>Lazris says he shows the theater diagrams to many of his patients and gets a wide range of responses. Some patients, he says, point at one of the three blackened seats and say, " 'That's probably me. I'm not taking any chances, I'm getting this test.' "

>"Other people," he says, "will see [the same diagram] and will say, 'Are you kidding me? I'm not going for that; that's not worth it.'"

>But in either scenario, Lazris says, he has done his job — he has helped his patients understand the odds and then let them make the choice.

This is wonderful!! Good on him!!

This is how medicine should always be practiced. Much too often a doctor/PA just orders a bunch of tests with ZERO discussion (other than maybe "we'll screen you for XYZ"). No discussion of risks. No discussion of the upsides of testing. No discussion of individual risk factors. No discussion about how the results will be actionable.

Sometimes they order tests before even meeting a patient for the first time or even telling you what they are testing you for. My last primary care doctor did just that, I made an initial appointment with him for a routine physical (I need referrals for my health insurance) and someone from his office calls before the appointment and says "Dr So and So has ordered some blood tests for you, please go to the lab and get then done before the appointment." Didn't think telling me any other information was important, like, uh, what I'm being tested for and why.

Of course, at least some of the tests he ordered were not evidence based.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5638475/

On top of that, I have untreatable anemia due to a genetic condition. His first tests found the anemia and he ordered follow up tests. Mind you, this is before I ever met him or even spoke to him. If he had a conversation with me, the followup tests would have been completely and totally unnecessary.

A different doctor did that to my husband recently as well ("we've ordered some tests for you" before even meeting him nor telling him which tests were ordered.) I looked at the lab work afterwards and turns out PSA was one of the tests they ordered, which has shown to cause more harm than good. ZERO discussion about risks vs benefits. No discussion of benefits of testing at your age vs an advanced age. No theater diagrams.

https://www.medicalnewstoday.com/articles/260087.php

https://www.uspreventiveservicestaskforce.org/Page/Document/...

I read a story about an elderly woman in good health with no symptoms who went to the doctor for a routine physical. The doctor ordered a bunch of blood tests and a urine test, turns out she had an asymptomatic urinary track infection. She was given ciprofloxacin and had a bad reaction to it.

Turns out:

A quarter of elderly women have asymptomatic urinary track infections. Detecting and treating them have not shown to have any benefit.

Ciprofloxacin is an inappropriate treatment for uncomplicated urinary track infections in the elderly due to the high risks of serious side effects.

https://www.nytimes.com/2019/03/15/health/antibiotics-elderl...

The story doesn't say if the doctor discussed benefits and risks of doing those blood and urine tests, but I'm doubting they did (considering both the testing and the treatment was against recommendations).

I'm not, as a rule, against screening tests. I'm against doctors not explaining the risks vs benefits of screening tests. I'm also against doctors ordering screening tests that have shown to have no benefit.