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unauthorized blood work


dancer67
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I haven't posted here in a while, but I really need to vent..........

 

So...I went to the Dr on Monday. My regular PCP.


I knew I needed to get a Basic Metabolic Panel to check my kidneys and my potassium levels. She brought up Cholesterol and I said no I wasn't interested. She said that was fine.

Welllll....I check my patient portal yesterday and I see my bloodwork results. Not only my BMP results, but the results of my cholesterol panel.

I was furious.

When I got my bloodwork done at the lab I even asked again, are you only doing a BMP? And the lab tech said yes.

I call the office yesterday. Told the receptionist that I had UNAUTHORIZED bloodwork done and I want the Dr to call me. She even looks up the order and stated that the only thing she saw the Dr order was a BMP. Said she would have her call me.

This morning the office calls me. It is not the Dr. It is her medical assistant. He is trying to tell me that because it was a physical.....the insurance company REQUIRES is to be done.

So now I am more furious. Tell him it is irrelevant. That the Dr and I discussed it and was agreed upon that I was not going to have this done. Tell him I want the Dr to call me.

I am beyond furious. I am not sure what the Dr is going to tell me, but ......

Is that even legal?

First, I stated I did not want it done. It was agreed upon. Can it be done behind my back?

If it was miscommunication, I am still upset about this because now I have huge trust issues.

I do not get a lab slip. It gets sent over by computer and the lab is right next door. I don't know if I can get the paper version before I get labwork done again when I go next year.

Again, not sure what Dr is going to tell me even IF she does call me. However, there is a patient portal so I have put this all in writing to her so there is some kind of paper trail.

What would you do????

 

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I don't know the legal issues involved. I can't get past wondering why you don't want your cholesterol checked?

Right? No snark, why does this make you so mad? It is important information for you and your doctor.

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The person on the phone said your doctor only ordered a BMP. If so, then it may be the lab you need to get upset  with -- for doing something beyond what was ordered.  (though I'm not sure I understand why you are so upset at getting a cholesterol panel done, not just why you said No, but that somehow it happening despite that is causing this level of upset.)

 

Edited by vonfirmath
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Not having it checked is a personal decision.

 

The issue here is that I told her I did not want it done, and she agreed. Yet it was done anyways. That is what makes me mad.

 

A patient has the right to deny testing. Regardless of how the Dr feels about it.

 

I will be calling the insurance company today though.

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I thought I read that many US insurance companies have it as part of a package deal - so if you bill for a physical, you have to give blood cholesterol results as well. 

It's an important test. I'd thank them, not yell at them. I don't understand why you'd say no. 

 

Unless you suspect the results will be bad and you're trying to buy new insurance policies...? 

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It may be in fact a lab error. But I don't know this for sure as she has not called me.

 

The medical assistant called me instead. Trying to tell me this was an insurance company requirement. I don't care what the insurance requires(if in fact this is true)...it was discussed several times with the Dr that I did not want this test performed and it was agreed upon.

 

Trying to find out if she snuck this in somehow, miscommunication, insurance co requirement............??

 

No matter what, the test was done. And I can't do anything about it now. Other then not have my insurance company pay. But I have huge trust issues now. And that is a big problem.

 

I wish she would call me as I want to hear her side of this.

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I am not trying to buy any new policies etc.

 

I have strong feelings about Cholesterol. I disagree that it is an important test. But that is a conversation for another time.

 

Insurance companies should not have the right to dictate what tests you need to have. And a Dr. should not have the right to order them if the patient refuses. I would think that would be illegal. This was not a drug test........

 

 

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I had this happen once, but not for cholesterol.   A dr had asked me if there was any chance I had an STD.  Absolutely not I said.  One ordered various blood tests including two that checked for STDs.  I had the lab slip, so crossed those off and did the rest - no issues.  The next dr asked if there was any chance... no... and I didn't get the lab slip.  I saw later that they had been tested - with no problems.  It was annoying at first because it does show the trust issue isn't there, but OTOH, I came to the conclusion that they probably can't trust many of their patients (or patient's partners), and in the big picture, it's just not worth getting worked up about.

