The Consult Guys - The Asymptomatic Carotid Bruit: Not Such a Pain in the Neck After All?
Authors: Geno J. Merli, Howard H. Weitz
Journal: Annals of Internal Medicine (2015)

Web Exclusives21 April 2015The Consult Guys - The Asymptomatic Carotid Bruit: Not Such a Pain in the Neck After All?FREEGeno J. Merli, MD and Howard H. Weitz, MDGeno J. Merli, MDSearch for more papers by this author and Howard H. Weitz, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/G15-3004 SectionsSupplemental MaterialAboutVisual Abstract ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The Consult Guys bring a new perspective to the art and science of medicine with lively discussion and analysis of real-world cases and situations.For more videos from and information on The Consult Guys, visit www.annals.org/ConsultGuys. Comments0 CommentsSign In to Submit A Comment Mark G. Bamberger, MDAttending Physician, Cedars-Sinai Medical Center, Los Angeles, CA4 May 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. Author, Article, and Disclosure InformationAffiliations: 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. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byAnticoagulation? Antiplatelet? What's the Score?Jonathan Hager, MD 21 April 2015Volume 162, Issue 8Page: CG1KeywordsDisclosureResearch grantsResearch reporting guidelines ePublished: 21 April 2015 Issue Published: 21 April 2015 Copyright & PermissionsCopyright © 2015 by American College of Physicians. All Rights Reserved.Loading ...