DnvrFox

My wife and I keep getting these fliers about how great it would be to have ourselves Life Screened (or something like that.) - along with "bargain rates" usually done at a local church or something like that.

PCP has never pushed it.

Several of the tests - ekg for afib, osteo - we already have done.

I am 72, the wife 74. The only heart problem I ever had was AFib, which I had fixed with an ablation 7 years ago.

Cholesterol for me is excellent - all markers good. Wife is getting better.

We are realy tired of interactions with the medical world.

Any thoughts?

chasm54

Yeah, lots of thoughts, but they are really only fit for P&R as they concern the reasons America spends so much on healthcare while having, in some respects, such poor health outcomes. Too many people making too much money out of promoting things that are of dubious benefit, among other things.

jon c. 

Stick with the advice of your local doctor. "Touring" medicine shows were a scam throughout much of this nation's history and I see no reason to think the modern variant is anything more than a cleaner, more professional looking version of traveling snake oil salesmen. You simply know these people are not in it because they're concerned about your health. They have only $$$ in mind.

cyclinfool

I suspect this is a service for those who haven't been seen by a local doc as much as you.

Dudelsack 

Well holy crap. They don't charge very much for the services.

The screenings include an EKG rhythm strip, ultrasound of the abdominal aorta, and Doppler flow studies of the carotid arteries and I think the ankle arteries. They can also include lipid panels and blood sugars.

I think it's a good idea for people who shun preventative health measures.

It also empowers the patient to be able to obtain them if their own physician doesn't recommend them.

For someone like D. fox, I'm guessing it wouldn't be very helpful.

BTW, the best information about the utility of abdominal aorta screening comes from UKs NHS. I doubt they're recommending it for the money.

John E

You are probably correct about that. Of course, many of us find prevention to be the cheapest and most effective form of medical care and the only true fountain of youth, but the medical industry does not want the word to get out.

chasm54

I worked in the UK NHS for many years. They are introducing that screening for men over 65. That makes some sense, though it is debatable whether it should have been given priority over other investments. For women, or men under 65, to pay for such a service In the absence of any family history, is simply a waste of time and money.

As for the rest of the life line screening programme, here is a UK perspective. note particularly Professor Wald's quote at the end of the article.

bruce19

I haven't done any "screening" per se but I did get my blood test results back last week. My testosterone level was right in the middle of the "normal" range. My LDL was 187 and my HDL was 65. Even after listening to all the MD talk I'm confused. This is pretty much what it was 4 yrs. ago even though my diet and exercise have improved greatly over the years. My MD has me on 5 mg of Crestor daily. Are those really bad numbers? My MD says the LDL should be under 100.

bigbadwullf

Uh................ask your Doctor?
As an eye doctor I can tell you that vision screenings are next to worthless. But don't believe me. Believe someone that sells bike parts for a living.

Ali_Pine

I'd rather take medical advice from a 'doc in the box' store front clinic than trust my testing to the traveling phlebotomis t- ultrasound operator.

Most of the offers I get say 'get the test - take it to your doctor for review'.

leob1

I love advertising.

gmt13

Screening certainly improves the probability that you will seek additional testing or treatment, whether of value or not.

-G

qcpmsame 

MY primary care physician takes care of all the above for me. I asked for a regular schedule of screenings appropriate for my age and health problems. Family history of cancer and heart attacks/strokes being pretty strong I feel better heading things off. With all of my health problems form the abdominal scar tissue growing rapidly and choking off the small intestine regularly I figure getting a potential problem taken care of makes sense. Not a worry thing, just prudent care by me. Our company's health insurance gives a lot of freebies for things like flu shots, various lab work items and some screenings for special things depending on your health history.

These screenings just make sense to me, always take the hard copy to my P.C. physician or have it sent directly to them if it is done out of their office. The U.K. NHS is a good thing, I feel, would support it here, however I would pay for some things myself for the knowledge I have to fight the problems with or head them off.

Bill

Dudelsack 

I look at it from a different perspective.

I believe in the "democratization of medicine": Patients should be able to order any non-invasive tests they want (as long as they are willing to pay for them), have free access to their own medical records, and self-prescribe with many exceptions, such as opioids, antibiotics, chemotherapy, and immunomodulators.

If people want to get this type of screening they should go for it, as long as they are willing to pay for it.

Screeners should be properly credentialled. If lots of companies want to get into the screening business, go for it. Let the price wars begin.

And, at risk of getting all the lefties in a lather, there really is nothing wrong with the profit motive, even in medicine.