 

With cholesterol, I really can't see any problem knowing the results.  I get mine checked twice per year just for my own info.

 

However, with it all, YMMV.

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Honestly, with my own experience, the line:

 

"Life's never perfect, so don't sweat the small stuff," is the conclusion I ended up with.

 

One can do far more harm to themselves by getting too worked up over the small stuff.  I dwelt on mine for about an hour, tops, before coming to that conclusion.  

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I heard back from the Dr.........this is what she wrote to me on my patient portal......"I had notified the lab prior to you going there that lipid order was deleted. i have since spoken to the lab and they will delete this as we did discuss this. sorry for the confusion this has caused."

 

So it was a lab error.

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You seem very upset, but I'm having trouble understanding why this is such a huge problem.

 

It would seem like a good idea to have your cholesterol levels checked, but even if you don't care about the results, why not just ignore them and move on?

 

Is your doctor concerned about your cholesterol results?

 

I'm sorry you're so upset, but unless you have an important reason why you would want to keep your cholesterol levels from being discovered, this seems like a bit of an overreaction to me. I feel like I must be missing something.

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My levels were ok, not great. Trigs were fine. Slightly high LDL, and slightly high total.

 

But my HDL is really good at 68.

 

Surprising as I have not had it done in 3 years. But I do not concern myself with cholesterol. I am strongly against it. I will share just one of several reasons why.....it is just one more push to medicate. Statins are a big business in the pharm. community. And they are bad news. I can list several other reasons why I believe cholesterol testing is not necessary, but I don't think I have enough room here................

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Glad it was an error and I agree with you on statins whole-heartedly.

 

I also understand your fury. Be it a small test and a small inconvenience, if this had been purposeful I would be deeply troubled. The medical industry overstepping their bounds along with insurance is not a road I want to travel. People's bodies are people's bodies and we should be able to dictate what happens to them. This was a good outcome though and it looks like your doctor can be trusted.

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My levels were ok, not great. Trigs were fine. Slightly high LDL, and slightly high total.

 

But my HDL is really good at 68.

 

Surprising as I have not had it done in 3 years. But I do not concern myself with cholesterol. I am strongly against it. I will share just one of several reasons why.....it is just one more push to medicate. Statins are a big business in the pharm. community. And they are bad news. I can list several other reasons why I believe cholesterol testing is not necessary, but I don't think I have enough room here................

 

 

How can you be against cholesterol?

 

I don't disagree about the big business of drugs.  But knowing your cholesterol level does not obligate you to take any drugs.  Or do anything differently.

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I had this happen once when I declined an STD test my OB recommended. I specifically declined it because I knew it wasn't an issue and didn't want to pay extra for a test I didn't need. Well, he did it anyway and a few months later I got the bill for it. I was furious! He got an earful, his office ended up paying the bill, and he lost me as a patient.

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Glad it was an error and I agree with you on statins whole-heartedly.

 

I also understand your fury. Be it a small test and a small inconvenience, if this had been purposeful I would be deeply troubled. The medical industry overstepping their bounds along with insurance is not a road I want to travel. People's bodies are people's bodies and we should be able to dictate what happens to them. This was a good outcome though and it looks like your doctor can be trusted.

 

YES YES......

 

The medical industry has definitely been overstepping their boundaries which is why I have to be a strong advocate for my own health. It is my body and my decision. Whether or not the general population does not agree with me, my dr , or the mailman.

 

This is the problem when the government wants to control your health care. They will ultimately be the ones who will determine who gets health care, and who loves and who dies.

 

Again, that is a whole other conversation because that can become political and that is not allowed on here. So I will leave it at that.

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How can you be against cholesterol?

