I went to the dr yesterday to get something for a cold that I’ve had for a week. It’s turned into a major cough with lots of phlegm. The dr listened to my lungs and said that I had some wheezing in my right lung. The dr immediately suggested an x-ray. I think it’s a bit exteme. Everyone in my office has had the same sickness and was given an antibiotic (as I was too).
This is only my second visit to this particular dr. I went a few weeks ago for a new patient check up. I told him I’ve been having some headaches. Without asking any further questions, he gave me a referral for a neurologist and also said that I should have a neck x-ray. I thought this was a bit extreme too. Any thoughts? I’ve had asthma for many years and have had wheezing off and on.
This is the part I don’t like: “I told him I’ve been having some headaches. Without asking any further questions, he gave me a referral for a neurologist.” This is a longstanding gripe of mine, the internist who doesn’t even bother to guess at what’s wrong with you, and just wants to send you off for some imaging studies and a specialist consult. Are they really earning their quarter of a million dollars a year that way?
Well, there’s an epidemic of defensive medicine these days. However, I’ll add that I took my son to the doctor for a cold when he was 5, the doctor suggested an x-ray, and it turned out my son had pneumonia. So it can happen.
The headache thing sounds a little alarmist (how about the eye doctor before the neurologist, maybe?), but the chest x-ray isn’t too much of a knee-jerk, with a deep phlegmy cough. (IME, of course, YMMV, IANAD, all that jazz.) Like CookingWithGas, the only time I’ve been sent off for a chest x-ray with a cold, I had pneumonia.
My daughter is the one in our family that when she gets a cold, it hits her hard. Lots of hard uncontrollable coughing. Until we learned to treat it aggressively with breathing treatments, it was a pain.
the one time I was sure that she had another cold ( and not nearly as bad as the rest of the ones she had endured) and was out of the breathing treatment medicine that I needed and had to take her in for another appointment for a refill, she actually had pnuemonia.
I’m also not too happy about them ordering up a neck x-ray for a headache.
If you’d said that you have sharp stabbing pains, visual disturbances or whatever, I could go with a head CT or MRI scan to rule out a tumor (talk about practicing defensive medicine) but the neck? Yes, mis-aligned vertebrae can cause what’s called a cervicogenic headache, but unless a vertebra is broken, a neck x-ray is likely to be inconclusive.
OTOH, the chest x-ray is a good call as you presented with gunky lungs.
For a similar reason, I gave up on a doctor after one visit. I’d gone in for my annual checkup, and I was bothered a bit that he seemed afraid to get near me. He quite literally had me at arm’s length when he was listening to my heart. OK, maybe he had personal space issues - I could have dealt with that. But when I mentioned to him that I was having some back pain, without examining me or asking any questions, he wrote me a script for some kind of pain killers.
On my way out of the office, I tossed the prescription in the trash and resolved to find another doctor (which I did) The back pain went away on its own in a couple of weeks - all I did was take it easy.
A chest x-ray for coughing/wheezing is pretty much SOP. Nothing out of the ordinary there.
A neck x-ray (either cervical spine or soft tissue) for headaches is a bit of a reach unless the symptoms you described zeroed in on your spine or if you had a previous history of injury/disease condition that might justify it.
But, I’m not a doc. Just an x-ray tech basing this on my experience.
This is a longstanding gripe of mine. Most primary care physician’s don’t make a quarter of a mil a year. Most of them are lucky to break between 80 & 100K after paying staff salaries, malpractice insurance, rent on their offices, taxes, etc. But yeah, the neurology consult was over the top. The chest x-ray makes sense, though.
'Nother vote for “No big deal.” The same thing has happened to me a couple of times. Far as I can tell, it was to gauge the severity of the phlegm in my lungs. I got bronchitis a couple times a year in college from living in petrie di-- er, I mean dormitories and it managed to catch things before they got out of hand.
Besides, you never know if something really important will show up.
XR for week-long cough and unilateral wheezing, a good idea.
Referral to neurologist for complaint of a headache without asking further questions or doing exam: Wimpy move, unless the doc is really, really, really not qualified in the area of headaches. And a primary care doc needs to be qualified to evaluate headaches, if they’re gonna call themselves a primary care doc.
What’s disturbing to me is that everyone in your office got antibiotics for what appeared to be the common cold. If they indeed had the cold, those antibiotics would be useless against it. What it would have accomplished, however, was to breed bacteria that were more resistant to the antibiotics, making subsequent treatment of any real bacterial infections that much harder. On the other hand, maybe everyone in the office actually had pneumonia, for which the antibiotics would have been effective. Which makes me wonder how everyone in the same office could have gotten pneumonia and whether there aren’t more serious health risks in that office.
Get the chest X-ray; if you have pneumonia, you want to know right away. Mine damn near killed me, but once it was diagnosed, it was under control.
Then find another doctor. If this one does not inspire confidence in you, then it’s just not working out. I trust my GP and feel like he actually gives a damn what happens to me, but I’ve had docs in the past who made me uncomfortable. It’s worth looking around until you find the right one.
My mom had a cold with a cough that wouldn’t go away and her doctor ordered an x-ray. Turns out she had lung cancer. (She smoked for 30 years). Two-plus years later she’s fine, but if her primary care doc hadn’t caught that, she’d be dead.
OK, maybe he had personal space issues - I could have dealt with that. But when I mentioned to him that I was having some back pain, without examining me or asking any questions, he wrote me a script for some kind of pain killers.