Just What the Doctor Ordered: It Ain’t Necessarily So!

It sounded crazy to me when an administrator in the ophthalmologist’s office said I needed an EKG and blood tests before I could have laser cataract surgery.  I might not be a doctor but I know an EKG isn’t considered the best diagnostic test for heart disease.

“That’s nutty. I’m not running to have an EKG. I didn’t need an EKG when I had lumpectomies on my breasts and had general anesthesia. Why would I need it for 15-minute cataract surgery with local anesthesia? Forget it, I’m cancelling the surgery,” I said, getting up to leave.

“Wait a minute. I’ll check with the surgery facility,” the administrator said, as she promptly picked up the phone.

“No, you don’t need it if you’re just having routine cataract surgery,” she announced after the call, not the least bit bothered that three minutes earlier she had told me I did need it.

“That’s good. Now other patients will be saved the time and expense, too,” I said, feeling as if I did my good deed for the day. As it is, Medicare doesn’t pick up the total cost of laser cataract surgery, so I’ll be paying quite a bit out of pocket.

Flash forward about five days, I get a call from my “regular” doctor’s office. “The ophthalmologist’s office said they require a CBC (Complete Blood Count), which we didn’t order when you had blood tests a few weeks ago. We’ll email you a prescription for it,” the nurse explained. (Note: A CBC is a blood test used to evaluate your overall health and detect a wide range of disorders, including anemia, infection and leukemia, reported the Mayo Clinic website.)

Here we go again, I thought, Googling “Is a CBC necessary for routine cataract surgery?” Nope, it definitely isn’t, I learned from many websites of major New York City eye surgery practices.

Back on the phone with the ophthalmologist’s office. “Hi Darlene (not her real name).  It’s Geri Brin again. I’m the woman…” Before I finished identifying myself, she knew exactly who I was. I guess no one had ever questioned the need to have an EKG before.  

“I’ve read that none of the major laser cataract centers in New York require a CBC,” I announced.

“That’s what the surgery center said you need,” Darlene answered, “but you can call yourself and ask.”  After the EKG incident, I’d have thought Darlene would have wanted to call herself!

Sure enough, the center confirmed that routine cataract surgery doesn’t require a CBC either.

I called to tell Darlene the latest news. “Hi Darlene. A CBC isn’t necessary.  I’d recommend that you call the center to hear it yourself so you don’t tell patients they need this test, too.”

Moral of the story: I don’t care how much you love and trust your doctor—any kind of doctor—just make sure to double check everything you’re told.  We’re living in an age when doctors want to protect themselves from malpractice suits; plus, the more tests they order, the more they’re likely to be reimbursed by insurance companies.

Think about costs incurred by the thousands of patients of this one ophthalmologist who unnecessarily had EKGs and CBCs.  No wonder our healthcare system is broken.