Coleman's 2nd Law Of Medicine

Vernon Coleman

There is no point in having tests done unless the results will affect your treatment.

If your doctor wants you to have tests done ask him how the results will affect your treatment. If the results of the tests won't affect the treatment you receive (and aren't needed as a baseline against which to compare future tests) then the tests aren't worth having.

Tests and investigations are often regarded (by both doctors and patients) as being harmless. They aren't. There is no such thing as minor surgery (Coleman's Law No 11) and even taking blood is an operation. There are dangers inherent in every test that is performed. And there is, in addition, the danger that the result will be wrong and that your doctors will treat the test rather than treating you.

One of the problems with doctors doing too many tests and investigations is the fact that this overloads the laboratories where tests are done.

As I write this I have in front of me a letter from a British doctor inviting a patient to have a routine cervical smear test. `Your result will be available from us within 12 weeks,'

concludes the letter, as though this was some sort of added benefit.

Twelve weeks of worry!

What sort of moronic doctor would send out a letter like that? Don't doctors realise that patients worry about the results when they have a test done to find out whether or not they have cancer? Don't doctors realise that worrying makes people ill?

For years I have received a steady stream of letters from readers reporting that they have had to wait weeks or even months before receiving vital results obtained after blood tests, X-rays, biopsies and other investigations. In many cases patients had to wait long periods of time to find out whether or not they had cancer. There is no excuse for this. Most test results should be obtainable within minutes or, at most, within a day or two. Any doctor who routinely expects patients to wait days, weeks or months to find out whether or not they have cancer or some other threatening disease is unthinking, barbaric and quite unfit to practice medicine. What damage does the worry do to the health of patients who need to be at their strongest? What additional damage is done to the health of worrying relatives and friends?

Doctors often refuse to start treatment until they have received all the test results back. If they get test results within hours or days that is fine. But in some hospitals it can take months for test results to return. For example, it is quite common for tests done to find out whether women have breast cancer to take over three months to be returned to the patient's doctor. Just how this can be explained, let alone excused, I have no idea. If the doctor thinks that the patient has cancer, and he really can't speed up the results, then he should start treatment anyway. If a patient with symptoms of a bladder infection provides a urine sample so that any urinary tract infection can be identified it makes sense to start the patient on treatment with an antibiotic. If the test result shows that the antibiotic result is the wrong one an appropriate drug can then be prescribed.

Doctors have a tendency to treat investigation results rather than patients. Don't let them do this to you. When clinical observations and laboratory findings are incompatible, the laboratory findings are wrong.

Taken from Coleman's Laws by Vernon Coleman, published by EMJ books. Coleman's Laws is available from the shop on this website and from all good bookshops everywhere - on and off line.

Copyright Vernon Coleman 2007