Do You Really Need That Angiogram?

This will come as a big surprise.  Hospitals offer tests patients don't really need.

According to a story by Julie Appleby, hoping to attract patients and promote good will in the community, hospitals "are teaming up with medical-screening companies to promote tests they say might prevent deadly strokes or heart disease."

But they're not just offering them to people who might become sick but to those without symptoms or other risk factors.  In other words, these tests are totally useless for many and could prove harmful.  In a lot of cases, they're being given just to make money.

Appleby quotes a government panel that notes that these tests find "too few problems" when weighed against the drawbacks -- unnecessary CT or MRI scans, biopsies, sometimes even surgeries. And guess what else?  The tests increase healthcare costs.

“A lot that ends up being found is clinically of no importance at all,” Steven Weinberger, executive vice president and chief executive of the American College of Physicians, wrote in an August piece in the Annals of Internal Medicine, Appleby reports. "He and two co-authors argued it was 'unethical' for hospitals to promote the tests without disclosing potential downsides," she writes.

So what to do when your doctor suggests you have your arteries checked to screen for heart disease when there's no history in your family, your weight is low, you work out, and avoid high-cholesterol foods?   Probably just say no.

But in a similar situation, as Gina Kolata pointed out yesterday in The New York Times, a man with absolutely no symptoms of heart disease, fit and healthy and lean, did indeed have clogged arteries that could lead to heart attack or stroke, because his family all had a gene that made them subject to early heart attacks  and death. In his case, the screening proved life-saving.

So it's your choice. I know we all tend to take our doctors' advice as sacred but it's okay to question them once in a while.  Sadly, for me, I only learned to do it once I had a child.


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