I worked in a retail pharmacy that offered regular health screenings; vision, hearing, skin cancer, and so on. During one of the events, a dermatologist was busy examining a long line of individuals who want her to look at their spots. I overheard many of the conversations and most of the exams ended with the doctor stating, “we ought to do a simple biopsy and a lab test”, or some similar comments to the participants.
During a break, I asked the doctor why such a high percentage of the visitors needed further testing. She explained that most are excellent at identifying that something isn’t right with their health. The screening is an opportunity to have someone take a look and support their personal diagnosis, or calm their fears. While the doctor told me she would rarely tell someone they actually had a cancerous spot, she felt very comfortable helping the person decide to move forward and do something more about their concerns.
Skin cancer affects approximately three Million individuals, a little more than one percent of the U.S. population. In the screening above, more than 75% recognized their own suspicious spots and were referred for more testing. They came to the screening because they already thought something was wrong.
Hearing screenings are similar. The overwhelming majority of visitors tested poorly and were referred for more advanced testing. Approximately two percent of the U.S. population suffers hearing loss and, again, more than 50% of the participants in the screening had measurable hearing changes.
Screening those participants already have suspicions there was something wrong.
It’s clear that individuals know themselves and their bodies far better than any third party could. They know when “something just isn’t right.” Although their personal evaluations might require attention, it takes a special effort to make that appointment with a doctor to validate those concerns. The person might conclude their concerns are just as likely that the doctor visit might show there’s nothing wrong and that the problem will go away on its own. That’s good news. On the flip side, it cost the person money and time.
Rather than waiting for a screening event, and there seem to be fewer of them these days, how might we learn to trust our own instincts and seek health advice when we think we have a problem?
The standard approach is to insist that everyone undergo an annual physical examination, even when nothing seems to be wrong. When done often, those regular exams are likely to find something that can be fixed. Instead of honoring the overwhelming success rate of self-diagnosis, our official approach is to encourage everyone to subject themselves to testing until something is discovered – and then return to the health system on a regular basis to keep up with the situation.
Simultaneously, there are numerous individuals who honestly believe they have a problem that routine tests don’t discover. That should be the trigger for medical intervention, not the battery of random tests ordered at every annual checkup.
Worse yet, the standard testing announces that the patient is wrong and that their health is fine, because some test results are normal. This seems to be the situation when it comes to thyroid problems.
Millions of individuals, especially women, know deep down that something is wrong yet the gold standard test result (TSH levels, when it comes to the thyroid) is WNL (within normal limits). The doctor is happy that the test results are okay, but the patient is sad because he or she continues to feel like dirt and exhibits every symptom associated with low levels of thyroid.
That’s a dilemma. In one case, those who feel fine are poked and prodded on a regular basis until something is discovered that can be treated – usually for the rest of their lives. At the same time, there are other individuals who know they’re sick, but the lab tests don’t support it. One group gets treatments that make the participants feel worse, and the other group is denied treatments. Something is out of balance and it seems we need to do something. Quickly. My approach is empowering patients to trust themselves, even when the doctor disagrees.
Larry Frieders is a pharmacist in Aurora who had a book published, The Undruggist: Book One, A Tale of Modern Apothecary and Wellness. He can be reached at thecompounder.com/ask-larry or www.facebook.com/thecompounder.