A friend called me the other day to say
that his wife had just received a rather concerning message after a visit to
her gynecologist. They had been away over the holidays and returned to find this
registered letter.
Dear Patient,
We have previously
contacted you or attempted to contact you regarding follow-up of your abnormal test
results. As we have not heard from you, we are writing to urge you to seek medical
attention if you have not already done so.
It is very important
that you contact us at your earliest convenience. If you have any questions or
would like an appointment, please call between the hours of 8:00 AM through
5:00 PM.
Very truly yours,
They were not too upset because many years ago she had a
false positive Pap smear (a test done to detect cancer of the cervix) and received
a similar letter. On that occasion, the repeat test was normal.
They made the appointment. During a three-minute visit with
the gynecologist, they were informed that the Pap smear was normal.
My friend asked the doctor why the letter was worded in such
an ominous way. He was told that was their standard letter and that the doctor “would
look into it.”
My friend wondered why the normal result couldn't have been been simply told to them by phone. I replied that the purpose of the registered letter was to
generate an office visit.
During the phone call, my friend told me that his wife was
having Pap smears every 6 months. He asked if that was routine. I said I had
never heard of anyone doing it that often, especially with no history of
abnormal Pap smears in the past.
Did I mention that his wife was 71 years old?
All guidelines say that women over 65 without risk factors
don’t need a Pap smear at all, so every 6 months seems a bit excessive.
Regarding the office visit and the too frequent Pap smears, the stockbrokers have a word for this sort of thing. It’s
called “churning.” To boost his income from commissions, a broker will churn by unnecessarily buying and selling a
lot of stocks for his clients.
It’s not unique to this gynecologist. According to an article
about a CDC report, 60% of women who have undergone a total hysterectomy, a
procedure which involves removal of the cervix, continue to have Pap smears
done. In case you aren’t familiar with this topic, cervical cancer is not going
to occur when the cervix is in a jar in the pathology department.
And even more amazing is that the article says in 2010, “About
two-thirds of women 65 and older who hadn't had a hysterectomy reported having
a recent Pap test. That's down from nearly three-quarters in 2000, but it's not
a huge improvement.”
“It’s not a huge improvement”? That’s quite an
understatement.
It's Medicare, so we're all paying for it.
Things like this make me really worry about the future healthcare
of my children and grandchildren.
