[conanbatt]

Healthcare produces a mental model on patients that is not how medicine is practiced.

Doing tests is not only economically costly, its also costly in terms of health, so ordering unnecessary tests is in detriment to health. There are also false positives. So tests without symptoms should not be performed. But that also means you dont find things pre-emptively.

For example, you are worried that your fatigue is due to a brain tumor (google surely told you that), so you ask your doctor to do an MRI to rule it out. MRI comes in negative. But the MRI radiation gave you cancer, because it does (in a very small amount of people), as well as gave you very expensive bill for it, because MRI are expensive everywhere, not only in the US.

[philipkglass]

For example, you are worried that your fatigue is due to a brain tumor (google surely told you that), so you ask your doctor to do an MRI to rule it out. MRI comes in negative. But the MRI radiation gave you cancer, because it does (in a very small amount of people), as well as gave you very expensive bill for it, because MRI are expensive everywhere, not only in the US.

Good example, except you're thinking of a CT scan, not MRI. CT scan uses x-rays. MRI uses no ionizing radiation.

[conanbatt]

Sorry! Thanks for the correction.

[tathougies]

Well... as an anecdote, I was worried my shortness of breath, numbness, inability to perform endurance sports, and anemia was due to thalassemia -- the most common genetic polymorphism worldwide, and especially prevalent in those of indian ancestry. I asked a doctor to test and told them my symptoms. Instead of being offered a relatively cheap blood test, i was sent for an EKG, told to take extra iron (very very dangerous for those of us with thalassemia), and sent to a cardiologist for a cardiac workup.

I ended up seeing a 'naturopath' and asked for the test and I have both alpha thalassemia minor and beta thalassemia minor, which explains all my symptoms.

As another anecdote, I went to a physical exam with no complaints. The doctor palpated my testicles and said I was fine. About 10 hours later, I get a call saying I have testicular cancer and need an ultrasound, which I did the next day. My testicles are fine; to this day, I have no idea why I was sent for this test.

[viraptor]

> So tests without symptoms should not be performed. But that also means you dont find things pre-emptively.

That's not entirely true. It's accepted you get periodic screening for many issues. (breast cancer, pap smear are probably the most common) Then there are tests you can easily request without any symptoms. (STI and allergy tests for example)

> But the MRI radiation gave you cancer

There's no MRI radiation. That's not how it works.

[conanbatt]

A broad generalization, it depends on the test. I was trying merely to make a point that the intuitive model (you want to know if you are sick, you do a test and you get a result) is not how medicine works.

I mixed up CT Scan with MRI, corrected in another comment.