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appropriate blood tests for annual physical

my 54 yr old husband went to doctor on 5/24/11.  He told her he was there for his annual physical.  She listened to his heart, palpated his abdominal area.  The only blood tests she ordered were PSA, Free Testosterone and a test for diabetes, the three he specifically asked for.  The year before he he was tested for CBC with Differential, Comp. Metabolic Panel, Kidney and Liver Function tests and Lipid Panel with LDL/HDL ratio and TSH. for his annual physical. This was done through another doctor in the practice.  He had assumed that she would retest all these again this year, therefore he did not specifically name them

He did not have to ask specifically for any of these tests the year before.  Why didn't the new doctor order these tests too?  Isn't that standard practice for an annual physical of a man his age?  Does he we now have to individually name each of the 44 tests ordered in the 2010 blood tests in order to get good care?  We have good insurance so money is not a consideration.  I am also in good health and receive all these tests every year without asking for each one individually.  I just say I want my annual blood tests as did he.  Do you think she is negligent?
1 Responses
1351808 tn?1276904027
Hi, thanks for your question. Yours is a really important one.

Turns out that you do not have to get that much blood work every year. Just as medical studies are done to decide what drugs people should be prescribed, studies have been done to find out what routine screening tests and blood work healthy people need.

I've spent the past 3-4 years understanding the medical studies behind screening tests to figure out exactly what a healthy person needs. You can find these on my website: http://beyondapples.org/checklist/ (they are also in my book). The results you find there are based on guidelines from the US Preventive Services Task Force (govt sponsored group) or the CDC, not my individual opinion.

The recommendations are not based on cost considerations or insurance, but rather on science. Ordering more tests can be more than a mere nuisance, they can suggest a problem that is not really there (false positives). So it is prudent to only get the tests you need.

In general the only blood tests I routinely get for men in their 50s is a cholesterol panel and if they are overweight or have high blood pressure a screen for diabetes. I don't order these tests every year, however. If the tests are normal, I do them every 3 years. If they are abnormal I may repeat them annually.

Hope this helps,
Dr. Nundy
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