“Doc, do I really need the colonoscopy?  It’s going to cost me $1500.  I have a $750 deductible.”

That’s a tough question to answer.  In reality, I’ll know the answer after the test is done.

If the colonoscopy is completely normal, then the answer is no, you did not need the test.  It’s not a complete loss.  You have the peace of mind of knowing that you don’t have some dreaded disease of the colon.  Fifteen hundred dollars is a lot to pay for peace of mind.

If you have a precursor (adenoma) to colon cancer, you definitely needed that test.  Once the adenoma is removed and the threat of cancer alleviated, your doctors can set up a monitoring schedule that will keep you colon cancer free for years to come.  It was $1500 dollars well spent!

If you have colon cancer in its earliest stages, your doctors can operate, remove the cancer and save your life.  What is your life worth?  Your life is well worth $1500 dollars!  As a bonus, your progeny gets the advantage of knowing they are at risk of colon cancer and the knowledge necessary to save their lives.

“Doc, do I need that test?  I certainly hope not!  I prefer to tell my patients they did not need the colonoscopy or CT scan.  I prefer to tell my patients we found no disease, no cancer, no problem!  I prefer that my patients waste their money.  I hate telling my patients they have cancer, they need surgery or chemotherapy.

On the other hand, I love telling my patients we found it earlier.  I love when the surgeon says, “I got it all!”  I love watching my families grow old together.  Yep, you need that test.

Stewart Segal is a family physician who blogs at Livewellthy.org.

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