It is with a heavy heart that I write you today with news of the latest medical scam that could hurt you or someone you love.
The practice has been referred to as “predatory screening.” It works sort of like this: a company offers to come to your church or an employer-sponsored health fair to do a free screening, or you could receive a flyer in the mail inviting you to come to a local hotel for a “preventive health screening.” Heck, I received one of these recently – the flyer gave me a special priority code and invited me to a local screening, telling me that “space is limited, so act now to reserve your spot.” For the mere sum of $149.00 I could receive a “painless, non-invasive” test and could even keep my clothes on! (An added plus for the over-60 set). The flyer scared the hell out of me. It said that my chance of getting a stroke is 1 in 5 and that most people who have a stroke have no symptoms. These companies rely on scaring potential consumers enough to convince them to purchase a screening package.
Turns out the company that does the screenings is “sponsored” by a local group of vascular surgeons. If a blockage is found on the “preventive screening” the patient is told there are medical procedures to zap it and, in some instances, even prevent an amputation down the line! Heck, who wouldn’t want to have that limb-threatening blockage removed ASAP? So, who stands to profit from this screening? The patient or the doctor treating the results of the screening?
Ding. Ding. Ding. Clearly, you’ve been reading my articles if you guessed, “the doctor.”
The peer-reviewed medical literature is clear. Routine screening for asymptomatic patients is medically unnecessary. Most people have some leg pain at some point in their lives and many patients over 60 (yes, that’s me) will have some amount of vessel narrowing or “blockage.” But stenting, lasering or “ballooning” legs are not typically medically necessary and has not been proven to have any real health benefits for the patient. These procedures have been known, however, to improve the financial health of the physicians who choose to turn a blind eye to medical ethics and science.
The unnecessary treatment, in sum, is THE POINT of the screening. It is a “business model” that has proven to be very lucrative for particular brands of entrepreneurial doctors.
Dr. Martin Makary, M.D., is a cancer surgeon at Johns Hopkins, a best-selling author and one of my personal heroes. In his latest book, “The Price We Pay,” he tells a story of a church fair that resulted in converting “a community of average residents into a pool of patients.” Dr. Makary is the one who coined the phrase “Leg is the New Heart.” You see, sending a patient to a cardiac cath lab to have a stent placed can be lifesaving. However, routinely stenting heart vessels has been shown to have no long-term effect on survival rate. Unnecessarily stenting heart vessels has come under scrutiny and, as a result, the practice is on the decline while routinely putting stents or “ballooning” leg vessels is on the rise. But, if patients aren’t having active problems, how do you build a medical practice? Where do the patients come from? Yes, you guessed it, “predatory screening.”
The U.S. Preventive Services Task Force has been abundantly clear, “there is no evidence to support screening for peripheral artery disease.” Simply put, luring potential patients in for unnecessary medical procedures is wrong. Using patients as human ATM’s is wrong. There is a consensus in the medical literature that it is wrong. There is no empirical data that these screening procedures are beneficial to patients. But, none of this is enough to stop doctors who place their own profits over patient safety.
I wish I could say that overstenting and “ballooning” legs is an isolated instance of healthcare providers screwing the patients and the system. But predatory medical screening is only one part of a bigger problem. Kaiser Health News published that “Some experts state that approximately $200 billion is wasted every year on excessive and unnecessary testing and treatment.” This “overtreatment” is believed to cause 30,000 deaths each year. This waste causes patient harm and excessive cost. And yes, some of this is costing you and me money in the form of our tax dollars and our increased health insurance premiums.
And who is most often getting tricked into these schemes? Lots of good folks including approximately 1,100 churches, synagogues and mosques who have inadvertently served as vascular screening centers, according to Dr. Makary and his team. And the results are in and should be no surprise… Dr. Makary’s research found that this practice is more prevalent in poorer socioeconomic areas of the country.
What do most of the victims have in common? A genuine interest in their health and a desire to get the medical treatment they have been tricked into believing they need.
It’s just wrong.