Sunday, September 30, 2007

Specialists can be harmful to your health !

I recently saw a patient who had conceived after IVF treatment. She had been infertile for 8 years, and had conceived in her very first IVF cycle, so she was on top of the world. At 10 weeks, we referred her to an obstetrician for managing her pregnancy. Her pregnancy was progressing uneventfully, but the ultrasonographer who did a detailed 20 week fetal anomaly scan ( to check the baby was normal) noted that the baby had " echogenic " fetal kidneys - just a fancy word to describe the fact that the sound waves reflected by the kidneys were a little denser than usual.

The rest of the scan was normal, but seeing this "abnormality" on the report, the obstetrician referred the patient to a fetal medicine specialist.

The trouble with specialists is that they see life through a specialised prism - a prism which is full of the problems in their field. If you have screwdriver in your hand, you tend to see only screws, and he then promptly advised an amniocentesis, to confirm that the baby was normal.
He even went so far as to suggest a termination, if she didn't want to take a risk !

It is true that life is full of risks - but these should be calculated risks ! While his advise was perfectly appropriate from a medical point of view, imagine the amount of emotional harm his words caused to the couple, who are now worried out of their wits. Rather than enjoying their long - awaited baby, each day is full of tension and suspense !

Tests are meant to reassure patients, but they often end up causing anxiety and worry - most of which is needless.

Tests are not always foolproof, and all medical tests have two major limitations.

1. False negatives , which refers to patients who have the disease, but the test fails to pick this up. Doctors worry like hell about these , because they can get sued for missing a diagnosis

However, far more common than there are the

2. False positives . These are the results which are reported as positive even though the person is healthy and does not have any disease. These results create more busy work for doctors , who then need to "run more tests" in order to clarify the situation , and rule out the "true positives" ( patients with the disease who have a positive test result ). However, these false positive results can create a lot of unnecessary anxiety in the patient's mind - as well as causing distress for family members. Unfortunately, none of anxiety is ever reported or considered by the specialist, who are blissfully unaware of the harm they have done.

No comments:

Post a Comment

Get A Free IVF Second Opinion

Dr Malpani would be happy to provide a second opinion on your problem.

Consult Now!