Thursday, September 10, 2009
Lab tests aren't often necessary
By Dr. Anthony Policastro

Many patients come to the office asking for lab tests or X-rays. They often do not realize that these tests do not always add a lot to the diagnosis. When a doctor sees a patient, there are many possible diagnoses. The information that the patient gives eliminates many of those. The questions that the physician asks helps narrow the possibilities even further. The next step is the physical examination. Once the physician has narrowed down the list of possibilities, the exam helps focus on what the actual diagnosis is. A good history and physical exam is much more important than lab tests or X-rays. One of the things I like to tell the lab personnel is that you should not often be surprised by a test result. You should know what result to expect before you order the test. If the history and physical have been done correctly, surprises should be few. In addition, if you are sure of a diagnosis before you do the test, perhaps you should not even do it. There is an old saying in medicine. Think of what you will do if the test is positive. Think of what you will do if the test is negative. If the answer is the same, don't do the test. Why waste your time if you are going to treat the patient the same way regardless? This becomes important as we further discuss the ways of decreasing the costs of medical care. One typical example occurs when a patient is transferred from one hospital to another. Usually, there are multiple basic lab tests that are done when a patient gets admitted to a hospital. Those tests are done by the hospital lab and the referring hospital relies on those test results. However, when a patient reaches the new hospital, those tests are usually repeated all over again. It is almost like the first hospital's lab results cannot be trusted. This is wasteful. There is a story about how these things increase the cost of medical practice. A woman had a pet duck. One morning she woke up and the duck was just lying there. She took it to the vet. The vet told her that the duck was dead. She could not believe it. She asked the vet if there was not some other test that could be done. The vet let a Labrador retriever out of a cage. The dog sniffed at the duck and walked away. The vet told the woman that was confirmation. She wanted something else to be tried. So the vet let a Siamese cat out of a cage. The cat came and sniffed the duck from one end to the other. The cat jumped off the table. The woman indicated that she would have to accept the fact. She asked what the bill would be. The vet told her it would be $350. She was amazed at how expensive that was. The vet told her that it was only $50 to make the diagnosis. However, the Lab test and the cat scan added the rest of the cost. We too need to be aware at how much more cost our expectations for tests add to the system.

Youth rehab lecture offered
Physical therapists, physical therapist assistants, athletic trainers and gym instructors will benefit from attending the 12th annual Distinguished Lecture Series at Delaware Technical & Community College, Owens Campus on Saturday, Oct. 3 from 7:30 a.m. to 4:30 p.m. This year's topic, "Treating the Young Athlete," will provide clinicians with an evidence-based approach to the evaluation and treatment of injuries related to young athletes. More children are participating in organized youth sports. These younger participants are being exposed to new movements and musculoskeletal patterns that are leading to both acute and chronic injuries. Presenter Dr. Jeff Konin is a licensed physical therapist and a certified athletic trainer who has written several textbooks and given numerous speeches on sports medicine topics throughout the world. The seminar fee of $135 includes handouts, a continental breakfast and lunch. For more information or to register, contact Delaware Tech's Corporate and Community Programs at 302-854-6996.

CASA seeks volunteers
The Court Appointed Special Advocate (CASA) Program in the Delaware Family Court seeks concerned, qualified adults to serve as CASA volunteers in Sussex County. CASAs are trained community volunteers appointed by Family Court judges to represent the best interests of abused/neglected or dependent children who are the subject of Court proceedings. The CASA volunteer advocates for the best interests of the child by investigating, presenting facts and recommendations to the Court, and monitoring a case until the child is provided a safe and permanent home. CASA volunteers have varied professional, educational, and ethnic backgrounds. Applications are being accepted now for the upcoming October training session. For more information and to apply to become a CASA volunteer, call the CASA office at 302-855-7410 or 302-855-7411. State outlines plans for flu season State agencies are working together to prepare for this year's flu season and Delawareans are encouraged to take precautions to protect themselves and their families to limit the spread of viruses. Health officials have been working since this spring's outbreak of the H1N1 flu strain to be ready when the flu season begins in the fall. Officials urge Delawareans to take common-sense steps, such as washing their hands and covering their mouths when coughing, to prevent contraction and spread of the flu. Delawareans are also urged to stay home from work or school when sick.The Division of Public Health is preparing to have additional flu clinics open this season to provide traditional flu vaccines as well as targeted vaccines from H1N1, and will be working with medical providers schools to increase the public's awareness. Secretary of Education Lillian Lowery said the Department is working to get out messages to parents and staff regarding ways to avoid getting the flu or sharing it with others. Those include practicing healthy habits (sleep, nutrition, etc.), practicing good respiratory etiquette and hand hygiene and not sending children to school if they have a fever or other symptoms of being ill. The Department of Education and the Division of Public Health are working on plans now for the voluntary vaccination of school children, who are at risk for the H1N1 virus.

