5 Things Your Doctor's Not Telling You

5 Things Your Doctor's Not Telling You

Even if your doctor isn't intentionally out to mislead you, we'll bet a box of tongue depressors that he is keeping you in the dark about certain things. These are secrets that can save you money, time, or even your life. Here's what you'll never hear—unless you know what to ask.

1."You Don't Need This Test"

To cover their own butts, doctors sometimes take a needless trip up yours. A nationwide sample of "surveillance" colonoscopies—follow-up procedures done after polyps are removed—found that up to 50 percent of doctors recommended these tests unnecessarily. This better-safe-than-sorry mindset keeps docs safe against lawsuits, and isn't limited to colonoscopies.

Get the Truth: Watch out for the most overused procedures: MRIs and CT scans, echocardiograms, and stress tests all scored high in a survey of health insurers. "When your doctor does make a recommendation that seems aggressive, ask why, and where you fit in the assigned guidelines," says Pauline Mysliwiec, M.D., author of the colonoscopy study.

2."This Will Cost You"

From deductibles to drugs, chances are your doctor visit will run more than insurance will pay. But while a Journal of the American Medical Association study showed that 79 percent of doctors think it's important to tell patients about these costs, only 35 percent actually do inform them. Their excuse? Many physicians say they're under time pressures and don't know how much patients are spending on out-of-pocket costs, says G. Caleb Alexander, M.D., the study author.

Get the Truth: Tell 'em where it hurts—in your wallet. If you mention medical expenses, most doctors will work with you to lower them, says Dr. Alexander. For instance, they can prescribe a 3-month instead of a 1-month supply of a drug to help you save on the co-pay. Or they can look at the prescriptions you take and services you receive, such as physical therapy, and reevaluate which can be used on an as-needed basis.

3."This Pill is Basically a Placebo"

Not the sugar-filled kind, but equally ineffective. "Forty percent of patients with colds who go to a doctor get an antibiotic," says Howard Brody, M.D., Ph.D., director of the Center for Ethics and Humanities in the Life Sciences at Michigan State University. "Doctors can spend 15 minutes explaining why the patient doesn't need medicine or take 1 minute to write a prescription."

Get the Truth: Tell your doctor you hope your problem isn't so serious that it calls for medication. This lets him know you're not looking for a bottle of pills, and it may make him more likely to discuss other treatments, says Dr. Brody. And watch out if your diagnosis is sinusitis. Because it can be either bacterial or viral in nature, sinusitis is one of the top conditions for which antibiotics are unnecessarily prescribed. Ask for a C-reactive protein rapid test—a raised CRP level signals a bacterial infection. Danish researchers recently showed that doctors who gave the test to sinusitis patients prescribed 20 percent fewer antibiotics than their peers who skipped the test.

4."I Don't Prevent Problems, I Fix"

Whoever first said "An apple a day keeps the doctor away" probably wasn't an M.D. A study published in the American Journal of Clinical Nutrition found that only one in six doctors preaches to patients about nutrition's role in preventing disease, while Colorado researchers found that just 28 percent of doctors mention exercise. "We tend to be more pharmacologically oriented because of our M.D. training," says Mark Houston, M.D., author of What Your Doctor May Not Tell You about Hypertension.

Get the Truth: If your doctor doesn't have answers about nutrition or exercise, he knows someone who does. Many general practitioners collaborate with nutritionists and trainers who help treat patients with lifestyle-influenced health problems, such as type-2 diabetes. Ask for a referral to discuss basic preventive health strategies.

5."I'll Always Push Surgery"

"In many doctors' value systems, surgery is the default," says Christopher Meyers, Ph.D., head of the Kegley Institute of Ethics at California State University. But research indicates that surgery often isn't the best option. A Baylor College of Medicine study showed that chronic knee pain didn't change after surgery, while another study found that taking a wait-and-see strategy with hernias may be as effective as going under the knife.

Get the Truth: "You should always ask what the alternatives are to surgery, including an approach that most physicians feel uncomfortable offering: to do nothing," says Meyers. If your doc is still scalpel-happy, get a second opinion from a doctor of osteopathy. "These doctors take a more holistic approach and are familiar with newer literature that promotes different strategies," says Dr. Houston.