You have the right to say no and select more affordable diagnostic and treatment options, even against your doctor’s wishes, after considering the risk and benefits of each procedure. Exceptions include certain emergencies, and if you are generally not competent enough to make an informed decision. While many such decisions are made in life or death scenarios, other such decisions also present itself during routine care.
For instance, a slit lamp is an examination performed by an eye doctor to view certain parts of your eye that cannot be examined easily. But first, the eye doctor first needs to dilate your pupils using eye drops, which means you need to wear sunglasses for a few hours after the exam. You then put your head against a machine where a vertical beam of light is moved left and right. But there is a more expensive option that doesn’t need the eye drops, called fundus photography. You look into a machine that takes a photograph of the inside portions of your eye. Such images can be saved and compared over time to see if there is progression of disease. While many insurances cover this procedure, this is much more expensive than the standard slit lamp exam, and you may have higher out of pocket costs. Research has shown this to benefit only in patients with certain eye disease. There is no benefit for patients with no prior disease.
Another area is in the investigation of chest pain. Your doctor may order a stress test if he/she thinks the pain is from your heart. There are many different types of stress tests, including exercise stress test, nuclear stress test, and echocardiogram stress test. Each will have a different price tag, often with a difference in the hundred or thousands of dollars. Ask your doctor why he/she chose a specific type of stress test, and about the cost and diagnostic accuracy of each option.