Autism Delaware holds tournament
Go Fish, a bass fishing tournament to benefit Autism Delaware's southern location, will be held on Saturday, Sept. 19 at eight ponds throughout southern Delaware, and will be followed by a celebration at Milford's Bicentennial Park. Anglers of all ages are welcome. Each team of two can register for $40 and will receive an information and fundraising packet. Prizes, including a grand prize of $500, will be awarded at the celebration. The general public is welcome to attend the celebration which will feature music, food, kids fishing demonstrations, a visit from Texas Roadhouse's Andy the Armadillo, and other fun at Milford's Bicentennial Park. Nominal fees will be charged to those not participating in the morning tournament. In addition to the tournament, a benefit night is scheduled at the Seaford Texas Roadhouse on Wednesday, Sept. 16. Pro bass fisherman Mike DelVisco will appear from 5 to 8 p.m., and will also fish in the tournament. There are only 160 slots for fishing, so register today by visiting or calling 302-422-2255.

Pampered Chef to benefit Hospice
Delaware Hospice will benefit from a Pampered Chef Fundraiser Cooking Show, organized by Karen Rogers, Pampered Chef senior consultant, at the Delaware Hospice Center in Milford, on Monday, Oct. 19, at 5 p.m. Delaware Hospice will receive 25% of sales exceeding $600 to benefit its programs and services to the community, including additional 10% bonuses at various sales levels. Orders to benefit Delaware Hospice will be accepted through Oct. 26 at 5 p.m. Orders specifying "Delaware Hospice" may also be placed at For more information or to register for the event, call 856-7717.

Committee to meet
Sussex County's Advisory Committee for the Aging & Adults with Physical Disabilities will take its September meeting on the road, hosting a session in which the public is encouraged to attend to ask questions and learn more about the issues facing today's seniors citizens and residents with physical challenges. The Advisory Committee invites the public to attend the committee's next meeting at 10 a.m. Monday, Sept. 21, at the Greenwood CHEER Center. The forum will be an open session to discuss a variety of topics, including transportation, health, state and non-profit services, and more. The Sussex County Advisory Committee for the Aging & Adults with Physical Disabilities is an 11-member panel established by the Sussex County Council to be an advocate for programs and policies that benefit older and disabled residents. The committee meets on the third Monday of January, March, May, July, September and November. All meetings are open to the public.

Prostate screenings offered
September is Prostate Cancer Awareness Month and the Cancer Care Center staff at Nanticoke Memorial Hospital will provide prostate screenings on Friday, Sept. 18 from 8 a.m. to 5 p.m. on the first floor of the Nanticoke Cancer Care Center (located next to the hospital). There is a $5 screening fee and pre-registration is not required. Nanticoke Memorial Hospital encourages men over the age of 50 to take advantage of this service. Also men 40-years-old and at high risk of developing prostate cancer are also encouraged to participate. African-American men have a higher risk for developing prostate cancer, as are men who have a family history of the disease. For more information, call Nanticoke at 629-6611, ext. 3765.

Depression Support Group
There will be a free bimonthly Depression Support Group meeting in Laurel on the second and fourth Wednesday evenings from 7 to 8:30 p.m. Any person who has signs and symptoms of depression and is under the care of a professional counselor/MD is welcome to attend. To register, call Life Matters Counseling and Consulting at 302-465-6612.

Living with a chronic disease
Have you been affected by a medical condition that has caused suffering and loss of physical abilities over a period of years? Some examples of chronic disease include cancer, diabetes, heart disease, stroke, arthritis and lung diseases. If so, join Delaware Hospice and The Wellness Community-DE, as they collaborate to offer "Living a Healthy Life with a Chronic Condition." This free 6-week program begins on Monday, Sept. 14 at 9:30 a.m. and will be held at the Wellness Community's Sussex facility, which is located at 18947 John J. Williams Hwy, Suite 312, Rehoboth. This chronic disease self-management workshop is open to any persons who have one or more chronic conditions and to their caregiver or family member. To register or receive more information, call 645-9150.

NMH holds diabetes classes
Nanticoke Memorial Hospital, Seaford, will hold a four-session diabetes educational program beginning Sept. 9 and continuing Sept. 16, 23, and 30 from 5 to 7 p.m. at the hospital. Registration for this class is required. The cost of the four-session program may be reimbursable by insurance. This four-session program includes weekly education sessions and individualized meal planning for diabetes self-management. Our goal is to give you the self-management skills to control your diabetes. Family members/significant others are welcome to attend the weekly sessions. To register and obtain additional information regarding the course, contact Nanticoke Memorial Hospital's Diabetes Education department at 629-6611, ext. 2446.

MS offers videoconference
Thanks to live videoconferencing technology, members of the Delaware Chapter of the National Multiple Sclerosis Society can stay close to home and still take part in the chapter's annual meeting on Saturday, Oct. 24, at the Ammon Medical Education Center on the campus at Christiana Hospital in Newark. For the first time, the videoconference will include participants at a satellite location at Nanticoke Memorial Hospital in Seaford. Like the participants in Newark, Sussex County residents who attend the satellite location will also receive lunch, take part in the chapter's annual meeting and recognition awards ceremony, and enjoy a client-focused discussion about MS research. Cost is $5 per person, and anyone who wants to attend must register by Friday, Oct. 9 either online at or by calling 302-655-5610.