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Buyer beware on ‘direct-to-consumer’ health screenings

Companies like Life Line Screening offer direct-to-consumer medical screening tests, but the benefit of such tests to asymptomatic patients is unproven.

They’re back!

Life Line Screening, that is.

On Tuesday, I received an unsolicited letter from that Ohio-based company inviting me to participate here in Minneapolis “in a simple, potentially lifesaving screening to assess your risk for stroke, abdominal aortic aneurysms and other vascular diseases.”

I received a similar letter from them a couple of years ago, only then it was “written” by Olympic figure-skating star Peggy Fleming.

If I call now, my new letter promised, I could get “all 5 screenings for only $149 and SAVE $126!”

Wow! What a deal! Right?


For the vast majority of us — no matter what our age — these screening tests are pointless, a waste of time and money. And they may even be harmful. That’s been the conclusion of many doctors and other health experts, including Dr. Kimberly Lovett, a professor of family and preventive medicine at the University of California, San Diego, and Dr. Bryan Liang, executive director of UC-San Diego’s Institute of Health Law Studies.

‘Targeting consumer fear’

Here’s what they wrote last June about Life Line Screening and other “direct-to-consumer” screening companies in a commentary article in the Journal of the American Medical Association (JAMA):

These [direct-to-consumer] companies market primarily by targeting consumer fear about undetected disease and acquiring a symptomatic, sometimes fatal, disease. … Beyond the suspect ethics of preying on consumer fears, some screening tests are suspect on evidence-based grounds.

Two other physicians, Drs. Erik Wallace and John Schumann, both associate professors of internal medicine at the University of Oklahoma’s School of Community Medicine, were even more blunt in an op-ed piece that appeared in the Tulsa World in January:

Consumers should have the freedom to spend their money as they see fit. But direct-to-consumer screening tests that offer little to no value wrapped in marketing claims of great medical benefit without disclosure of the potential risks are at best disingenuous and at worst unethical.

The tests that Life Line Screening wants me to have fail on the evidence. Four of the tests claim to be screening for heart disease and stroke. Two are ultrasound tests of arteries in the neck and abdomen. A third test measures blood pressure in your arms and legs to determine if your arteries are “hardening.” And a fourth uses EKG electrodes to identify an irregular heartbeat.

But, as the U.S. Preventive Services Task Force (USPSTF) — our leading and most independent authority on screening tests — has noted (for example, here and here), there is no evidence that these tests help save the lives of people with no existing symptoms of heart disease or stroke.

And that’s the group that screening tests are, by definition, aimed at: asymptomatic people.

The only exceptions are male smokers aged 65 to 75 years old. Such individuals, say the USPSTF, may benefit from an aortic aneurysm ultrasound screening. But those men should talk about the test with their personal physician first.

The problem of false positives

As for the rest of us, the harms of these tests far outweigh the benefits. Those harms include false positive results — results that suggest you have a health problem when you don’t.

“Many times, follow-up tests need to be arranged to disprove a falsely positive screening test,” explain Wallace and Schumann. “These follow-up tests, such as CT scans, MRIs, and additional procedures or surgeries may be anxiety-provoking, painful and carry risks such as allergic reactions, bleeding, infection, kidney damage, exposure to unnecessary radiation, stroke or heart attack.”

That’s right: Stroke and heart attack, the very same illnesses you wanted the original screening tests to “catch early” for you.

Negative results can also be harmful because they “may lead people to avoid important care,” write Lovett and Liang. “Without professional guidance, patients may be falsely reassured and forgo further care because they may assume the conclusiveness of a single negative result.”

Once again: The USPSTF does not recommend these tests unless you have symptoms. And if you think you are experiencing symptoms of heart disease or stroke, you really should be talking with your doctor (or going to the emergency room of your local hospital), not having an ultrasound test in the parish hall of a Minneapolis church (which is where Life Line Screening has scheduled its screenings next month).

Line Line Screening has a carefully worded statement in the little brochure that accompanies its unsolicited letter about why doctors “can’t” do the screenings offered by the company. “Most physicians can only order diagnostic tests if you are experiencing symptoms,” the brochure says. “They are usually not able to order them as a preventive measure because insurance will not cover them.”

What Life Line Screening doesn’t say, of course, is that doctors don’t order the tests — and insurers won’t pay for them — because there is no good evidence they save lives in asymptomatic people.

