As imaging exams become more routine components of clinical practice, doctors and patients alike may benefit from reframing the medical definition of “normal,” the Washington Post reported this week.
While physicians themselves are well-accustomed to abnormal findings during doctor’s visits, Danielle Ofri, an internist at Bellevue Hospital and the New York University School of Medicine, told the Post, patients often aren’t—and the public’s perception of medical testing doesn’t help.
“Lab standards are not the perfect black and white that patients and society expect,” Ofri said. “You have to draw the line somewhere, but very few things are ‘yes’ or ‘no.’”
She said increasingly sensitive imaging tools are also proving to be hurdles, because many patients stumble upon abnormalities by chance during an unrelated radiological exam. Accidental findings show up on CTs and MRIs as much as a fifth of the time, and things like liver lesions and asymptomatic thyroid tumors are picked up often.
Despite the fact that most of those findings are innocent, patients often worry about the nature of their abnormalities, which can lead to immobility and a heavy dose of anxiety. That anxiety can slow the healing process, Ofri said, and worry oftentimes gives way to more imaging tests and increased radiation exposure.
She said physicians should maintain an open dialogue with their patients about abnormal imaging results, even if results are clinically insignificant, and that imaging exams should only be used in certain cases.
“There are very few things in medicine that aren’t ambiguous,” she said. “Being comfortable with uncertainty is a necessity.”
After graduating from Indiana University-Bloomington with a bachelor’s in journalism, Anicka joined TriMed’s Chicago team in 2017 covering cardiology. Close to her heart is long-form journalism, Pilot G-2 pens, dark chocolate and her dog Harper Lee.