DEAR DR. ROACH: I recently turned 65 and changed primary doctors because my previous doctor did not accept Medicare patients. I very much liked my new doctor. He ordered a vitamin D test. However, when I got to the lab, they gave me something to sign because Medicare might not cover the test. (It was about a $250 cost.) I declined the test.

When I got home, I read the visit notes I was given. To my surprise, it said I was overweight. I have tried all my life to keep my body mass index (BMI) under 25, rather successfully. The notes indicated that my BMI was 27.1. I wondered how this could be.

After further review, I noticed they listed that I was 3 inches shorter than my actual height. They did not actually measure my height during the visit, but it was on my driver’s license, which they asked me to provide.

I called the office and advised them of the error. They said they could not change the information, but if I came in soon, they would update the records. The next day, I went back, and they measured my actual height and advised me that they would update the records.

I am surmising that the doctor decreased my height in order for Medicare to cover my lab tests. Should I change to a better health insurance or change Medicare doctors? — R.M.

ANSWER: Falsifying medical documents in order to bill Medicare more would be fraud and carries a large penalty. I think it is much more likely that there was a mistake about your height. Perhaps they estimated your height badly. In any event, making your height lower so that your BMI (a flawed measure of obesity) would appear abnormal would not have affected the payment for blood tests.

Measuring vitamin D levels has been controversial, but a fairly recent and large study suggested that there is little benefit in testing vitamin D except in cases where low vitamin D is expected. These cases are based on whether a person has risk factors for low vitamin D (such as a condition that affects absorption or people who rarely get sun exposure), a suspected condition that is associated with low vitamin D (such as osteoporosis), or symptoms of low vitamin D (such as muscle weakness).

In these cases, the doctor would have no trouble ordering the test if he entered the diagnoses.

DEAR DR. ROACH: I often hear the term “generic drug,” but I don’t really know what it means. — A.Q.T.

ANSWER: When a drug is first patented and brought to market, the company that does so has protection, generally for 14 years after it is approved. During this time, only the manufacturer can sell the drug, usually under a brand name.

When the patent protection expires, the drug can be manufactured and sold by any company, as long as they meet the stringent criteria for purity as required by the United States Food and Drug Administration. It is usually sold under a generic name, although there are brand names for some drugs that are brought out after the patent protection expires.

Generic drugs are as high-quality as brand name drugs, and most physicians, including me, use generic medications when they’re available for themselves and their families. There are a small handful of drugs where brand names have some evidence of being better, not in purity or exactness of dose but more commonly in the ability of the medication to be absorbed in a precisely controlled way.

Occasionally, a person might have a reaction to a nondrug component of the pill.

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. (c) 2025 North America Syndicate Inc. All Rights Reserved