Guidelines are simply guidelines. My biggest problem with screening guidelines is they are age based and they’re not functional based. If somebody’s working full-time at age 75 and enjoying a completely happy life then I screen as if they were 45.
I continue to get PSA readings in most of my male patients and I do a very good digital rectal exam & find very small nodules as well. I think a good digital rectal exam is not a specialty requirement.
This opinion of mine is applicable to screening for colon cancer as well. The problem with guidelines is that insurance companies use guidelines and don’t allow us to do our job when we are suspicious and want to screen a patient. When they use guidelines as they always do, they forbid payment for patients that want to be screened as well. That is horrible. Guidelines save money, not lives.
Guidelines are simply guidelines. My biggest problem with screening guidelines is they are age based and they’re not functional based. If somebody’s working full-time at age 75 and enjoying a completely happy life then I screen as if they were 45.
I continue to get PSA readings in most of my male patients and I do a very good digital rectal exam & find very small nodules as well. I think a good digital rectal exam is not a specialty requirement.
This opinion of mine is applicable to screening for colon cancer as well. The problem with guidelines is that insurance companies use guidelines and don’t allow us to do our job when we are suspicious and want to screen a patient. When they use guidelines as they always do, they forbid payment for patients that want to be screened as well. That is horrible. Guidelines save money, not lives.
Mark Erlebacher MD FACP