TOI Sunday 29th June 2014, carried the headline…. “AIIMS doctors lead the way, wage war on unnecessary medical tests”
The right comment, albeit somewhat late in the day.
Current scenario:
– Corporates offer health check packages for certain cadres of/ all employees
o Almost 25% do not avail of the facility
o Nearly 50% do not even open the report (A 42 year young man had to undergo bypass surgery; his previous year’s reports had diagnosed a coronary artery disease. Had he opened the envelope, his surgery may have been avoided)
o Remaining get counseling by their own doctors as most centers where the tests are done, do NOT offer posttest consultation/ counseling. But very few diligently follow the recommendations! Result à worst / unchanged reports next year
o Under guise of privacy the payer (corporate) does not get to know about health status of the team.
– Companies have been started, which are indulging in totally unnecessary tests; it was unbelievable, when we learnt of it at first, they even do CT scan brain and MRI spine in totally asymptomatic patients under guise of preventive checks. How they lure the unscrupulous patients is to show that tests worth 72,000 INR are being done in 35,000 INR. But no one needs them.
– There are hospitals, which send vans to rural areas to lure rich farmers for checkups costing 28 to 30,000 INR where everyone (whether symptomatic or not) is subjected to a cardiac CT.
– The sales personnel get trips to Bangkok, Malaysia for getting a certain number of cases.
The ‘one-time health checkupprograms with no follow-up’ doesn’t work. The one-time shots should be viewed as a start and need to be integrated into an overall wellness strategy.
What is actually needed:
– Age & medical history based focused checks
– Rational Health Risk Assessment
o Identifying risk factors
o Predicting possible sinister events in next 10 yr
o Listing scope of improvement
– Setting goals to be achieved with time frame for each
– Hand holding for achieving the goals through adoption of healthy lifestyles and/ or use of drugs if indicated
– Reassessment of deranged parameters, periodically
– Proving at next comprehensive checkup that all is well
Any approach that relies primarily on providing medical services after a person falls sick is a failed strategy.
To sum it up, all facets of Healthcare & wellness programs need to bePersonalizedand should encompass health professionalguiding the four aspects
- Predictive inform
- Preventive in technique
- Promotivein daily life and
- Managed Care should the need for curative care arises.
The issue is not what it costs to stay healthy and productive but to appreciate what are the actual costs of not being healthy?
Dr Chander Asrani and Team Life Countz (a division of CM Health Solutions) with a collective clinical experience of over 350 yr, is soon to launch a similar service that focuses on crucial health elements and elaborates the actions required to fine tune your lifestyles, reduce the Health Risks and thus achieve a state of ideal Wellness.
So true, Dr Asrani
My husband at 33 was put through PSA, rectal ultrasound and me through mammography at 33. After reaching USA, I learnt that mammography should not be done below 45 if there is no family history. Sad! & only because my husband was Director in his company.
Thanks, Sunanda
There are several like you who get duped by such checks.
True Sir! This also happens in general practise where patients are advised to undergo unnecessary tests just to inflate the bills and the pockets of the referring physicians. Few days ago I saw a doctor’s letter where he had advised Widal Test and Dengue Test for a patient complaining of loose motions of 2 days duration!!
Dr. Asrani,
I had a reply from you on Quora for prventing recurrence of stroke. I had two months back. No history of BP or diabetic. Yes live in stress in family. I am still on steroids. Worried about condition after stopping steroids.
Sir,
Recently my company asked me to go for heart fitness test which is cardiac ct, 2d echo as they had to submit to insurance company under corporate health care plan. My cardiac ct revealed that I have 90 percent plus blockage on left artery type 2, the second one around 40 percent plus and the right one with plaque. I have diabetes around 150 to 160 fibs and 250 pps.what would you recommend angioplasty or bypass surgery. Is it curable with medicines without doing for angioplasty or bypass surgery.