DEAR DR. ROACH: How do I get primary care doctors to understand that I do not do any health screenings and that their badgering only infuriates me more. My feeling is that if you’re not going to treat me, why test me? I only need the doctor for prescriptions and referrals to a specialist if I choose to see one. I am a nurse and do not need their lectures. As a patient, I have the right to autonomy and when I choose to use it.

— Anonymous

ANSWER: Primary care doctors recommend screening tests because we prefer to find serious conditions earlier rather than later. As a nurse, you might not have seen a person who comes in with obstructing colon cancer and terrible pain, and who will then be treated through a necessary emergency surgery that is still unable to cure the disease.

Primary care doctors see many cases of early prostate and breast cancer, and we know that treating enough of these cases will prevent a few people from dying of these diseases. We believe in the effectiveness of preventive care. It is certainly true that it is your body and your choice, but understanding why we recommend health screenings might make you less infuriated when we do.

I am also concerned about what seems like a dismissive attitude toward the role of your primary care provider, such as a family medicine doctor, internist or nurse practitioner. We aren’t here to simply send you to a specialist and refill prescriptions. Primary care practitioners save lives not only through health screenings but by conducting a careful history exam and really listening to a patient, who may have noticed symptoms that indicate something serious. We do a physical exam to try to identify diseases in their early states.

I have many patients who are nurses and physicians, and we work together as partners — each with the goal of promoting wellness, treating disease if it is present and trying to identify early signs of serious problems.

I hope you consider this approach and that you will find your meetings more productive.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu.

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