“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.
Lowenstein M. Choosing Our Words Wisely. JAMA Intern Med. 2016;176(9):1249–1250. doi:10.1001/jamainternmed.2016.3653