Tuesday, February 5, 2019

It’s his wallet paying the tab

A couple months ago, Pierini Fitness read an article in Consumer Reports about medical screening tests you do and don’t need.  The article reported how some of these tests may be life-saving while others can be a waste of time and money and pose risks.  The subject interested me, so I read the entire article.

The article went on to say how there are scores of blood tests, ultrasounds and CT scans for conditions like cancer and low bone density.  And, increasingly, many of these tests are offered direct-to-consumer, meaning that we can order and pay for them directly without having to get our physicians or health insurance carriers approve them in advance.

Since Pierini Fitness pays his own health insurance premiums because he’s self-employed, he has chosen a high-deductible health insurance policy in exchange for lower health insurance premiums.  This means a higher annual deductible so for many years now, he’s shopped around and paid for medical care and tests without using a physician.

Around twice a year, he has blood work to assess his cholesterol level, fasting glucose and an assortment of other health markers depending on what he would like to know.  He uses a company named DirectLabs to directly order various lab tests.  After the lab order is placed, a requisition form is provided that you take to any one of several local labs, the same ones you’d go to if your doctor ordered the test, where blood is drawn.  Generally, within 48 hours, the lab results are directly provided to me via online access.  I then study and evaluate the lab results. Sometimes, it’s necessary to read up and learn more if a lab result reading indicates something is outside what’s considered a normal reference range.  Since I’m a meathead and not a medical doctor, fortunately I have a couple physician acquaintances I can go to if I have questions.

My next scheduled blood lab work is coming up in a couple weeks on my birthday.  Having lab work done on my birthday is an annual ritual I’ve been doing for several years now.

Something else I recently had done about four months ago was a series of screenings performed by a company named Life Line Screening.  It offers more than 15 preventative screening options to detect risks for heart disease, stroke, cancer, osteoporosis and more. 

What I had tested used ultrasound to assess for the existence of any plaque build-up or restriction of blood flow in my carotid arteries, atrial fibrillation, abdominal aortic aneurysm, peripheral arterial disease, and osteoporosis.

The Consumer Reports article indicated that screening has become a big business.  While little information is available on how many dollars are spent nationwide for screenings that are beneficial, one study found that about 26 percent of individuals had at least one test or treatment identified by experts as unnecessary.

Most of the overuse in this study related to 11 services and eight of them were screening tests, perhaps like the ones I had done.  For example, the study reported that about $40 million alone went for annual electrocardiograms (EKGs) and other heart screenings for people at low risk for cardiovascular disease and without symptoms.

This may very well be the case for Pierini Fitness.  Based on medical history, recent lab work measuring cholesterol levels and other health markers including blood pressure, he meets the definition of being at low risk for cardiovascular disease and is without symptoms.

Nevertheless, according to the Center for Disease Control and Prevention, heart disease is the second leading cause of death for individuals aged 55 to 64 years, the age decade of Pierini Fitness. 

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Back to the screenings that Pierini Fitness had done late last year.  He paid $149 for the previously mentioned screening tests and learned the following:

Carotid Artery Disease – No evidence was found of plaque build-up or restrictions of blood flow in my carotid arteries.

Atrial Fibrillation – No atrial fibrillation was detected.

Abdominal Aortic Aneurysm – No aneurysm was detected.

Peripheral Arterial Disease – Normal results were detected meaning that the blood pressure in my ankles are as high or higher than the blood pressure in my arms. 

Osteoporosis – My bone density was 0.791 which was rated as moderate risk for bone diminishment.  It was recommended that I receive further evaluation from my primary care physician.  This was a surprise to me and I’m studying what my next course of action will be.  I had judged by bone density to be adequate.

Consumer Reports concludes its article by commenting that when recommending screenings, your physician should generally rely on scientific evidence and guidelines from the government and expert organizations.  Studies have found, however, many physicians aren’t up-to-date of this evidence of these guidelines.  Therefore, Pierini Fitness has decided to learn more and raise his medical knowledge bar and be a better-informed medical and health care consumer.

Were these tests unnecessary?  According to the experts who conducted the study previously mentioned that found many tests done are unnecessary, the answer may be yes.

But, Pierini Fitness was the consumer for these tests, paid the $149 and is very satisfied with the information provided and the assurances received.  He’ll continue to have direct-to-consumer blood lab work and other health screening procedures done as he chooses because he’s the medical consumer and besides, it’s his wallet paying the tab.

Pax Domini sit semper vobiscum

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