“But I want all the tests.”
She was a young, healthy woman, and this was our first visit. Near the end, I suggested the few indicated screening tests and started to move on to follow-up. She expressed distress, wondering why I had not ordered more.
“What do you mean by all the tests?” I asked.
“Well,” she countered, “I just want you to order some more tests to make sure there isn’t anything wrong.”
I took a deep breath. From the patient’s perspective, this request seemed perfectly reasonable. Of course she wanted to discover and avert any potential health problems. I made my best attempt at addressing her concerns, inelegantly explaining concepts such as pretest probability and positive predictive value. She was not reassured.