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| John Singer Sargent |
The chirpy young woman who was reading the script informed callers that "While the cost of the scan is typically not covered by insurance, this may be the best $200 you have ever spent on yourself!"
There was a smile in her voice and you could just hear the exclamation point in the script.
There are so many problems with this, it is hard to know where to begin:
1. The efficacy of detection has not been clearly established.
2. The number of false positives is always a concern with any screening test. How many people will get surgery for benign lung nodules is unknown.
3. Is a "low dose" CT really all that low dose. How many CT scans over a patient's life would he need?
4. Will patients continue smoking, knowing their CT scans are "negative" figuring, "Well, I dodged the bullet. I don't have cancer and I've smoked twenty years, so that's not going to be what gets me," and exactly what conclusions will the patients draw?
5. Why are we encouraging patients to do tests separated from the doctor who might be able to weigh in on some of these issues?
The reason for this ad is to generate income for the radiology group. At this particular hospital, the radiologists are independent contractors. They are, in many ways, like the old snake oil salesmen of Huckleberry Finn . They have something to sell, and they want to sell it. Their concern is not your health, your longevity, but their bottom line. CT scan machines are expensive and they want to pay theirs off as soon as possible.
Get your carotid ultrasound and your bone density at church. When you get the results, you're on your own.
Welcome to corporate, for profit, American medicine.
Phantom,
ReplyDeleteI guess the benefit would depend upon who they screen. According to an article I read, a government sponsored medical task force just this week recommended annual low dose CT lung scans, but for a very specific group-namely smokers 55-80, who smoked a pack per day for 30 years or ex-smokers who smoked that amount in the previous 15 years. Also, in compliance with Obamacare, insurance companies will have to start picking up the tab for these by the end of 2014.
However, the spokesperson for this task force also cautioned that "the harms of screening outweigh the benefits" for non-smokers and ex-smokers who haven't smoked in 15 years. He cited the same problem you do-the high rate of false positives in this group leading to additional needless and more invasive screenings. So, if the Radiology Department only screens the population recommended by the task force it would seem they'd be providing a beneficial service. But if anyone can schedule a CT scan-like one would schedule a manicure-than it would appear they are doing a big disservice to their patients in order to sweeten their bank statements...
Maud
Maud,
ReplyDeleteBet on the latter.
Phantom