Annual exams vs. annual wellness visits

Happy New (Calendar) Year!

It’s the start of a new year or, in health insurance lingo, the start of a new calendar year deductible. I’m reposting this from last January, because this month is the best time to start trying to schedule that annual exam or annual wellness visit (it could take weeks, after all, to get an appointment!)

I usually advise people to get any screening tests or annual exams done early in the year, just in case an abnormality is found and more testing/treatment is necessary.

Especially with the current trend towards enormous deductibles (up to $14,300 for Continue reading

“Bridge Over Diagnosis”

I’m going with an overdiagnosis theme this week.

Here’s the latest healthcare parody video from pharmacy professor James McCormack, as he continues his much-appreciated effort to raise awareness of overscreening, overdiagnosis, and overtreatment in this country.

As usual, this video is full of supporting statistics and excerpts from leading healthcare journals, so take time to pause the video and really understand the information being shared.

As I said in a previous post, overdiagnosis and the resulting unnecessary treatments cost hundreds of billions of dollars every year.

Equally bad, if not worse, I think, is … Continue reading

Risk Benefit Theater – Screening mammograms

I’m all about high-value, evidence-based healthcare.

I’ve written a lot of posts about the problems, including high costs, of overscreening and overtreating. (We spend hundreds of billions of dollars every year on unnecessary healthcare!)

So I love this video by Andrew Lazris, MD, and Erik Rifkin, PhD. They use the visual of 1000 women sitting in a theater to illustrate why screening mammograms are not the life savers many women think they are.

A picture (or video) is worth a thousand words, isn’t it?

I understand Lazris and Rifkin want to create more videos to … Continue reading

Life Line Community Healthcare and Life Line Screening

Buyer Beware

I’ve posted before about the limitations of Life Line Screening.

The screening tests they offer in their basic “wellness” package are either not recommended at all because they aren’t effective screening tools (carotid ultrasound), or are not recommended for the general public (abdominal aortic aneurysm ultrasound). Please read my previous post for more information on that: Don’t reach for Life Line Screenings

Screening tests are best discussed with your primary care physician. He or she will help you know which tests are right for you—based on your age, health history and family history—as well as how often they … Continue reading

Don’t reach for Life Line screenings

I first posted about Life Line screenings two years ago. I’m re-posting today as this post still gets a lot of traffic and I wanted to reopen the comments. 

life line screeningsOvertreating, overspending

I just received an invitation in the mail!

Not to a party or a wedding or anything fun, but to a Life Line Screening event being held at a local church. The letter says they’re holding a spot for me on this particular date, but I must call NOW to confirm and register, because spaces are LIMITED!

“These aren’t just routine medical procedures—they can help save your life”

Oh, … Continue reading

Skin cancer screening guidelines

skin cancer“Insufficient evidence”

Many years ago I had a primary care doctor who used to perform a total body skin examination (TBSE) on me every year as part of my annual exam.

Of course, those all-inclusive physicals are a thing of the past. I haven’t had a physician perform a TBSE for a long time.

I often wondered about that. A TBSE seems like a relatively easy and harmless way to quickly screen for skin cancer. The goal, of course, is to find a melanoma, the deadly skin cancer, when it’s small and possibly curable.

Related post: A must-watch video about Continue reading

Screening kids for lead poisoning

The high lead levels in Flint, Michigan’s water supply have been news for several months. There’s been a lot of finger pointing and congressional hearings and such, but the bottom line is that because an agency didn’t do its job properly, the health of many kids was put at risk.

Lead poisoning is especially serious in infants and young children, as it interferes with brain development.

Sadly, the situation in Flint is not unique. Washington, DC, had a similar crisis a few years ago, and just last week my home state, Washington, reported that 34 water systems had lead … Continue reading

Screening eye exams in older adults

Just yesterday I posted about the United States Preventive Services Task Force (USPSTF) and the fine line they walk between providing evidence-based recommendations for screening tests and making medical specialist groups happy.

Sometimes it just doesn’t happen.

