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Unethical Doctor orders PSA w/o Patient consent

Posted , 11 users are following.

craig84609
craig84609

First I want to say that I am a 47 year old man that is on Testosterone replacement because I have Osteoperosis due to my body not making testosterone any longer. The reason for this is probably from IBD. When one has Crohn's disease it can reduce Testosterone production or in my case stop it all together. I have been seeing this Endocrinologist for a couple of years now and after my last RX refill of it he said that I will NEED TO HAVE A PSA TEST. Not here are the reasons I believe it would be a good idea, can I put you in for one. Instead it is an ultimatum, you will have a PSA test or I will no longer give you Testosterone. Now, in my defense I have no family history of Prostate cancer so I am not in a high risk group and being on Testosterone my PSA will be elevated and that can lead to a false positive test resulting in a biopsy or worse someone thinking they have cancer when they probably don't. I support every mans decision reguarding this test, whether they decide to have it or not it is a matter of personal choice and it is unethical for a doctor , in my opinion to sneak this test in a blood workup without first discussing the pro's and con's of it with their patient. It is my choice as to whether I choose to have it or not. If my doctor had said we need to disuss how you feel about this test and here are the possible outcomes of it then I would not be upset. I called them and told them I didn't want to be tested. I said that being on testosterone my PSA would most likely be elevated and I am of low risk so I decline the PSA. I also said I need to know soon if he is requiring it to continue giving me testosterone, because I need to get a new doctor before running out. The nurse seemed nervous and said ok I will leave a note for them letting them know you are not willing to have this test. What I really wanted to know is why on earth would he order this test without discussing it with me first. I find this to be unethical in nature and I am losing my trust with this doctor. Ok, rant over. Has anyone else had a similar problem? If so what happened? What did you do about it?

1 like, 22 replies

22 Replies

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  • Siakzar
    Siakzar craig84609

    Posted

    Take your PSA test, not a big deal but good indector of prostate problem.

     

    • craig84609
      craig84609 Siakzar

      Posted

      That is the thing I am low risk and it will be falsly high as a result of testosterone. So what good can come of me taking it. I would stress out because of the thought of cancer. It can't predict cancer and everything I have read states that a doctor needs to go over the reasons to have it done and the negative side effects of it. None of this was ever discussed with me. It was added to my usual blood tests without my consent. Again I totally support those that wish to have it but I also support those that do not. I am one of those that dosen't want the test. I have no reason to have it before age 50 when it is only suggested not recommended. The PSA has low accuracy when it comes to cancer detection. It should be combined with DRE to increase detection accuracy. My biggest problem with this is my doctor didn't discuss this with me he snuck the test into my pannel. The nurse said she took it off and I thanked her for it.
    • Siakzar
      Siakzar craig84609

      Posted

      Information does not produce risk. Your decision does.

      PSA is only one of the means to determine whats happening with your Prostate.

      If you are concern, do a Prostate Ultrasound. I do it every year, when my residue increases, I do more.

      I did extensive testing at Johns Hopkins and they suggested I should do TURP or green laser, But I made the decision that its not risk free not the Dr.

      I am scheduled to do the PAE, They asked for PAS and all Ultrasound results.

      ​I went through extensive MRI, but I made the decision.

      Is comforting to know you have low PSA and the test is not risky.

      Information is wisdom and does not produce risk. Your decision does.

  • lester90053
    lester90053 craig84609

    Posted

    PSA usually has false positives anyhow and is usually included with blood tests for men your age regardless of your condition. The time to discuss this with your doctor is after he gives you the results. If it is very high you may have problems. If it is moderate you may not.
    • craig84609
      craig84609 lester90053

      Posted

      Giving me the test without my consent is unethical. In contrast would it be ok for a doctor to test someone for HIV without first telling that patient? I think not.
  • ramblin
    ramblin craig84609

    Posted

    I have lost patience with the medical profession.  My advice would be to go to another doctor, depending on the circumstances of your insurance. My insurance allows me to "self refer," which means I can go to any specialist in their network, which is large (GEHA). If you have an HMO, you will need the approval of your Primary Care Physician, or start by finding another PCP.
    • craig84609
      craig84609 ramblin

