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Consumer Group Urges Hospitals To Stop Promoting Questionable Screenings

By Julie Appleby

June 19th, 2014, 12:24 PM

Consumer advocacy group Public Citizen on Thursday called on 20 hospital systems to stop partnering with companies that offer low-cost screenings for heart disease and stroke risk, saying the promotions are “unethical” and the exams are more likely to do harm than good.

In recent years, more hospitals have paired with firms offering such testing packages, partly to build community goodwill and referrals.  Hospitals say residents benefit from the testing packages, which can cost less than $150, because some will discover they are at higher risk for heart problems or stroke early enough to take steps to reduce their risks.

But some medical groups and consumer advocates object to the programs, saying they are a waste of money for most consumers.

Public Citizen argues “the promotions rely on fear mongering and erroneously suggest that for most adults in the general population, these screening tests are useful in the prevention of several potentially life-threatening cardiovascular illnesses.”

It sent letters to hospitals in eight states, including Inova in the Washington, D.C. area, Scottsdale Healthcare in Arizona, Dignity Health in California and the University of Iowa Health Alliance, urging them to stop promoting such tests.

The programs are advertised on websites, in newspapers or through direct mail. Screenings — often performed in specially equipped buses — include  ultrasound tests for blockages of the carotid artery and weak spots in the abdominal aorta, a resting electrocardiogram, or EKG, a test of elasticity of the arteries and another for blockages in arteries serving the legs, a condition called peripheral arterial disease.

What the promotions don’t say, generally, is that most of the tests are not recommended for people without risk factors or symptoms.  Widespread screening of people without the risk factors could lead to misleading results and potentially even unnecessary surgery. Other medical experts warn that the tests could needlessly raise health-care spending.

Patrick T. O’Gara, the president of the American College of Cardiology, said consumers are right to raise questions about the value of some screenings , noting the specialty group offers recommendations to physicians to guide them in making decisions with patients about their risk for heart attack and stroke.

“Other than assessing blood pressure and serum cholesterol, being attentive to diabetes and promoting a healthy weight with regular exercise, we do not recommend broad and untargeted screening,”  he said. “Decisions about the need for additional testing should be based on each patient’s circumstances.”

11 Responses to “Consumer Group Urges Hospitals To Stop Promoting Questionable Screenings”

  1. Killroy71 says:

    This is great news – usually consumer groups come down on the side of “more is better” and “free” care for everyone.

  2. Jakob Stagg says:

    How else is the government going to fulfill J.Edgar Hoover’s dream of knowing everything about everybody? Just spying on everyone’s communication is not nearly enough. Gotta fill those DNA profile records for some real leverage against Americans.

  3. Gene says:

    I’ve had a cartioid ultrasound image done. I must say that the visual image of one’s own artery is much more motivating than being told where you stand statistically based on some tests. I understand that there are many cases of heart attacks where the symptoms were never picked up by standard statistics based measures. Given that Cardio Vascular Diseases (CVD) of all kinds are THE #1 reason for premature death – and long term care for those that survive – mass screening techniques make a lot of sense. In my experience Cardiogists are focused on acute situations. I’d argue that there is a tremendous amount that can be done to prevent CVD if its progression is detected early – and before cardiologists are required! Early effective and convincing early screening – like Blood Viscosity measurement – would radically reduce the demand for specialists. At the risk of sounding extreme, specialists are where the money is so from their perspective widespread prary-care based prevention would have a big impact on reduction of acute cases.

    I understand that the classic stress test does not detect problems until arteries are 60% occluded and the situation is beginning to require advanced intervention. Many heart attack victims have never been diagnosed with CVD.

    Stroke, for example, is devistating and expensive. Tests like ultrasound imaging and blood viscosity testing also offer the ability to show patients that the early prevention path they undertake are (or are not) effective.

  4. Gene says:

    Typo in above comment: “priary” should be “primary”.

  5. Hal says:

    If you ask Republicans politicians, they say we should be protecting the shysters that are promoting bogus health screenings rather than protecting consumers. When was the last time you saw a Republican politician trying to advocate in favor of the consumer? Republicans politicians hate consumer advocacy groups! Why? Because Republican politicians are shysters themselves! Just like the corrupt businesses that they take money from.

  6. Tom Betts says:

    Just another liberal democrat group trying to destroy our health care system. What these inane liberals don’t get is that this is preventative medicine. This concept is foreign to democrats because they don’t want people to have access to a system that democrats want to restrict.

  7. Ida Miller says:

    Interesting discussion. Who pays for the test? Who pays for the follow up? It sounds like it caters to the middle class who are most likely insured. Kind of like going to the bowling alleys to recruit Medicare advantage members. The worried well? I would think insurance companies would be putting the kabash on the practice. If it reduces long term costs I suppose we should embrace it. Interesting phenomena, I wonder how it will progress….

  8. Jack O'Brien says:

    Actually, this is not a political issue, nor is it a ‘preventative medicine’ issue. It is a patient safety issue. Many of the tests included in these programs are not recommended by the US Preventative Sevices Taskforce and/or the CDC because there is a lack of scientific evidence to support their use in widespread screening. Every test has a ‘false positive’ rate, meaning the test can incorrectly suggest that disease is present when it is not. The lower the prevalence of the disease being tested for in a population, the higher the false positive rate. And most postive tests – including false positives – generate more testing and possibly procedures/surgeries with all of the associated risks. As a hospital-based physician, I see the complications (including death) caused by unwarranted testing and procedures every week.

  9. Panagiotaropoulos says:

    Public Citizen is plain wrong. For middle aged people and older these tests are useful. Actually there was an item in ACCELL a few months ago (audio journal of the American College of Cardiology) about screening for atrial fibrillation in venues like super markets with 1 lead ECGs. Thousands of people go around without knowing that they carry a condition that could result in a devastating stroke or death. Exploitation would be if they tell you come back in 6 months to see if your 30% blockage became 35. There is a profit motive for sure, but it is not the whole story.

  10. Hasletine says:

    These promotional brochures are 100% fear-inducing. The ones I have received target people who already have physicians who can recommend necessary testing and they carry adequate health insurance. These types of people go for their annual exams once a year and will only respond to the mailings if they get worried, so that’s what the marketing departments present. Draw your own conclusions about what a waste of money these random testing programs are.

  11. nancy says:

    My primary care physician (PCP) does not subscribe to random screenings. If I need a screening, I trust him to recommend exactly what I need based upon my health history and my specific physiology. Sadly, 50 million Americans aren’t as fortunate as me. They are uninsured. They do not see a PCP. They don’t have choices. They just get sick. And when that happens, they get their healthcare totally gratis at the hospital emergency room and they rely upon the hospital’s uncompensated care fund to pay the bill. Eventually, we all pay for those 50 million non-paying uninsured people. We pay higher and higher insurance premiums for those that don’t pay at all. America needs a healthcare system where “everybody” pays higher taxes so that “everybody” is covered. Sound like socialism? Call it whatever you want. If it works, we need it!