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Older models are not going to come without some "Needs TLC" instructions (for underlying conditions) from drs for surgeons. I'm talking about what's considered low risk surgeries like cataracts, etc. ~ not lengthy surgeries or open heart surgery. I've noticed PCPs sending seniors down endless rabbit holes to financial ruin and physical hardship to any & every dr to get every scan, x-ray, test imaginable to check every tiny blip of elevation ~ vs. an off the chart reading. One PCP did a pap smear on a 60+ year old who went for cataract surgery clearance! It looks like a racket.


It's also required that patients sign a waiver before surgeries that they know and accept the risks of surgery. There are no guarantees .. even with surgical clearances.


Seniors are doomed to not get what they need because they can't get what they know they need, or in time ..because drs refuse to grant clearance until one spends mega time & money ..seniors don't have before they will grant the magical surgery clearance. Is this how it is in all of America now?


Does anyone here know how to find drs who are not into this practice? Or stop drs who are doing this?

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This does sound as tho the seniors in your area are being used as cash vending machines. Sorry, but this isn't unusual. The senior needs to make it clear that they are coming in for a basic minimal check up of bloodwork and blood pressure, ekg and etc in prep for cataract surgery. When all the other things are suggested they need to learn to say "No. Full stop". This is something you would NEVER see in something like our Kaiser System in California, where the idea is to keep you well and not try to make money with testing.
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You give examples without naming the name of what healthcare provider or system or state in which these abuses are occurring. Which ones are you talking about? What do you mean by "grant clearance"? Who give the doctors this clearance...insurance companies? Are you talking about pre-approval? Not all health insurance plans require this.

FYI my friend's husband is a GE (gastroenterologist) who told her that his practice makes a lot of profit on lab work. So it is no surprise at all that they order a lot for patients. It is also a way to cover their backsides. But also, when people (especially the very senior) aren't very good at describing or identifying what type of pain of problem they're having or where it's occurring, lab work helps the doctors figure it out. Pricing transparency will help bring the cost of care under control.
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JoAnn29 Feb 2021
When you are going for a surgery, lets say cataract, the eye doctor will require "clearance" from the persons cardiologist lets say. They need to know that there is no underlying health problem that would cause complications.
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Honestly, just say no.

I remember back when I was having my first baby, the doctor wanted to do an ultrasound. (This was before it was a given.)

"Why?" I asked.

"To look for any fetal abnormalities. Besides, the insurance pays for it," he said.

"Any reason to believe there are abnormalities?"

"No."

"Then, no thanks."

End of conversation.

It's tough, but once you get it in your head that doctors are not gods who can't be questioned, it's pretty easy to stand up for yourself.
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Thank you all .. helpful to know others see and have experienced it. I hear you AlvaDeer & MU1929. Good advice. You were lucky, MU1929. The rub now is ..a patient's refusal to any tests, specialists, etc. usually results in no clearance ~ This is where drs get you again, and they know it. Seniors either do and pay for unnecessary tests or drs won't give you the magical surgical clearance. Then start over with another dr with hopes to not be on the same ride.
I get that Geaton777.. I meant taking advantage of seniors like you described with the GE. It's rampant .. and obviously in other areas, too. Drs' backsides are covered because patients sign papers before surgery that say 'hey, I know there are risks and no guarantees with surgery.' That should be enough along with any special instructions to surgeons for a patient's needs. Otherwise, most every senior would never get surgical clearance for anything.
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I would switch doctors very quickly if I had an experience like you are describing.

Is this extremely common? I have never experienced anything like that with my doctor.

I wouldn’t hesitate to switch to another doctor if I was dissatisfied with my care.
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lilhelp Feb 2021
Yes! Extremely common. I've watched this happen numerous times. Seniors who went in for surgery clearances for low risk surgeries, were in good health ~ not even on medicine! But referred to more drs, numerous specialists for tiny blips ..not off the chart ones, tests, and then invasive tests. They were left shells of their former selves ~ on a multitude of expensive pills, drs, follow ups for the rest of their lives and broke. Then, they were cleared for low risk eye surgery! Their lives as they knew it ~ over.
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That particular PCP probably did the pap smear on the 60+ year old because the lady had ignored individual and public health advice to get one for four decades and it was about time. Most doctors I know wouldn't have bothered: if she was going to drop dead from aggressive cervical cancer she'd likely have done it by now. I've just checked - the NHS (i.e. free to patients) screening program targets women aged 25-64. There is considerable pressure to reduce the lower age limit; but not that I've heard of to extend the upper.

