Did I just put my health at risk?

So, as mentioned, in not the most astute bit of scheduling, I had a physical this morning on the heels of a three (really four) day weekend.  And man oh man did I have a pile of emails to get through this afternoon.  Finally a few minutes to blog…

And what I cannot resist on this day of my annual checkup (though, not quite annual in my case) is this recent Brian Palmer story in Slate that argues going to the doctor when you are not sick does more harm than good:

here are two kinds of arguments against the adult annual health checkup. The first has to do with the health care system overall, and the second has to do with you personally.

Annual checkups account for more than 8 percent of doctor visits and cost the health care system $8 billion annually—more than the total health care spending of several states. Each visit takes around 23 minutes, which means doctors in the United States spend approximately 17 million hours each year running their stethoscopes over 45 million completely healthy people.

It’s important to separate preventive care from annual checkups. Only one-half of annual checkups actually include a preventive health procedure such as a mammogram, cholesterol testing, or a check for prostate cancer. (Annual gynecological visits are excluded from these numbers, although the evidence supporting those is not particularly overwhelming either.) More importantly, only 20 percent of the preventive health services provided in the United States are delivered at annual checkups…

Many primary-care doctors order totally unnecessary procedures during annual exams, squandering patients’ time and our health care dollars. Perhaps they just want to make patients feel like they’re doing something. Here’s where this stops being about the efficiency of the health care system and starts being about you: unnecessary screenings can be hazardous to your health.

People have a hard time viewing screenings as dangerous. Take, for example, the “hands off my mammogram” uprising that followed a 2009 government recommendation that mammograms be started later in life and conducted less frequently. Reactions of this kind appear to be based on two misunderstandings. First, many people overestimate the accuracy of screening exams. The false positive rate for a single screening exam is usually low, but when you take them year after year, it becomes very likely that a healthy patient will receive a false positive. A 2009 study showed that, for many cancer screening tests, a patient who undergoes 14 screenings has more than a 50 percent chance of a false positive…

There’s also the risk of unnecessarily “medical-izing” minor illness. People who go for annual checkups typically report symptoms that they would have otherwise ignored. In some cases, that’s a good thing—some patients minimize their symptoms and ignore the warning signs of serious illness. Most of the time, however, it forces the physician to investigate and treat a problem that would have gone away on its own.

Okay, so my report.  Well, I did get a cholesterol screen (no results yet).  Hooray, “preventative medicine.”  I also had a nice discussion with my doctor about the folly of PSA tests.   Got a prescription for some nasty plantar’s warts on my foot (TMI?), Over-medicalizing a minor problem?  Maybe, but they’ve been there over five years– definitely not going away on their own.  And, hey my propecia prescription requires I see a doctor every now and then (no shame, it’s no secret that my hair is pretty damn thin on top and that propecia is the difference between me not having a nasty sunburn this past weekend).  We also had a nice talk about my ongoing sore tricep (ever since I threw a boomerang toy about 100 times on Memorial day) and how getting PT at this point would be premature.

Anyway, so there you go.  I’d like to think given my lack of unnecessary screenings, Palmer would not be too unhappy with me.  Of course, your typical medical consumer does not blog about PSA tests and look up articles in PubMed.

Photo of the day

So, unbeknownst to my family until we arrived, the motel we stayed at over Labor Day weekend did not have internet (hello, this is 2013!).  For some people, this is a hardship.  For the Greene family, this was a real hardship.  We got by, somehow.  I did end up going to bed a lot earlier than usual.  Though, I did not get any blogging done obviously.  Throw in my first “annual” check-up in about 3 years this morning, and I’m way behind.  Sorry.  Until then, enjoy my favorite photo I took this weekend (probably took about 400, this is my favorite):

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