觀點體檢

Why medical tests don't always have the answer
體檢並非多多益善


不加選擇的檢查會帶來許多壞處,不僅費時,費錢,還有可能出錯。而且,它產生的心理影響也是明顯的:你做得檢查越多,就會越擔心。

When someone comes to see you with a worry about their health, it helps if you can guess what they would like you to do. Often, they’re hoping that you’ll send them for a test. Or even several tests. By “tests”, people rarely mean the simple investigations you can do in clinic: blood sugar levels, oxygen saturations, a urine dipstick. These never seem to inspire as much confidence as X-rays or blood tests, or anything involving a consent form. While many people hate hospitals – anxiety, fuss, too hot, too busy – some greet the prospect of an X-ray with beaming relief. Nothing could be more popular – except for a CT scan. You can almost see people thinking: “At last – answers! Results!” There is no doubt medical investigations are potentially invaluable. So why are we always withholding them, a patient with backache asked me. Why not do some tests, if we have so many available?

當有人因爲擔心自己的健康來找你的時候,如果你能猜出他們想讓你做什麼,這通常會很有用。他們往往希望你讓他們去做一項檢查,甚至是好幾項檢查。就「檢查」而言,人們很少指的是簡單的臨牀檢查:血糖水準,血氧飽和度和尿液試紙。它們帶給人的安全感似乎總也比不上拍X片、驗血、或是任何涉及同意書的檢查。儘管許多人痛恨醫院——這裏充滿了焦慮與緊張,或是太熱,或是過於忙亂——但有些人認爲,做X光檢查能令人放心。除了CT掃描,沒有什麼檢查能比拍X片更受歡迎。你幾乎可以想像,人們會想:「終於——有了答案!有了結果!」毋庸置疑,醫學檢查的潛在作用不可低估。一位背痛患者曾經問我,我們爲什麼總是儘量不讓病人做檢查。既然有這麼多可以做的檢查,爲什麼不去做一些呢?

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