Diagnostics tests follow symptoms

Also, note how Life Line Screening refers to “diagnostic” tests in that statement. Diagnostic tests are tests that are ordered after symptoms appear. They’re used to determine if a disease or medical condition exists. So, yes, physicians do only order diagnostic tests if you’re experiencing symptoms. For asymptomatic people they recommend screening tests — but (and I feel I must repeat myself here) only if those tests have been proven to save lives.

Become a sustaining member today

Oh, and the fifth screening test in the Life Line line-up? It’s an “osteoporosis risk assessment.” That, too, is unnecessary, according to the USPSTF, except in women aged 65 and older or in younger women with definite risk factors.

But the best and most predictive test for assessing bone density and the risk of future, potentially life-threatening fractures, the USPSTF adds, is dual-energy x-ray absorptiometry (DXA) performed at the hip joint — not the ultrasound scan of the heel that Life Line Screening offers.

If you’re worried about heart disease or stroke or osteoporosis, talk with your doctor. And ignore your junk mail.

Comments (15)

  1. Submitted by Joelle Reizes on 06/18/2012 - 10:08 am.

    Screening tests are not ‘pointless’

    Dear Ms. Perry:

    We have posted a full response on our blog from our Chief Medical Officer (CMO), Dr. Andrew Manganaro, to address your criticism of Life Line Screening. We hope your readers will take some time to read our stance on health screenings so they can decide for themselves if our services are valuable or not. We have cited some recent research in the blog post of which you may not be aware. We also find it interesting that your article is sponsored by UCare, a Minnesota health insurance provider.

    Please visit our blog to read our full response:

    Joelle Reizes
    Communications Director
    Life Line Screening

    • Submitted by sandra Deane-Lee on 03/10/2018 - 08:06 pm.

      Life line screening

      Thank you Lifeline…you saved my life when my hmo apparently thought it wasn’t worth $150. Courteous, professional, quick and easy, and your information was on spot. I have a Lifeline screening scheduled for April 10, 2018, five different screenings for less than $150. If I could do this through my doctor/insurance this would cost me a bundle and would take at least three appointments. So thanks for being in business. Sandra Deane Lee

  2. Submitted by Paul Johnson on 10/15/2013 - 03:37 pm.

    Will preventative medicine save me or will it kill me???

    I don’t know if Life Screening’s screens are valid or predictable but I do find it interesting that in this article the doctors cited want it both ways. Were we to listen to the proponents of Obamacare and the AMA itself, the chief problem we have in health care is the dearth of preventive medicine. And in this article we’re told it’s not only us no use, it’s dangerous.

    So which is it. Will preventative medicine save me or will it kill me???

    • Submitted by joan davis on 06/12/2015 - 02:52 pm.

      life screening

      we have for the first time in history a GREAT health care system. where our government tries to put a hold on doctores hospitals and health corp. trying to squeeze our people and charging whatever they want. all the doctors who have commented against lifescreening do so for one reason——-they want us to come to their office and pay them the higher prices for all these tests. i have been with lifescreening for four years and i am a very healthy woman of 78 years. i only take one perscription and see a doctor once a year. and i still feel the need for the extra screenings from lifescreening.

  3. Submitted by Tessa Smith on 11/28/2013 - 11:02 am.

    Preventive Medicine and Direct-to-Consumer Screenings

    Ms. Perry,

    I know that you want to be research-based, but you also need to interview the little guys, put out a survey or something, because I am thankful to LifeLine Screening and the report I received based on evidence that my arteries were clogged at 50%. I was able to go to a preventive medicine website and order a product to unclog them and when I went and did the screening again it came back with “Low Risk” of heart attack. I don’t know about you, but people, like myself, want to be able to have this option available to be able to be free to choose to do the tests and have our own opinions about them. I am very pleased with LifeLine. I was able to take action and then rescreen and find that what I did to help myself worked. So if you have not tried it, please do not write about it from other persons’ perspective and who are these other persons? They are all related to the medical field. Of course none will want to support the direct-to-consumer option, they want us to come in and drain our insurance and our medicaid or medicare. The article is one sided, Ms. Perry, you need to write from the stand-point of the little guys…US!

    • Submitted by sandra Deane-Lee on 03/10/2018 - 07:51 pm.