Texasplumr

You threw it out there, so I guess you want input. I'm certainly not qualified to give medical advice although I did own a PDR back in the day.

I get a physical every year and they screen for a lot of stuff. Granted, I'm only 58 so probably haven't been through what you have. And I was in the hospital for the first time in my life this year but that was from anti inflamatories eating a hole in my stomach. So I don't know what is exactly appropriate for what age. But I do have a doctor and I like him and I trust him. He actually went to medical school and I, well, I once owned a PDR.

If it was me and I was curious, I would ask him. Just like I call my buddy who owns an HVAC business when my A/C isn't functioning because he certainly knows more than me, I talk to my doctor about health questions. He can certainly explain the pros and cons to each of the screenings. And he may say to go for it.

qcpmsame 

Well I do trust the physician, I'd walk away in a heartbeat if I didn't. Never owned a PDR but use one regularly they give much better information and I can understand it. I assume the physician went to med school, I chose him from his bio that said he was a combat medic before becoming a Physician's Assistant and then a physician. I'm 55, 56 in November, and was doing great until I injured my spine in 1989. Not worth the time to get into it.

I agree completely with you on asking a doctor when I have a medical question. It makes sense, but I did ask him to refrain form doing any engineering on construction matters until I could bid on it. With all the time in hospitals and all the surgeries (16 since 2000) I can't afford to use internet medicine and "internet doctors". We agree more than is first evident I suspect.

Bill

chasm54

don't regard myself as a"lefty" though some of my views would undoubtedly be regarded as dangerously communistic in the States. And I'm certainly not going to get in a lather. However, there is a great deal wrong with the profit motive in medicine.

In the first place, it provides an incentive for the doctors, and the institutions that employ them, to overtreat. That is, to prescribe investigations and interventions that are at best of borderline utility and at worst, potentially harmful. There is plenty of research to support this. In the UK, where dentists even within the NHS have always been paid on the basis of work done, their behaviour was monitored as the funding regime changed. When the fee for extractions rose, they did more extractions. When the fee for conservation treatments rose, the number of extractions fell. Back in the eighties I remember a study that estimated that in the USA over 2000 people died each year from the complications associated with what, on review, appeared to be unnecessary cardiac surgery. There is no doubt that the desire to maximise income influences, and in many cases distorts, clinical decisions.

Secondly, it deprives the poor of access to services. The scandalously high infant mortality rate Mississippi is not justbecause people are unhealthy, but because many communities have very poor access to high quality care. There isn't enough money in providing them with a service, because they are poor.

Thirdly, it promotes massive over provision. One reason you spend more than twice as much per head as we do on healthcare is that in wealthier areas you have huge overcapacity. There are hosts of hospitals and physicians competing to provide essential services, and to promote non-essential ones.

The combination of these factors means that many Americans are over-screened and over-treated, at vast expense, while many others are disgracefully neglected. The Hippocratic oath makes "do no harm" the cornerstone of ethical medical practice. Profit-seeking doctors do rather a lot of harm.

bruce19

Agreed....FWIW calling people "lefty" or "righty" serves no purpose except to alienate and deflect from discussion of actual issues.

MikeWMass

FWIW, there are reasons other than money that not everyone gets screening EKG's, ultrasounds, CT scans, etc. Things are found on these that then need to be evaluated. These are called "incidentalomas". If all the healthy 40 year old non-smokers in the US had chest CT scans, a significant number of them would have nodules in the lungs. At a minimum, this would require a followup scan in 6 to 12 months if they are above a certain size. If they get bigger, they require a biopsy. A certain percentage of the people who get biopsies will have a complication. For the population I mentioned, the number of people who do not have significant disease but get a complication from the evaluation would far exceed (orders of magnitude) the number who would have significant disease picked up. And this is not even talking about the cost of all these scans and biopsies, and treatment of complications. Currently there is controversy about the usefulness of screening in high risk (older smokers) populations. Similar stories could be told for EKG's, carotid ultrasounds, etc. For example, the screening for aortic aneurysm mentioned above is currently recommended (US Preventive Services Task Force) for men over 65 who ever smoked.
Any primary car provider should know (or at least be able to look up) screening recommendations for all of the things these programs look at. If they are appropriate, most insurances will cover them. If your insurance does not cover them (large deductible or only catastrophic coverage) your doctor should be able to find out whether it is cheaper to go to one of these programs or have him order the tests and you pay out of pocket.