      Posted

      Well I gave them the opportunity to take the test off, but if I had not noticed it, it would have been done against my wishes. This is the part I have trouble with. They should not assume that every man wants this test. I may try and find a new doctor. Lucky for me I don't need a referal.
    • cartoonman
      cartoonman craig84609

      Posted

      Well, your matter begs the question: Why DON'T you wish for the test to be done?  Is it because of the likelihood of the false positive you mentioned?  Or that you just don't wanna know, regardless?!
  • cartoonman
    cartoonman craig84609

    Posted

    Craig, you know the drawbacks of depending on the test, and your doctor may or may not.  My suggestion:  just take the test (It doesn't hurt!  :-)  ), and don't put too much stock in the results!  And... start shopping for a different doctor.  Talk with friends and ask for one who encourages openess and dialogue.

    In the doctor's defense: Most patients DON'T WANT TO KNOW these details; "Just fix me, Doc!"  Time and time again, I've had doctors express surprise about how much reading I've done, how many questions I ask.  Understand that you are in the minority, and are looking for a doctors who welcomes the patient's participation in the healing...

    • craig84609
      craig84609 cartoonman

      Posted

      I am upset I wasn't counseled for it. The PSA test is unaccurate at best and I am low risk so it doesn't make sense to me. If I were high risk I would say ok. I would however choose the 4k score test instead. Also I would really prefer not to know the results as it may cause me to worry for nothing at all. I believe a doctor needs to give the facts to their patients about the test and what it could mean, that way one can make an informed decision on whether to take the test or not. Some have been so stressed by their results they have commited suicide. Granted those men were probably suffering from some sort of mental health issue. As simple as it sounds it can have damaging results as far as false positives for cancer. I really don't want the stress.
    • cartoonman
      cartoonman craig84609

      Posted

      Yes, and... It sounds as though, from what you wrote earlier, (1) the doc is required/thinks the PSA is needed, for renewing the prescription.  And (2), since you know of the unreliability of the test, you treat whatever number that comes up as just that, a number.  And not attach any worrying to it.  A good exercise in non-attachment, I suggest seriously.  If you are a worrier by nature, then, yes, you have other matters that come into play.  To me, aware but not a worrier (I'm 66; I have time to worry or I have time to live life; I've decided to focus on living a glorious life!  :-)   )
    • craig84609
      craig84609 cartoonman

      Posted

      Exactly, I prefer not to cause myself the worry that happens to me from medical testing. I would just rather focus on living and forget the whole thing. They have not called me back saying that it is a requirement so maybe he was trying to be cautious. 
  • caringbah
    caringbah craig84609

    Posted

    I'm totally with you Craig. I refuse to be PSA tested now and here's why. For years I was routinely tested PSA ....I had a very enlarged prostate and eventually my PSA got up to 9.1. My GP sent me off to a urologist who told me I needed a biopsy. He did a 30 core trans perineal biopsy and good news...no cancer. 

    But that's when my troubles began...I couldn't pee properly anymore ...up 6 times a night etc. whereas I didn't have these issues before. The uro said it would improve but it didn't. He put me on Flomax but that didn't do much. it got worse and worse with UTI s because I wasn't fully voiding. 

    All this because of a biopsy. I eventually had a PAE which fixed the problem.

    The point is this...an elevated PSA will make you anxious. The doctors will tell you to see a uro. The uro will rub his hands with glee because he has another well paid biopsy on his hands. 

    i am am in remission from lymphoma. My oncologist is a great guy and we chat about everything. He refuses to have his PSA tested also. He quoted a study with two very large groups of men. One group had no PSA testing, the other group did and had biopsies etc and other interventions. After 15 years there was no significant difference between the mortality rate of the two groups. 

    Stick to your guns Craig and avoid urologists at all costs. I have no time for them.

    • craig84609
      craig84609 caringbah

      Posted

      I am so sorry you had to go through that hell. It is what I am trying to avoid for myself. Ultimately it is each mans choice as to what they choose to do and their doctor needs to inform them of all the complications of it. It is unethical not to.
  • nealpros
    nealpros craig84609

    Posted

    I agree with you. Your testosterone replacement, like mine, should be taking us from low (me), and none (you) to normal. Your doctor SHOULD be testing YOUR TESTOSTERONE LEVEL! Some doctors worry that God forbid, you would use the testosterone for body building, or something. Get a new doctor. This one doesn't seem to have a clue.

    Neal

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