyp I should consider a cholecystectomy (removal of gallbladder). Now usually the doctor performing the scan is not the one to recommend treatment, but I am mentioning this case, because they voiced their opinion anyway. I told them that polyps of size less than 4mm are considered very low risk and cholecystectomy is not advised in those cases based on the guidelines (unless there are some other risk factors) - on which he responded that size did not matter that much and seemed somewhat skeptical of the guidelines.
Final Thoughts
To sum up, while being informed is important, I am not suggesting that we should ignore a doctor’s advice without due consideration. Sometimes, we may not be aware of all the reasons behind a recommendation. That’s why it is usually wiser, if possible, to discuss any questions or concerns directly with the doctor.