 

I don't disagree about the big business of drugs.  But knowing your cholesterol level does not obligate you to take any drugs.  Or do anything differently.

 

I am against it because it is my personal decision.

 

Believe it or not, there are some Dr's who agree with me. Unfortunately, those Dr's do not take my insurance. Why don't those Dr's take my insurance? Because they take top tier only. I have state funded insurance. Soooooooooo..........that should tell you a lot.

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I can understand your anger, as a medical office tried to charge me (my deductible hadn’t been met yet) for unnecessary STD testing when I had a pap test done even though I rejected the extra tests when the doctor asked me if I wanted it before doing the exam. I discovered they didn’t even actually do the extra tests—they just tried to bill me more for them. I never went back to that provider.

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I am against it because it is my personal decision.

 

Believe it or not, there are some Dr's who agree with me. Unfortunately, those Dr's do not take my insurance. Why don't those Dr's take my insurance? Because they take top tier only. I have state funded insurance. Soooooooooo..........that should tell you a lot.

 

 

Cholesterol is a compound. So I am not clear why you are against a compound.

 

Of course it is your body and if you don't want to have a test or take meds then by all means don't.  

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Buuut, how many times has a doctor seen a woman who was certain she didn’t have an std actually have an STD? I understand on the std thing why doctors insist.

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I don't care if it's STD testing or cholesterol testing, or pregnancy testing or whatever.  A doc should never be performing a test, or any other medical procedure, that I have specifically requested not be done.  If it's a mistake, it's a mistake, and mistakes happen.  But if I say "no, don't do that" to a doc, he or she should NOT be doing it.  This is as true for cholesterol testing as it is for administering pitocin while in labor.  NOW, if I say no to XYZ test or procedure the doc then has the right to say "ok, then I cannot proceed with ABC treatment"  (ie not prescribing a med without having taken a pregnancy test.)  But I, as the person who's body it is, should be able to choose whether or not ANY procedure or test is done.

 

The ONLY exception should be in a serious emergency situation, and even then, case by case basis.   Obviously patients who are unconscious can't consent to specific tests that may need to be done to perform certain treatments to save the patient's life. 

 

 

I agree.  But unless someone is trying to make me pay for the test I can't see what is so upsetting about it.

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I don't care if it's STD testing or cholesterol testing, or pregnancy testing or whatever.  A doc should never be performing a test, or any other medical procedure, that I have specifically requested not be done.  

 

I 100% agree, and I'll fully admit I've learned not to trust doctors when it comes to medical things, but when something has been done and it's really not a big deal in the big picture of things (like a cholesterol or STD test), I think it does more harm to a person to get overly worked up about it.  Hence, I chose not to.

 

I agree with those who refused to pay for things they specifically said not to do, but in my case, the test wasn't expensive so I did pay the bill (me, not health share) and I still don't feel it's worth getting overly upset about.  I didn't change providers with that doctor either (GYN).  I'm content going along with the thought that she needed to make sure even if I was 100% certain.  In all other aspects, I like her.  If I'm honest, I'll admit I even like the fact that she is concerned enough about my health to fudge rules when she thinks I'm wrong - as long as it's just a test and not administering meds or something far larger in the scheme of things.

 

I know not everyone thinks that way on the latter part, so YMMV.  It's just the way I feel.  Legally I'm pretty sure she was wrong, so anyone in the field ought to go with the law rather than assuming they'll run across another person who thinks the way I do with that.

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You wouldn't be upset if a doc did something you said not to?  You would only be upset if you have to pay for it? 

 

 

Honestly.........the whole paying for it thing is a whole separate issue.  The way our medical billing and insurance situation is, it's WAY too easy for docs to get away with this on purpose, specifically because insurance will pay anyway and the patient will likely overlook it because hey....they aren't paying for it, insurance it. 

 

 

Paying for it would include billing my insurance. I would not be cool with that.

