Saturday, June 25, 2011


A very nice dermatologist called me about the small growth on my father’s ear, which he had biopsied. He left a phone message asking me to call him at home (over a holiday weekend! I liked this guy already). His message said that “more removal needs to be done.”
From our subsequent conversation:
Doc: It’s a benign growth. A nevus, a mole. But it’s irritated, and he seems to be picking at it. And irritation can turn it into something worse.
Me: How frequently does it happen that a benign mole becomes malignant? What are the odds?
Doc: Well, if the odds are one in 100 and you’re that one, then your odds are 100 percent.
(If the odds of a meteor landing on my head are one in 80 million, I think, and I’m the one, then my odds are 100 percent. But I don’t walk around wearing a hard hat.)
Me: Let me talk to my father about it and get back to you.
How can anyone make a rational decision without better information than that?
The dermatologist explained, as I probed a bit, that the risk of this small mole becoming cancerous was low, and the risks of the minor office procedure he was proposing were also low — the worse part, apparently, being the injection of local anesthesia. The excision would take a few weeks to heal. There weren’t big drawbacks to the procedure, he said, but also not much downside to doing nothing.
I talked to my father. Given that he is almost 89, we agreed that this sounded nonurgent. He’ll live with his mole for now.
But later I thought: Isn’t this why health care costs keep climbing?
Maybe you’ve had a similar health care experience when you felt that a doctor or hospital was steering an elderly parent toward a test or procedure that just didn’t seem necessary or advisable. If so, I’d like to hear about it.

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