I hope everyone knows me well enough to agree that I am not one for lazy stereotypes or, usually, for commenting on how other countries run their societies. But you cannot at one and the same time fume at doctors/health insurers for testing to financial destruction and sue everyone in sight. Ha! - I thought I'd better check that too :) and it turns out the USA is only the fifth litigious nation in the world, with the UK running close behind you at sixth.

Prizes for guessing the winner!
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lilhelp Feb 2021
Thanks. I know she had one a year before that ~ by the same dr. She also had no pain, complaints that warranted checking anything there. It also was not needed for a surgical clearance, esp. not for cataract surgery.
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Germany is the top nation in the world for litigious behaviour. Sweden comes in at number 2, Israel is at number 3, and Austria number 4. The field is rounded out in this order: The United Kingdom (UK) at number 6; Denmark at number 7; Hungary number 8; Portugal at number 9; and France at number 10.
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Geaton777 Feb 2021
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This just sounds whiney to me. Of course it seems reasonable to have a patient sign something that indicates you realize that there can be risks involved in procedures you might undergo. Screening for potential risks also seems reasonable. If the real complaint here is the cost, the solution is in overhauling our healthcare system to provide equitable care to all people, regardless of age, sex, finances, race etc.
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Yes Medicine is a business. Doctors get kick backs if he can get a patient to use a certain medication. I have high cholesterol. First thing out of the NPs mouth was, Lipitor. I said your kidding right. Its known to have the worst side effects. The doctor probably gets a kickback. Drs recommending doctors, kickback. Yes the more tests they can sell u the more money in their pockets.

Clearances are needed to protect the Drs. doing the surgery. Now for cateracts, if you are already going to a Cardiologist, then yes the eye doctor will request a clearance. But I have never heard of a person being sent to a Cardiologist just for a clearance that wasn't already going to one. My sister needed to see one because of the chemo she was being put on. They wanted to make sure her heart could take it.

My Moms PCP was having her come every 2 months. Other than blood pressure my Mom was healthy. In my state you only need to see a doctor every 6 months to renew a prescription. I said if he says "now what are we here today for" Mom won't be back unless she needs a renewal or she is sick. He said it, no more every two months. See, Medicare probably allows that 2 months. Our PCP sent my husband to another doctor with tests to get before the appt. DH saw the doctor, he explain the test results and sent him for more testing. The PCPs office called saying the Dr. wanted to go over the test results with DH. I told the girl that the Dr he was sent to went over the results already. See Drs. keep in touch with each other by letter, "We saw your patient Mr. Jones today..." Where I live we have Medical groups. If you stay within that group with your doctors, they can see all your info by going on their computer. So really no need to see ur PCP when you see a Specialist in the same group.

Yes, doctors are using Medicare to the limit. If Medicare is willing to pay for office visits every 2, 3, 6 months then the doctor will have them come in. Our PCP called to remind DH he is passed his yearly checkup Medicare allows.

Sorry to say, we are not big on doctors. I feel once you are stable, you no longer need the Specialist that ur PCP can take over. You can always go back to the Specialist. We are responsible for our health. We can say when enough is enough. I truly think there is a cure for cancer. My sister passed 25 years ago from breast cancer and they haven't found a better way other than chemo to treat it?

You are your own advocate. You need to research your health problems. Ask questions, get second opinions.
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"It looks like a racket." That is exactly right! It is a racket. Many doctors treat Medicare like a cash cow. And they have no intention or incentive to stop! Seniors need to understand that.

Seniors must learn that they have the right to question their doctors - "Why do I need a pap smear to be cleared for cataract removal?" - and to refuse treatment and/or change doctors and vote with their feet. Look for a geriatrics or family medicine practice. And ask friends and neighbors - heck, ask your mailman - if they are happy with their PCP and why specifically.

Lots of seniors also don't know that they can monitor their doctors' charges to Medicare through the Medicare website. Everyone on Medicare should be monitoring those charges. When something looks fishy, followup. Yes it's work but you monitor your bank statements, right?

I don't know many doctors who want their children to go into medicine, certainly not as general practitioners. American healthcare is highly specialized and saturated in and around urban centers. If you live in a rural area, hospitals are closing and it's hard to find a doctor.

As for the doctor who did a pap smear on the woman before clearing her for cataract surgery, I would write a letter of complaint to the medical board! Things won't change unless *we* start advocating for what is right.
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