      Life line screening

      Thank God for Lifeline…I am alive because of them. Screenings I had with them that my hmo dissed,,, 70+percent blockage!! Equals an on coming truck!!!

  4. Submitted by allana Stroop on 04/25/2014 - 08:23 am.

    Tessa Smith

    I agree with your comment whole heartedly. After reading the article and your comment I will be sure to get this test done. The only thing the doctors can offer you is a pill. Take this pill until it is too late. Tesse what site did you go to which told you about a product to unglog your arteries. The name of the product and site would be very helpful. Thanks

  5. Submitted by joan davis on 06/12/2015 - 03:00 pm.


    any screenings that take away from doctors and hospitals profits, they comment negatively. lifescreening results go to my doctor and we discuss what i think and its alot cheaper. he may not be happy about not making the profit off those screenings but its my choice.

  6. Submitted by steve mitzner on 07/14/2015 - 10:56 am.

    Pitching FEAR

    Susan Perry’s “Pitch” ‘Targeting consumer fear’ for me was oxymoronic. She convinced me to have the screaming [Thank you.]

    FEAR the Medical / Pink industry’s bread & butter. E.G. “You may die of Cancer if you don’t have your breasts crushed [to rupture possible tumors] and exposed to fearful, & invasive A-bomb type, ionizing radiation.” [Good luck with that]

    ” They can “prove” it using slick misleading, Relative Risk Statistics on the suckers.”

    Do YOUR OWN “research” The Industry has different interests than yours.

    Steve Mitzner Ca.

  7. Submitted by Calvin Childers on 02/08/2016 - 02:12 pm.


    There five tests you can get at most hospitals for free. So why would anyone, that could, pay for them? NO reason!

    • Submitted by Heather Stoudt-Gammache on 12/11/2016 - 04:19 pm.


      Where on earth do you get a free EKG, free ultrasound?

    • Submitted by Carter Champlin on 12/04/2017 - 07:02 am.

      Hospital Scams

      Wow! Where is this? I want to go! I went into the emergency Room to have them look at my neck, With no insurance upfront the nurse told me it would be 500 for all exams for that night. They ordered a cat scan on my head which I tried to get them to change then brought me back Did blood pressure and EKG, Told me I had a stiff neck and sent me on my wayLike I was wasting their time. A couple days later I got a bill in the mail for $2600 just for the hospital test. Then another couple of days I got I got a sub contractor doctor bill for 500 Then in another couple of days A150 bill for reading cat scan and then a $75 bill for reading EKG.

    • Submitted by Ben Shenkleton on 04/09/2018 - 10:11 am.


      It’s free to you only because I am paying for it. To me, even after $980/month premium, it is not free.

  8. Submitted by Heather Stoudt-Gammache on 12/11/2016 - 04:20 pm.

    Terrible article!

    Ok so I read the article and from a person who had been in medicine for 15 years, this article is absolute crap! The author touts that heart attack and stroke should only be treated, and tests ordered when someone is having symptoms. That is insane! If you wait until you have symptoms, which many people wait too long, it may be too late! Any preventive screenings are extremely worthwhile because risk can be identified and then you can discuss the results with your doctors. While I agree with the author that young people, or those with no risk factors are probably wasting their money, those with a family history or risk factors could identify a life-threatening problem like atrial fibrillation. I think the comments by the doctors in this article represent the typical ego driven medicine that has become a big part of our society where doctors think they are the only ones who can practice medicine and nothing should be done without their consent.

  9. Submitted by Donna Smith on 08/11/2017 - 06:41 am.

    It really can’t hurt…

    I have my first screening scheduled. I go regularly to my doctor for physicals, etc. and have no issue with that. However, unless I have a problem, nothing is checked proactively other than blood pressure, cholesterol and breast exams for the most part. These screenings, which are harmless, will just be another data point for me (and my doctor). I will still be going to my doctor and have her view the results of these tests that she would not have proactively ordered otherwise. For some of us who no longer have living parents and do not have much information about our family medical history, this is also valuable information to have (and I assume also for those who are adopted who may not know about their family medical history). I would like to take control of my own health care while working with my doctor. The insurance companies and our medical system are the issue…not these simple screening tests. My vet does more preventative screenings on my dog than our medical system does on humans. 🙂

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