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DEAR DR. ROACH: In your recent column, a reader complained about a doctor using AI to write after-visit summaries. I think my doctor has begun using AI for this purpose, but I like it. The reason why I think she is using AI is because she has begun looking at me while we discuss my health, rather than looking at her computer while she types the report. This feels much more personal, and the after-visit summary seems to be just as accurate. -- G.U.

ANSWER: I appreciate your writing. This is one good outcome from the use of AI scribes. It does often feel like we physicians are too busy interacting with our computers to interact with our patients. But if AI can help take care of the administrative tasks of being a doctor and free us up to have better relationships, then I am all for it!

Many of my colleagues have worried that the use of AI will only serve to increase the expectancy of seeing more patients in a day. This is not what any of us want.

DEAR DR. ROACH: I am a 97-year-old male. Two years ago, I had a stent that was inserted for an abdominal aortic aneurysm and a right iliac artery aneurysm. I just had my two-year body-scan checkup with no problems noted. My surgeon recommends continuing annual scans. At 97, is there any good reason for getting annual scans? -- J.M.

ANSWER: In my opinion, you should only get follow-up scans if the information is going to be useful. If the scans show that one (or both) of the aneurysms is enlarging despite the stents, would you want to get surgery? Even if you didn't want surgery, would you want to know? The answer to this is much more one of personal preference than it is a medical one.

Many people in their 90s aren't interested in surgery unless it is absolutely necessary to treat symptoms that are ruining their quality of life. But others would want to get surgery if it meant improving their life expectancy without too much risk. Only your surgeon can help you personalize these results, but there is a big difference in the risk of an endovascular procedure (done through the blood vessels) versus an open-repair procedure (a traditional surgery that opens the abdomen), which is very risky in an elderly person.

DEAR DR. ROACH: My urologist wants to do a cystoscopy as he thinks I'm not getting all the urine out of my bladder. The test showed less than 2% retention. I don't have a burning sensation when I urinate, and it seems like I am getting rid of most of the urine. I am on 0.4 mg of tamsulosin (two pills per day), and I never have to get up at night. I am 86 years old. Do you think I need this procedure? -- B.C.

ANSWER: Although we used to put a tube in the bladder after a person voided to see how much urine was left, the use of an office ultrasound freed patients from this procedure. Now it makes no sense to do a cystoscopy to look inside the bladder just to determine how much urine is left. Your urologist must have another reason that they must not have explained well.

The most common reason for a cystoscopy is to find a cause for blood in the urine, but another reason is to understand why a man has symptoms (which you don't seem to have). Recurrent infections are another reason. You need to discuss the procedure with your doctor to better understand why it was recommended.

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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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