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by DollarGuru 2450 days ago
I'm not familiar with US healthcare. As the customer in such a circumstance are you within your rights to refuse any such diagnosis tests when you reasonably believe they are unnecessary? e.g you have prior history of those symptoms.

I have heard stories of some doctors and consultants making biased recommendations that are ultimately to line their pockets not cure the patient.

5 comments

Yes, you can refuse testing that you recognize as superfluous, but, well, I'm not a doctor, they are. More often it goes the other way - eg most of the time I request a test that WebMD has convinced me will tell me that I don't have, well, cancer, and doctors are willing to oblige, but only at my behest. Serina Williams famously almost died because her doctor didn't think a test was warranted. Her advocate had to lobby the doctor to run a test which led to a diagnosis that saved her life. (A combination of racism and sexism certainly played a part there.)

The problem is that the profit motive is hard to deny, simply because healthcare is run as a profit seeking venture, which makes money on the difference between the cost of running a test and the price a patient's insurance will pay. Pharmaceutical companies bribing doctors to prescribe specific medication doesn't help.

These out-of-network bills have successfully been challenged and a law passed to address them in NY (https://www.dfs.ny.gov/insurance/health/OON_guidance.htm; I think).

But, in the first place, these bills were never really valid: in no other market am I informed of the cost after I have received services. This fact is why the law was passed, though it shouldn't need to have been passed. The "contract" is already unenforceable.

There can be a lot of psychological pressure. "Don't you want to get to the bottom of this? If we don't figure it out now, this could come back and be worse." Or with a kid, "The responsible thing to do would be to rule out (cancer or whatever)."

It takes a lot of courage and knowledge to say yes, my child is in pain, and I will decline additional medical treatment and testing and just wait it out. I have declined a lot of tests and some interventions. I can do this because I have a physician in the immediate family who I can call for a second opinion at any time, and I read said physician's medical journals, and I have academic access to journals so I can do some of my own research and decisionmaking. And maybe I'm a little hard-hearted or hyperrational or something, and I can plan out a course of watchful waiting and stick to it much more than other people I know.

> As the customer in such a circumstance are you within your rights to refuse any such diagnosis tests when you reasonably believe they are unnecessary?

Of course. You're within your rights to refuse any medical test or procedure whatsoever, including one that would save you from imminent death, unless you're first declared mentally incompetent, which is not a quick or simple process.

But most people will trust the doctor when he says "we need this test to treat you effectively." He's the expert, and I don't want to bet my health on the possibility that he might be scamming me.

And docs honestly believe that the test will help. Many are not scamming you, they really want to know the result.

The single most helpful question I have if you're deciding on whether to take or refuse a test is this: "How will knowing the result change the course of treatment?" I avoided an intestinal biopsy once this way, as the answer was, "It won't. It would just be nice to know."

Thanks, that is a good question to ask. I'll have to remember that.
Yes, you can deny any treatment, as long as you are able to comprehend reality and express your denial, which the parent suggests they weren’t able due to their illness.
due to illness...and lack of medical degree.