Medical Test Results Dictate Treatment not Patients
- Jean Jordan
- Oct 23
- 4 min read
Updated: Oct 24
Is patient shared decision making a myth?
Recently my values of patient centred treatment were being questioned by personal experience. My experience with medical treatments, after a fall that broke my arm. More recently my husband's who had blood tests for PSA without his knowledge and how that prompted medical procedures.
Here I write about our expereince and how disappointed, upset and worried after deciding to take a stand after much agnoising and doing my own research. I decided to not follow their treatment dictates.
First, My Story
Dexa Scan dictates Bisphosphonantes Prescription
December 2023, I fell in the park and broke my arm. My treatment went well, and I'm fully recovered with the exception of the fear of falling remains in the shadows.
However, my complaint is the impersonal nature of the aftermath of my recovery.
Firstly, a letter arrived from Health New Zealand telling me to go for a dexa scan and sending me an appointment.
It seemed that I should have a dexa scan, I didn't think too much about it and said OK.
Following my scan, I got a letter saying I should take a bisphosphonate medication instructing me to go to my doctor to get a prescription.
T-score scan result not discussed with doctor
Obviously, my ‘T’ numbers from my scan prompted this diagnosis and medication. Generally focused on my age and the fact that I tripped over a piece of wood in the park and fell over.
No one. Not even my doctor has contacted me to discuss my inadequate bone density, or any lifestyle changes I needed to make. No-one gave me the opportunity to talk about the pros and cons of taking the various types of bisphosphonates.
Hence it seems you could explain my treatment as "Medicine by Numbers"
o Never mind the person.
o Don’t talk to them or explain what was happening.
o Don’t ask their opinion just start taking this medicine!
Never mind considerable side effects of biophosphonates
Next, My Husbands Story
My Husband failed his PSA blood test
My husband was told by his dentist that during a dental operation his blood pressure was concerning. After this he went for a check-up about his blood pressure.
He failed the numbers test - immediately put on blood pressure medication.
Unbeknownst to my husband in the check-up the doctor included a PSA blood test. It wasn't mentioned but it seems it's protocol!
What about informed consent and shared patient decision making?
Later enquiring why he was given a PSA without his knowledge, we really didn't get a satisfactory answer except: -
o Well, you're an old guy now 65.
o We're going to check for prostate cancer.
o He had no urological symptoms.
o It hadn't even been discussed if he wanted this test.
o No risk factors, except age.
What happened next?
You guessed it he too failed the numbers test.
o Immediately sent for an MRI. No waitlist?
o Recent PSA test - the number had gone down by 15%.
Next procedure was a prostate biopsy
Then sent an appointment for next week for prostate biopsy.
Again, during this numbers experience and rapid movement to invasive procedures there was no conversation, no discussion, no patient centred consideration, no joint decision making?
Best Practice Research at University for Patient Care
Patient centred treatment and joint decision making are certainly being researched, developed, and espoused at university level to provide better healthcare for New Zealanders?
Both of us are health practitioners, but regardless of this we all should be given the space and consideration to make our own decisions or at least be given the opportunity to discuss and make our own decisions.
My husband's case he decided he wanted a second opinion. He paid for this second opinion. He has since seen a specialist, who also hasn't read the latest research about joint decision making and client centred approach. Just reiterating risk factors and percentages and why he has to have a biopsy.
Incidentally, I gave the somewhat surprised specialist his % score (a low one) on client centred approach and joint decision making! Couldn’t resist this small step.
Is there more to healthcare than test results?
But how many people are failing the numbers test even by a small margin in what, in some cases especially PSA are arbitrary numbers and ‘T’ scores probably made within the industry.
Without the consideration of the cost of the quality of life and possible economic costs to the nation.
I rarely share such personal stories, but change is needed, and I applaud those GPs and health practitioners that I connect with on LinkedIn who are trying to make a difference. For lifestyle medicine to thrive in this environment is certainly going to be a challenge.
To find out more about lifestyle medicine
Conclusion
I have used the word dictate often throughout this article. This is how it felt throughout our interactions with doctors and specialist or even non-interactions in the case of my bone health.
One other component that is worth considering and perhaps a reason for the lack of discussion and consideration of our views is that we are both over 60.
Jean Jordan
Naturopathic Medicine Practitioner 20 years’ experience in treating ongoing pain issues and anxiety.
Trainer for 2nd career health practitioner available through Natural Pain Solutions.
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After studying Postgraduate Pain Management & Freedom from Chronic Pain with Howard Schubiner, I want to spread the word about holistic self-help techniques and introduce basic neuroplastic ideas.
NOTE: This article is for educational purposes only and any health concerns should be discussed with a suitable healthcare professional.
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