Testing, testing...

While I was in the middle of breast-cancer treatment a couple of years ago at St. Michael's Hospital, I was also seeking advice from various orthopedic surgeons at Toronto Western Hospital about my back, foot and leg -- my regular guy was retiring, and I was making overlapping visits to a new one. One day I found myself, clad in a skimpy gown, being summoned from the waiting room by an X-ray technician who seemed awfully familiar. My chemo-addled brain made some grinding noises and with difficulty I managed to recall that she had taken an X-ray of me just a few weeks before -- the same back X-ray she was about to give me, again, it turned out. I asked her to check, and, sure enough, we were about to do a completely unnecessary test. After some consultation with the doctor, the X-ray was cancelled and the recent films were dug up. Had I not recognized the technician, I would have been exposed to yet more radiation (my lifetime total is approaching the scary), and charged the taxpayer for it needlessly.

Last week I booked a physical with my family doctor (what made it a physical, I'm not sure -- he did very little) and mentioned that I'd recently had a bone-density test -- I couldn't recall exactly when, or exactly who had ordered it, but concluded it had been my oncologist. The GP had no note about it, let alone any results, because he hadn't ordered the test, and I still don't know how it turned out. And if anybody at St. Mike's wants to compare it to my earlier bone-density tests, they're out of luck, since those were done at Toronto Western. The GP then ordered some bloodwork -- quite possibly the same bloodwork that the oncologist did just a month ago (except I couldn't remember the date), but unless he'd been sitting at a computer in St. Michael's Hospital, he couldn't know that.

"Aren't you supposed to be Cynthia Central -- the clearing house for my medical care?" I asked my GP. He gave me a look that made me realize that only I can be Cynthia Central. I resolved to start my own medical journal, in which I'll keep track of doctor visits, recommendations, prescriptions and diagnostic tests. But I was thrilled to hear on the radio yesterday that the city of Edmonton, Alberta (wouldn't you know it), is proposing to create a central database in which all medical diagnostic tests will be recorded, so that patients don't keep having the same tests over and over again, ordered by different doctors in different locations. Not only does duplication of testing cost the taxpayer a fortune, but there are risks involved in many lab tests -- a CT scan apparently exposes me to hundreds of times more radiation than a simple X-ray, and my doctors order CT scans at the drop of a hat, it seems to me. Once you've had cancer, every little bump and twinge gets checked out automatically. By every doctor you go to. And the lack of a central database can cause some major slip-ups: My original breast-cancer diagnosis was delayed by a month because the breast centre lost my mammogram and ultrasound, which had been done at an outside lab, and wouldn't do new ones without the old ones.

One more reason to move to Edmonton...