 

I am just not that concerned about some test being done.  

 

But then I don't have the illusion of privacy in the current world we live in.

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I get it.  I'm against certain tests for MYSELF.  I dont care if you want to screen for certain things but some things I do not want to screen for due to (what I perceive as) unnecessary medication push, false positives, negative side effects from the screening test or over treatment of the problem. 

 

I've had bad experiences that have caused me severe anxiety.  I did my research and have a set of things I don't want test for and others I'm fine with. 

 

YES.........^^^^^^^^^^^^^^^^^^^^^^^ THIS EXACTLY.

 

I have severe anxiety. I have had some pretty severe false scares in the past. Kidney Cancer was one huge one. Big, big mistake made by radiologist, which in turn made me have multiple, painful, unnecessary, expensive further testing to rule it out. For a whole month I had to wait and wait to see if I had cancer or not. I was a wreck.

 

I also had a blood cancer scare. Had to wait 8 weeks for a Heme appt all for him to tell me I only had Anemia.

 

Yea, so I am all set with tests. I only have the ones that I know I need to have done. I am against many pre-screenings. I do not need to go into another meltdown mode over idiotic people who can't read results, or the results may not be accurate, false positives and calls for further testing and further anxiety.

 

My Cholesterol levels are not even accurate because they were not even done as a fasting blood test. Unreal.

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I actually tested high for cholesterol in May--high enough that my OB/GYN who ordered the test recommended that I see my primary care to discuss it. I didn't at the time but I made some dietary changes (a lot less saturated fat, added fish oil, flaxseed). When I had to see my PCP this fall for something else, I asked him about my cholesterol. He calculated my risk of a coronary event in the next ten years at 1.7% and said they don't begin to look at statins until you're over 10%. We talked a bit about the dietary stuff. So for me, it's useful information to have--I can make educated decisions about my health. I wouldn't fear the information because you fear you'll be pushed to a particular treatment path. It's just information.

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Buuut, how many times has a doctor seen a woman who was certain she didn’t have an std actually have an STD? I understand on the std thing why doctors insist.

A doctor trying to insist that a patient consent to having it done is one thing. But if that patient continues to decline it the Dr has zero right to go against the patients wishes and order the test done anyway.

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What I get what you are saying about the blood test being done, how you don't view that sort of thing as a big deal, to me, it's kind of like when a Jehovah's Witness refuses a blood transfusion.  To me, they are no big deal, but to them it's a super big deal.  I am not going to tell them not to get upset about if a doc gives them a blood transfusion after they said no, even though to me, that procedure is no big deal. 

 

 

Good point.  I would flip totally out if a blood transfusion was forced on me.  But that is actual treatment....a test is just....a test.  

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I'm glad that it was a lab error and not intentional on the doctor's part. I agree that patient wishes should be respected!

 

Technically, yes, a test is just a test, but that's really not the issue. The point is that (1) the patient's wishes should be respected, and (2) tests lead to other things, so it's rarely as simple as just being a test.

 

I had a physical a few months ago and my iron levels were low, so the doctor told me to take an iron supplement and come back in a few weeks for another test. I did. When I got called back about the second results, and the doctor went on and on about my cholesterol levels, how they were high and I'd need to take medicine, etc. Ugh.

 

The thing was, I was supposed to be getting my iron rechecked, NOT my cholesterol!  Cholesterol levels were fine the first go round when I actually fasted, but the second test was late in the afternoon after I had eaten at least two meals. Of course my cholesterol was going to be off! I was so flustered about why she was going on about cholesterol, that I forgot to get my iron levels.  I didn't ask, and she never even mentioned my iron.  <_<

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dancer67, have you thought about what would help you feel better? Venting can be useful, but when you are ready to move on, sometimes it's helpful think through the situation and try to find solutions.

 

What I am hearing is three concerns:

 

1) A medical procedure was performed without your consent. That is upsetting on its own.

