News Item

Yeah...it is much cheaper to care for us when we are dead.

a couple of years ago my PCP switch completely to a system of "screenings." My patient record has a list of regular screens and follow ups I did (things like BP, blood tests to monitor meds, vaccines, etc.). I can email the doctor anytime I want with questions and concerns (I always get an answer with in 24 hours, from her or whoever is on call). They have a reminder system and when I need something, like a BP check or a blood test the RN will email me.

I haven't had a physical in 3 years and don't feel like my care has been compromised. When I am sick, I go in and they let me know when routine procedures and tests are needed. Works for me.

Andrew

It's outrageous to think that not knowing you have a disease is preferable to knowing! If you find out early you have a chance to nip it in the bud before it's so bad it can't be cured.
I wish I had known I had PCa earlier. Maybe I could have killed it before it escaped.
I've seen lots of examples of guys finding out they had stage four cancer only when they felt pain and it was too late.
Bob

A few years ago there was a movement to stop breast cancer screening. Next it was prostate cancer screening. Now the focus is to end the annual physical. Sounds like programmed conditioning to me. Start getting the masses to think along a certain line and eventually the masses will fall in line.

Many significant screenings (PSA, blood pressure, glucose, breast exam and mammograms, BMI, blood panels, ultrasound screening, etc.) can be done easily and often free without going to the doctor. Thus, the benefit of the doctor comes down to the actual touching and observing, taking the history and questioning us on our conditions and lifestyle.

Once this has been done, do most people need to see the doctor yearly or is it better to do so when they see or feel some unexplained change? I agree that the blood and urine testing should be done regularly, but that does not require a physical.

Could the physical be done less often than annually? Should it be tailored to the individual with some needing the physical more often some and far less often for others? Yes.

after what I've seen on this forum it doesn't surprise me.

ed

Although many believe the false meme that preventive health services are "free," the cost of these services are factored into the premiums that everyone with private insurance pays.

hook me to to a morphine pump
and call me done.

Andrew

I had a "physical" for the first time in years recently. I think it was just a way for the practice to bill my insurance.
I see the doc every six months or so for bloodwork. Cholesterol, PSA, etc. Don't most of us? Always get blood pressure checked, weighed, listen to the chest, etc. That's to get refills on meds.

So I think physicals for me are kind of a joke. The physical consisted of the "refill" routine plus:
* a check of my waist size.
* an eye exam (!)
* a balance check.

ChrisR -- if you dont want to know that's your choice but as a policy it's just plain dumb. how many of us could have been treated sooner. how many too late?

ed

You've gotta just love these recommendations. I know I benefitted from semi annual PSA test and 3x a year EKGs, which caught the abnormalities that led to finding an 85% blockage. I know, stunting blockages has not been proven to extend life. Know I've read that somewhere. Meanwhile back at the ranch , my symptoms of angina, which I didn't realize we're symptoms have disappeared.
Oh, and the PSA test that found my G7 at the apex. Totally unnecessary. For sure.....

The American Academy of Family Physicians has identified a number of procedures that have become routine in today's practices and may be overused. They say patients may want to consider these recommendations before agreeing to these procedures.

1. Don't use dual energy X-ray absorptiometry, known as DEXA, screening for osteoporosis in women younger than 65, or men younger than 70 with no risk factors. DEXA is not cost effective for young, low-risk patients.

2. Don't order annual EKGs or other cardiac screenings for low-risk patients without symptoms.

3. Don't perform Pap smears on women younger than 21 or who have had a hysterectomy for noncancer disease.

4. Don't screen for carotid artery stenosis in asymptomatic patients. Screenings can lead to unnecessary surgeries that could result in harms that outweigh the benefits.

5. Women older than 65 who have had adequate prior screening and aren't at high risk for cervical cancer don't need screenings. There's little evidence of benefit for screening after 65.

6. Don't screen women younger than 30 for cervical cancer with HPV testing, alone or with cytology. This can lead to more invasive testing and procedures.

7. Don't routinely screen for prostate cancer using a PSA test or digital rectal exam. PSA-based screenings can result in over-diagnosis of prostate tumors, many of which are benign.

I'm with Redwing. And Halbert. This stuff smells. Whether it's an article or an article about an article. It smells of bad economics. It's common sense, I don't have to be a scientist to know that.

Ugh.

Halbert--A very apropos quote from Dickens. The guy was prescient and one could effectively quote Dickens to good effect about almost any woe that afflicts modern society.

One axiom of logic that I keep in mind when considering any study is that association does not mean causation. And data can be manipulated to serve a purpose (dare I say it? an insurer's purpose). Food manufacturers (not farmers) manipulate data all the time to "prove" that a processed food is healthy, when in reality it is not. The medical business is learning to do the same, and as effectively. Some of the recommendations against PSA screen testing use a logic that is so fallacious as to be labelled, not fuzzy math, but silly math--even stupid math.

And so it goes.