Word: cancerous
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...them when they become patients themselves. When Dr. Lisa Friedman felt the lump in her breast in the summer of 2001, she did--nothing. "I just sat on it," she says, "because I clicked into the mode of being physician, not patient, and I thought, 'Most lumps are not cancer, I'll just watch this.'" That was her first mistake...
...said, 'I'll pay for my own mammogram. Just let me get it done.'" She won her appeal and finally had the test. "They didn't even have to do a biopsy," she says. "The radiologist just looked at it and said, 'Oh, my God. You've got breast cancer...
...education of Lisa Friedman, patient, had begun. Like any other patient--and perhaps even more so--she had to drag information out of her physicians. "They were treating me like I was knowledgeable, but they weren't listening to me." When she found out that the cancer had spread to several places in one breast, Friedman told her surgeon there was no need to preserve her breast for cosmetic reasons; she was more concerned that the cancer be entirely removed. She asked for a mastectomy--but she was told that a lumpectomy would do the job fine. "I went along...
...does a biopsy may be paid as much as $1,600 for 15 minutes' work, notes Dr. Jerome Groopman of Harvard Medical School. "If you're an internist, you can easily spend an hour with a family where a member has been diagnosed with Alzheimer's or breast cancer, and be paid $100. So there's this disconnect between what's valued and reimbursement...
...unnecessary test; that childhood injury, that illness during a trip abroad, that family history of excessive bleeding. When the orthopedist hears that Mary broke her leg when she was 2 years old, he can hope that the dark spot on her tibia may not be a deadly bone cancer but something more benign, like a Brodie's abscess. He may still remove the abscess but not have to do a whole invasive tumor workup. Doctors talk privately about the cost--economic and physical--of the bias toward overtesting. They are less beguiled by flashy technology, more aware of the risks...