 

2) It involved an invasion of your privacy because it tested something you specifically did not want tested.

 

3) You worry about trusting your doctor in the future.

 

I would argue that you may be able to solve 1) and 3) pretty easily. In the case of 1), they didn't actually perform an unauthorized medical procedure on you. Your blood draw was with your consent. Up until that point, you were okay with everything that happened, right? You aren't happy with what they did with your blood afterward, but your bodily autonomy was not violated. Would it help to think of it that way? I would have a hard time letting go of somebody "doing something" do my body, so I think it would help me to recast the violation as not one on my body itself.

 

Then as for 3), I really liked your doctor's response. She apologized and also it's now clear that she did not order the test against your will. I would feel able to trust my doctor after that.

 

So that leaves you with the privacy issue. Yuck. That feels terrible. And I'm not sure it really helps for a bunch of people to say that they wouldn't feel it was a privacy violation in the same situation. I personally am not sure if I would or not, but I do know that when I have felt my privacy was violated it feels awful.

 

I hope you can find a way to feel better about it and not have lingering anxiety. :grouphug:

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I am not trying to buy any new policies etc.

 

I have strong feelings about Cholesterol. I disagree that it is an important test. But that is a conversation for another time.

 

Insurance companies should not have the right to dictate what tests you need to have. And a Dr. should not have the right to order them if the patient refuses. I would think that would be illegal. This was not a drug test........

 

I (think) I get what you are saying about cholesterol and all the conflicting info about what is normal or high and statins and what not. You are right in that nobody should have taken the liberty of testing for something you did not want tested.

This could possibly impact other insurance - like life insurance premiums - IF it shows you have high cholesterol by their standards.

 

The whole thing sounds like an insurance overreach to me but let us know what happened once you figure it out.

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In this case, a blood test (for the panel) was already authorized.  No one did an extra test on the OP.  They did an extra test on the blood that was drawn.  That may seem like a small point but if you are talking about unauthorized procedures then it is relevant because it was not an unauthorized procedure per se. 

 

I'm not sure I agree with this.  While it is not the specific case here, let's say that someone wanted to do a case study, but couldn't get people to come in to have blood drawn.  So they start using blood that has been drawn from people, without their consent, because hey - its just an extra test.  The blood draw was authorized so they can test for whatever they want?  So now as a patient I have to worry that the medical establishment may have data about my blood that I don't know about? 

 

Even if the original blood draw was authorized, it is still an unauthorized test.  And I think any lawyer using your argument above would lose in court.

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What I get what you are saying about the blood test being done, how you don't view that sort of thing as a big deal, to me, it's kind of like when a Jehovah's Witness refuses a blood transfusion.  To me, they are no big deal, but to them it's a super big deal.  I am not going to tell them not to get upset about if a doc gives them a blood transfusion after they said no, even though to me, that procedure is no big deal. 

 

I see a huge difference between the two things and suspect pretty much all doctors would too.  Even in the post right above (or shortly above if someone else is typing at the same time), had my STD test turned out positive totally surprising both hubby and myself, the first thing I would do is ASK for a retest rather than trust those results.

 

I had an iron test come back low once - causing me to go on iron supplements - and those caused pretty major problems along with associated stress.  I stopped the iron because I needed to feel better for "today" and wondered how low the next test would be.  The next test was fine.  I don't think it's unusual for tests to be wrong and the next time a test tells me something is wrong without any accompanying symptoms, that's going to be where my suspicion lies.

 

In general though, I'm different than the OP.  I think more information is better, not worse.  I like knowing where all of my basic numbers are (hence getting them voluntarily tested twice per year) and going from there with the info.  I was ok with no STD test because I 100% know myself and 100% trust my hubby.  My dr doesn't know either of us to that level.  There were symptoms that could have come from that.  I knew I could rule it out.  She didn't.  She was acting in my best interest checking.  That's not at all the same as ordering something other than a test (like a transfusion).

