Beware misleading diagnostic studies
In a recent issue of The Glenwood Springs Post Independent, there was a photograph of an ultrasound technician performing a stroke screening on a young women’s carotid artery at a program sponsored by a company called Life Line Screening.This company has inappropriately entered the Roaring Fork Valley for at least two years in a row circulating flyers which indicate that for $139, paid in advance by major credit card, they will screen patients to prevent themselves from carotid artery narrowing, abdominal aorta widening, peripheral arterial disease, and osteoporosis.The public is being misled into believing that this relatively inexpensive, noninvasive series of ultrasound examinations is worthwhile. The reality is something quite the opposite.The issue of unscreened patients being subject to diagnostic test of little or no value has become a major problem in American medicine, so much so that a recent editorial appeared in The New York Times stating that “full body scans to screen healthy individuals for hidden disease have never been shown to be effective.”Evidence that such diagnostic studies performed on an unscreened population is mostly anecdotal. There are no recommendations by the American Cancer Society, the American College of Radiology, or the American College of Physicians to suggest that performing these diagnostic studies in people who have not been seen by a physician and recommended to undergo such testing is of value.In fact, these procedures often create more turmoil than positive effect. A patient will often receive a postcard from the screening institutions notifying them that an abnormality has been detected in one or more areas and that they should then bring this to the attention of their primary physician. The primary care doctor is now in the position that if he does not proceed with extensive evaluation of the suggested abnormality, he will be responsible for what possibly may happen to this patient at some point in time. If he orders the diagnostic studies, insurance companies will often appropriately refuse to pay for them on the grounds that in the absence of signs or symptoms or a family history, there is no indication to perform such screening. This leaves the patient in a very uncomfortable position thinking they are at greater risk for either a stroke, osteoporosis, an abdominal aortic aneurysm or rupture when, in fact, they are not.This Life Line screening has been organized out of Cleveland and is run by physicians who are not licensed to practice medicine in the state of Colorado. I, as a member of the board of directors of the Colorado State Medical Society, have been very active in trying to get our legislature to pass a regulation which would only allow such individuals who are licensed by the Colorado Board of Medicine to perform such diagnostic studies. This would then subject them to review by the Board of Medical Examiners and, if they were deemed to be performing substandard practice, they would be issued a Cease and Desist Order and such studies would not be able to be performed in our community.The money spent on this Life Line screening could far better be directed to move appropriate measures which would promote the health care of the individuals if they would but take the time to seek advice from their primary care physicians.Ira S. Jaffrey, MD, FACP is a physician with Western Slope Oncology Associates PC in Glenwood Springs. He is a diplomate of the American Board of International Medicine (ABIM) and the ABIM’s subspecialty of medical oncology.Ira S. Jaffrey, MD, FACP is a physician with Western Slope Oncology Associates PC in Glenwood Springs. He is a diplomate of the American Board of International Medicine (ABIM) and the ABIM’s subspecialty of medical oncology.
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AS OF THURSDAY, MAY 13