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Consumer website helps doctors fight back against unnecessary health screenings

anti-screening website
privatehealthscreen.org
The website attempts to counter claims made by health-screening companies.

A group of British physicians has gotten so fed up with private, for-profit companies peddling unnecessary and potentially harmful health screenings to an unsuspecting public, they’ve launched a new website to help people know what questions they should ask before signing up (and handing over their hard-earned money) for such tests.

Although aimed at Brits, American consumers will also benefit from the information provided on the website, which is called Private Health Screening (although you’ll need to know that the acronym NHS stands for the U.K.’s free National Health Service).

“Private health screening tests are oversold and under-explained,” writes one of the creators of the website, general practitioner Dr. Margaret McCartney, in the Guardian newspaper. “Health screening can cause more harm than it prevents, so companies have a duty to provide full information to customers.”

The health screenings criticized by McCartney and her colleagues on the new website are not the ones physicians give to people who have symptoms or are at high risk for a particular illness or condition. The website's creators are instead challenging the screenings (usually ultrasounds, ECGs and blood tests) that private companies sell to healthy people to “check” for heart disease, aneurysms, high cholesterol, type 2 diabetes, osteoporosis and other ailments. The companies sweep into a city or town (or British village) and set up temporary screening clinics, often in church basements, community halls or shopping malls. After a day or two, they move on to a new location.

McCartney and her colleagues feel those companies are not giving consumers full and fair information about the screening tests for which they’re charging up to $300.

“[S]creening — testing well people as opposed to people who already feel unwell or who have symptoms, like a lump, or palpitations — always has the potential to harm, and is a constant balance of pros and cons,” she writes. “There is a risk of false positives, false negatives and false reassurance, and the problem of sometimes giving people a diagnosis they don't need, or subjecting them to treatment they won't benefit from. Noninvasive tests may cause few hazards, but the way the knowledge from a positive or negative scan is used may result in harm to the patient for no benefit.”

McCartney offers this example:

Take for example scanning the carotid artery — the main artery in the neck — which Life Line Scanning [sic] offers to completely well people. [Life Line Screening is the primary company that peddles private screening tests, both in the U.K. and in the U.S.] This is a useful test for people who have had a stroke, because if they have significant narrowing on the scan, an operation to clear this can reduce the future risk of stroke due to narrowed arteries.

However, there are risks associated with the surgery used to clear the blockage — not least, ironically, a stroke. This may be a reasonable risk to take if the chance of stroke caused by the carotid narrowing is high. But for people who haven't had a previous stroke or a ministroke, the risks of causing harm outweigh the chances of benefit, which is why the UK National Screening Committee doesn't recommend that the NHS provides it. It is not a case of the NHS being mean, it is simply that it is not a good test. For people who haven't had a stroke, the risk of stroke or death during the operation is about 3%.

Annotated ads

The new website has a wonderful section in which the physicians comment on the claims and other statements made in the advertisements produced by the for-profit screening-test companies. Click on one of the ads (which are similar to those used in the U.S.) and up pops the physicians’ annotated version.

Here, for example, is a paragraph from an ad:

To help detect your risk of stroke a 10 minute scan of your Carotid arteries examines blood flow to your brain, and “plaque.” (“Plaque” is the term for fatty deposits that can build up in your arteries, without showing any symptoms.)

And here is the physicians’ comment on that paragraph:

Carotid artery screening for people without a history of stroke or ministroke isn’t done in the U.K. because it causes as many problems as it prevents.

Making evidence-based decisions

Next time you receive a direct mailing or see a flyer about these private health screenings, compare it to the information on www.privatehealthscreen.org. Among the information is a list of articles about the ethics as well as the science of health screening.

“[S]creening is often counterintuitive and harmful,” writes McCartney. “Because of these inherent problems, people need to make good choices about whether to be screened based on evidence.”

You can read McCartney’s Guardian article at that publication’s website. She also wrote about the topic earlier this year for the journal BMJ, and that article is also available in full online.

(Hat tip: HealthNewsReview)

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Comments (4)

The Real Challenge

Now, if we could only find a way to inform patients about unnecessary screenings and procedures made by physicians intent on increasing personal revenue. One study found that 210 billion is spend per year on such unnecessary procedures. At a recent healthcare forum, a former financial consultant mused that the primary and often the only financial concern of the 50 physicians he served was: How do I make more money? The answer:perscribe more procedures. As uninformed patients, we are at a distinct disadvantage to doctors and insurers focused like a laser on generating more revenue by prescribing unnecessary procedures and creative coding of those procedures.

Re: The Real Challenge

Dee Ann: I've covered the problem that you raise in your comment many times before. Type "unnecessary screenings" into the MinnPost search engine and you'll find several of my posts on that issue. This particular post is about private screening companies.

The Value of Health Screenings

At Life Line Screening, we recognize there will be ongoing debates over health screenings. We’ve always offered high quality, convenient, affordable private screenings that individuals can voluntarily choose if they have appropriate risk factors and decide that the screenings are right for them. Criticism of private health screenings, however, fails to account for the context in which screenings are taking place. While others are free to disagree, we believe a model that promotes education and prevention can serve a vital role in the health care continuum. Please visit our blog for more facts about health screenings and to read our full response to recent critiques: http://www.lifelinescreeningblog.com/index.php/presenting-the-facts-by-a...

Joelle Reizes
Communications Director at Life Line Screening

Supportive

Thanks for the informative article. I had not known of these consequences and work that is going on. It is really a bad thing that people are just playing with people's lives for money or expanding their business. They need to be checked because common people are just not aware of the fact that they are doing and it is simply just cheating them. A false response we get from these private health companies running on. It is just a crime and must be given stress. Just as described above they are just changing their destinations to work free as well as not to come under the hands of the law. http://urgentcarenow.com/directory/ny