 

With a different issue I had a doctor once order a cardiac stress test.  I was pretty certain my issues weren't cardiac so protested.  He didn't insist, but told me he couldn't keep me in his practice if I refused because that was something he felt was worth checking into.  I had the test - it wasn't a problem.  I was right.  His "method" of getting what he wanted was probably a better one, but it's also not like someone can sneak in a stress test.   :lol:

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I am not trying to buy any new policies etc.

 

I have strong feelings about Cholesterol. I disagree that it is an important test. But that is a conversation for another time.

 

Insurance companies should not have the right to dictate what tests you need to have. And a Dr. should not have the right to order them if the patient refuses. I would think that would be illegal. This was not a drug test........

 

Insurance companies can only dictate what they will or will not pay for. You may have to pay for all physicals and blood work in the future. 

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Surprising as I have not had it done in 3 years. But I do not concern myself with cholesterol. I am strongly against it. I will share just one of several reasons why.....it is just one more push to medicate. Statins are a big business in the pharm. community. And they are bad news. I can list several other reasons why I believe cholesterol testing is not necessary, but I don't think I have enough room here................

 

I completely agree with your thoughts about cholesterol. 

 

That said, having worked in a high thoughput lab, I can assure you that mistakes happen.  The technician was probably on autopilot or maybe was ordered by a superior to do the test.  Or maybe they thought they were doing you a favor. 

 

You have the right to expect that you not be charged, but probably not much else.

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How can you be against cholesterol?

 

I am not against cholesterol testing like the OP is, but I do think that the body's drive towards homeostasis means that people have different set points and that it is ridiculous to try to alter those points either through diet or drugs.  This opinion does not extend to people with ultra high cholesterol though.

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Buuut, how many times has a doctor seen a woman who was certain she didn’t have an std actually have an STD? I understand on the std thing why doctors insist.

 

I couldn't care less about other patients' test results. The doctor asked if I was interested in additional tests. I said no. That should have been the end of it.

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I haven't read past this post yet, but I have to disagree here. When I was pregnant with my oldest ds, I had refused STD testing because I knew I didn't need it. Doc ordered it anyway, and lo and behold, results came back showing herpes. They wanted to treat me the last months of my pregnancy, to protect my baby in delivery, and I don't even want to remember the effect this information had on my marriage.

 

The thing is, I don't have herpes. My bloodwork shows no antibodies to herpes, indicating I have NEVER had herpes. Not only was a test done against my express wishes, but then the results were mixed up with someone else's, someone who was likely given a clean bill of health deapite carrying an STD. There was some damage done in this that can never be undone. It isn't always just a test.

I don't want to hijack the thread, but is your spouse aware that something like three quarters of the population has HSV, and that both types can be contracted orally by something as simple as sharing a drink? The idea that HSV-1 is oral and HSV-2 is genital has been thoroughly debunked, and both can lay dormant with zero symptoms for decades. So if you did have it- and I'm glad it turns out you don't- you could have gotten it as a child from sharing a straw or something. I think your spouse massively overreacted.

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I'm surprised so many would think this was okay because of the nature of the test.  The nature of it makes no difference.  What makes a difference is that we are in charge of our own bodies and medical choices and no doctor has a right to violate that.

 

I get that in this case it was a mistake and those happen.

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I am not trying to buy any new policies etc.

 

I have strong feelings about Cholesterol. I disagree that it is an important test. But that is a conversation for another time.

 

Insurance companies should not have the right to dictate what tests you need to have. And a Dr. should not have the right to order them if the patient refuses. I would think that would be illegal. This was not a drug test........

 

I agree with you on the cholesterol thing and about being mad they did this even though you didn't want it.

 

I guess I would only bother making an issue of it though if I had to pay for it.  And I might find another doctor.  I can't really imagine what else you COULD do.  You complained and told them you were mad so hopefully they actually listen next time.

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