Geno J. Merli, MD; Howard H. Weitz, MD
Disclosures: Geno J. Merli, MD, reports the following: Research grants/contracts: Bristol-Myers Squibb, Bayer, sanofi-aventis; Consultancies: Bristol-Myers Squibb, Bayer, sanofi-aventis. Howard H. Weitz, MD, reports that he has no financial relationships or interests to disclose.
Editors' Disclosures: Christine Laine, MD, MPH, Editor in Chief, reports that she has no financial relationships or interests to disclose. Darren B. Taichman, MD, PhD, Executive Deputy Editor, reports that he has no financial relationships or interests to disclose. Cynthia D. Mulrow, MD, MSc, Senior Deputy Editor, reports that she has no relationships or interests to disclose. Deborah Cotton, MD, MPH, Deputy Editor, reports that she has no financial relationships or interest to disclose. Jaya K. Rao, MD, MHS, Deputy Editor, reports that she has stock holdings/options in Eli Lilly and Pfizer. Sankey V. Williams, MD, Deputy Editor, reports that he has no financial relationships or interests to disclose. Catharine B. Stack, PhD, MS, Deputy Editor for Statistics, reports that she has stock holdings in Pfizer.
The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.
Mark G. Bamberger, MD
Attending Physician, Cedars-Sinai Medical Center, Los Angeles, CA
May 4, 2015
The angry patient
Excellent discussion. This is not my patient so I don't know how he or she would feel after the discussion, if in fact there was one. Your explanation and appropriate "defense" of not screening is great for the clinician. Unfortunately, I have found explanations along these lines difficult for some people to understand. Patients often get some part of it, but then don't believe that the recommendations apply to them. Sometimes we end up battling our colleagues. Some patients believe that the "better" physicians are the ones who do more tests. In a fee-for-service environment, there is incentive to "be better." Telling a patient that another physician is incorrect, or not in keeping with the current data is difficult. Again, I enjoyed your discussion. I am just pointing out that patients often don't understand. No matter what the literature supports, many will still line up for the low-cost mobile screening tests that you mention. They'll still push for stress tests and often question their physician's commitment if those, and tests like them, are not ordered. Saying no to tests is still challenging.
Geno J. Merli, Howard H. Weitz. The Consult Guys - The Asymptomatic Carotid Bruit: Not Such a Pain in the Neck After All?. Ann Intern Med. 2015;162:CG1. doi: 10.7326/G15-3004
Download citation file:
Published: Ann Intern Med. 2015;162(8):CG1.
Results provided by:
Copyright © 2017 American College of Physicians. All Rights Reserved.
Print ISSN: 0003-4819 | Online ISSN: 1539-3704
Conditions of Use