Bob Bury

Bob Bury recently retired as a consultant radiologist in the NHS

Screening firms playing on our insecurities

By Bob Bury - 26th April 2010 1:35 pm

My son (who moved out, finally, about 12 years ago) received an invitation sent to our address today. It was from Life Line Screening, and was signed by Karen R Law RDMS, RDCS, RVT. Karen clearly felt that my son, a fit 32-year-old, was in the at-risk group for carotid atheroma, aortic aneurysm, asymptomatic atrial fibrillation and osteoporosis. They offered to free him from his intolerable burden of worry concerning these life-threatening conditions using ‘cutting edge’ ultrasound and ECG technology (and presumably DEXA scanning for the osteoporosis, although they didn’t go into details about that, presumably because they felt their target population - i.e. everyone with more money than sense - wouldn’t understand it).

Now I don’t know what RDMS, RDCS and RVT stand for, but I am sure they are bona fide qualifications and that Karen and her colleagues are capable of performing the scans they are offering. In fact, I quite admire people who spot a gap in the market and set out to fill it; or at least, I do if no-one gets hurt in the process.

However, although Matt is a sensible chap (how could it be otherwise, with me as his father?), and was about to consign his letter to the bin when I asked if I could have a look at it, these indiscriminate mailings do have their victims. There are plenty of worried well people out there who would be concerned to hear the story of Sidney Larcomb from Walsall, whose surgeon said that his narrowed carotid arteries were ‘a disaster waiting to happen’, and whose life was undoubtedly saved by responding to Karen’s timely offer of screening. Of course, for every Sidney Larcomb, there will be a hundred or more Mathew Burys, who were never at significant risk of any of these conditions in the first place. And it will be the NHS (‘your full results report will be posted to you so that you can share with your GP’) that has to pick up the fall-out from all the false positives.

I’ve blogged before on the topic of ‘whole-body MOT tests’ using CT, and the impending tightening-up of the ionising radiation legislation to regulate with these self-referral enterprises. Ultrasound doesn’t use ionising radiation, the equipment is relatively cheap and I assume that any Tom, Dick or Harry setting up a screening service is bound only by the regulations governing advertising and the sale of goods. Even so, I can’t help feeling that Life Line Screening are sailing pretty close to the wind if they are sending out indiscriminate mailshots of the type received by my son.

Still, vote for that nice Mr Cameron, and I’m sure he’ll put a stop to this sort of irresponsible free enterprise. Oh, wait a minute, he’s a Tory, isn’t he?

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2 responses to “Screening firms playing on our insecurities”

  1. Mark II says:

    Always a bit torn on this one. If people want to purchase health services they should be allowed to do so. And why shouldn’t they do it closer to home from non-NHS providers? We have to start treating patients like grown ups.
    But, and it is a big ‘but’, it turns the NHS into the safety net whether it’s the worried well with a scan, or a post-op complication from the private sector.
    If all patients held a real, personal budget, a bit like in social care, that could be transferred between the public and private sector for both diagnostics and treatment, it would at least bring some clarity and control to the relative roles.
    If this was introduced with a series of charges - notional or real for GP access - healthcare would start to get a sensible value and be accessed more responsibly.
    I think most doctors accept that the NHS is unsustainable in the longer term and we need to be discussing more challenging ideas.

  2. Doctor Death says:

    I am at a loss to understand why peolpe should think they can share the results of these daft tests with their NHS GP, who did not order the investigations. These tests are not generated as a result of a proper screening programme, and the predictive values in an asymptomatic population with a low prior probability of disease are not known. How can a doctor interpret the results in a healthy person? Were I a GP faced with such a patient, I would point out this fact and advise the patient to return to the test provider to ask for their advice. Then again, I am not a GP, and (as my golf buddies from GP land have observed) I have clearly had the empathy nucleus of my brain excised.

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