The task force recently gave an “I” grade to vision screening in patients over 65. An I grade, or Insufficient evidence, means that the task force can’t definitively say that the benefits of vision screening in older adults outweigh the possible harms.

The American Academy of Ophthalmology (AAO) doesn’t agree.

Specifically, the task force reviewed the evidence for primary care doctors screening for … Continue reading

Don’t use the Instant Blood Pressure app

Aura Life, the makers of the popular smartphone blood pressure app Instant Blood Pressure, probably made a mistake when they initially used the well-known medical research complex Johns Hopkins in their marketing campaign.

Aura Life boasted their app “uses a patent-pending process developed by a team from the Johns Hopkins University—a world leader in health innovation.”

Baffled, Johns Hopkins sent Aura Life a cease-and-desist letter, but they also decided to do some research into how well the blood pressure app performed.

Not well.

The researchers recently released their findings that showed the Instant Blood Pressure app, which uses an… Continue reading

The S-RAY – Dental imaging without radiation

One of the great things about living in Seattle is that because we are home to so many biotech companies, I often hear about innovative devices before they’re on the market.

I like to see (sometimes) where health technology is taking us.

I just saw a news report on a new dental imaging x-ray that actually isn’t an x-ray because it doesn’t use radiation. Instead it uses ultrasound, and it’s called the S-RAY.

I’ve posted before about the dangers of too much radiation from imaging studies, including dental x-rays. Dentists frequently order x-rays every year, even though the American … Continue reading

Be informed – PSA screening tests

PSA stands for Prostate-Specific Antigen. It’s a blood test used to screen for prostate cancer.

Doctors used to recommend an annual PSA test for men over 40. But now we know that the PSA is not a good screening tool. It results in a high number of false positives, and not all forms of prostate cancer need to be treated.

Too many men have received unpleasant, expensive treatment they didn’t need.

In an excellent YouTube video, Dr. Mike Evans explains more:

In 2012 the United States Preventive Services Task Force (USPSTF) recommended against Continue reading

Know your family health history

Tomorrow is Thanksgiving Day.

Did you know it’s also National Family History Day?

Each year since 2004, the Surgeon General has declared Thanksgiving to be National Family History Day. Over the holiday or at other times when families gather, the Surgeon General encourages Americans to talk about, and to write down, the health problems that seem to run in their family. Learning about their family’s health history may help ensure a longer, healthier future together.

As a nurse, I have taken hundreds of patient histories and I am always surprised by how little most people know about the health … Continue reading

Confused by mammogram guidelines?

October is Breast Cancer Awareness Month, so I can’t let it pass without commenting on the American Cancer Society’s (ACS) recently updated screening mammogram guidelines.

Before, the ACS recommended annual mammograms starting at age 40.

Now they recommend annual mammograms for ages 45 to 54, with screening mammograms done every other year after age 55.

But, they add, women should still have the choice to start screening at age 40 and have yearly mammograms thereafter.

The confusion arises not only because the ACS is a bit wishy washy on its guidelines, but because the American College of Obstetricians and Gynecologists … Continue reading

A routine urinalysis is unnecessary

This week the National Kidney Foundation (NKF) started a public health campaign called “Everybody Pees.”

The highlight is a short video featuring a catchy song and colorful South Park-esque kidneys peeing in all sorts of places—parks, swimming pools, on top of a car, etc.

OK, it’s cute, kind of. But here’s my problem with this video (other than the it’s a cartoon more appropriate for six-year-olds): a routine urinalysis is NOT recommended to screen for kidney disease.

But that’s what the song seems to tell us to do:

The smartest place to pee

Is at

Continue reading

Atul Gawande – Overtreament, “Overkill”

A friend of mine who is an avid reader of both The New Yorker and my blog sent me the following link: Overkill: An avalanche of unnecessary medical care is harming patients physically and financially. What can we do about it?

The author is Atul Gawande, MD, one of my favorite surgeon/writers. It’s a long article, but if you are interested in saving money on your health care (and possibly saving your health), I encourage you to take time to read it.

I have posted many times about America’s obsession with overtreatment—too many tests, too many specialists, too many … Continue reading