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Looking forward to my stress test

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Looking forward to my stress test

Old 12-28-22, 10:31 AM
  #26  
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Originally Posted by pdlamb
Aggravating, I know.

I knew how my stress echo had gone before I walked (gingerly!) out. Helps to have a wife working with the tech!

Too many doctors getting too much money sticking their finger in the pie when a tech can tell you (but often isn't allowed to tell you) but you still have to wait. It's not like the doctor is performing a useful function, like Hane's Inspector #14 did years ago for underwear. How much do you think your insurance company pays for the doctor's signature on the letter with your test results? And yet, as likely as not, it's the insurance company that demands that signature to pay for the test itself.
Medical tests, especially imaging, don't have binary readouts and cannot be accurately interpreted without clinical context. When I was a working clinician, I would have gone absolutely ballistic if a tech, or even a radiologist, discussed the results of an imaging study with a patient, and no one paid me for anything except showing up.
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Old 12-28-22, 03:01 PM
  #27  
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Originally Posted by MoAlpha
Medical tests, especially imaging, don't have binary readouts and cannot be accurately interpreted without clinical context. When I was a working clinician, I would have gone absolutely ballistic if a tech, or even a radiologist, discussed the results of an imaging study with a patient, and no one paid me for anything except showing up.
I normally discuss what tests I'll be having, and why, with a doctor before I go in to them. I've had a couple of doctors tell me something like, "Jane or Joe does these tests all day, every day. They know what to look for even better than I do, but they're not supposed to tell the patient."

So I must be missing something. What is this "clinical context?" Does the doctor needs to discuss with the patient anything that's not a normal sinus rhythm on the stress EKG, or anything anomalous on an X-ray? Is there some reason the technician shouldn't be able to tell the patient, "As far as I can tell, everything looks normal?" Or is the doctor there to double-check the new tech without 5-20 years experience?
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Old 12-28-22, 03:24 PM
  #28  
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Originally Posted by pdlamb
I normally discuss what tests I'll be having, and why, with a doctor before I go in to them. I've had a couple of doctors tell me something like, "Jane or Joe does these tests all day, every day. They know what to look for even better than I do, but they're not supposed to tell the patient."

So I must be missing something. What is this "clinical context?" Does the doctor needs to discuss with the patient anything that's not a normal sinus rhythm on the stress EKG, or anything anomalous on an X-ray? Is there some reason the technician shouldn't be able to tell the patient, "As far as I can tell, everything looks normal?" Or is the doctor there to double-check the new tech without 5-20 years experience?
Clinical context: An EKG shows sinus rhythm at 38 bpm and voltage criteria for left ventricular hypertrophy. What does that mean? Answer: Doesnt mean **** unless you know whether the patient is a 65 yo hypertensive man on a beta blocker or a 40 yo endurance athlete.
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Old 12-29-22, 08:07 AM
  #29  
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Originally Posted by MoAlpha
Clinical context: An EKG shows sinus rhythm at 38 bpm and voltage criteria for left ventricular hypertrophy. What does that mean? Answer: Doesnt mean **** unless you know whether the patient is a 65 yo hypertensive man on a beta blocker or a 40 yo endurance athlete.
In the context of this thread, what clinical context should override the stress technician from telling the victim, I mean patient, you had a steady sinus rhythm at 150 bpm when you exceed the test protocol limit?
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Old 12-29-22, 08:40 AM
  #30  
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Originally Posted by pdlamb
In the context of this thread, what clinical context should override the stress technician from telling the victim, I mean patient, you had a steady sinus rhythm at 150 bpm when you exceed the test protocol limit?
What keeps a tech from discussing results with a patient are the tech's professional ethics and the likely next question from the patient: "What does that mean for me?" Even radiologists (the invasive kind excepted) avoid that conversation. Patients, I mean victims, get hurt by partial information and changing stories.
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Old 12-29-22, 05:04 PM
  #31  
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Originally Posted by MoAlpha
What keeps a tech from discussing results with a patient are the tech's professional ethics and the likely next question from the patient: "What does that mean for me?"
On a related note, I once had a scan of some sort and the technician said to me: "I am not a doctor and I cannot diagnose you. But that's appendicitis."
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