• filter:

Medical pros: your view on mobile screening services, e.g., LifeLine

  • Page :
  • 1
  • Text Only
  • Search this Topic »
Voting History
rated:
Filed in FWF, relates to insurance, cost vs. benefit, etc. ---

In connection with annual preventive exam, doc ordered two ultrasound tests:  carotid bilateral (CPT 93880) and abdominal aorta (76775).  Neither test is covered as preventive by my (high deductible)insurance, such that I will wind paying radiologist's negotiated rate, which will be a lot higher than "package rate" that I could get from one of the mobile screening companies, like Life Line.

Do any FWF medical pros have views/experience on the overall quality of mobile US tests vs. office tests?  My understanding is that in each case, a radio doc reviews the work done by US technologist.  Assuming solely for sake of argument that avg person working in the mobile sector are not "as good" as one in traditional office practice, are they still "good enough" for purposes of basic screening?

TIA.

Member Summary
Most Recent Posts
you do know that's how medical science works, right?  Otherwise we still be doing voodoo and beat the evil spirit out of... (more)

ZenNUTS (Jun. 03, 2017 @ 11:43p) |

Your complication analogy is flawed. I don't pretend to know the numbers so I'm just putting it out there for sake of ar... (more)

atikovi (Jun. 04, 2017 @ 5:19a) |

The sensitivity for either test is high, so as long as you get a copy of films in addition to reports for your records, ... (more)

Rubl (Jun. 05, 2017 @ 8:24a) |

Staff Summary
Thanks for visiting FatWallet.com. Join for free to remove this ad.

rated:
Sometimes you do get what you pay for. Check around, prices can vary significantly.

rated:
How much are we talking about? Shouldn't be too expensive

rated:
Freakazoid said:   Sometimes you do get what you pay for. Check around, prices can vary significantly.
  I don't think any traditional doc will be able to match offer I got recently by email from Life Line.  Below package of tests for $178.
 
1. Carotid Artery Screening (Plaque)
2. Heart Rhythm Screening (Atrial Fibrillation)
3. Abdominal Aortic Aneurysm Screening
4. Peripheral Arterial Disease Screening
5. Osteoporosis Risk Assessment
6. Disease Risk Assessment predicts the risk of 6 chronic conditions: stroke, diabetes, heart disease, congestive heart failure, COPD, and lung cancer. Includes complete lipid panel and glucose panel.

ETA:  I'm really only interested in the 2 that my doctor wants.  Had EKG and blood/urine in the office already.

ETA:  "A board-certified physician reviews each screening, with the exception of the 6 for Life Health Assessment (disease risk assessment) — data from this screening are run through a clinically based predictive program."

"If we recommend you see your own physician for further evaluation due to abnormal results, we will include printed images of your carotid artery, abdominal aortic aneurysm or atrial fibrillation (irregular heartbeat) screening results in addition to the written report."

sample results: http://www.lifelinescreening.com/~/media/Files/US/pdfs/SampleRes...

rated:
No, I don't believe you will be able to get a price of less than $178. That's a great deal if it's real. Let us know if there are any gotchas. I think normally just the carotid ultrasound would run a few hundred, but you might not have a good idea the what they report out and whether the information is useful to a doctor or if it is watered down like those test at home genetics companies.

The heart rhythm screening is an EKG (you might just get a printout of the interpretation rather than the actual EKG). Peripheral arterial disease screening is a blood pressure measurement of the arm and the leg. The type of bone density screening that they do for osteoporosis risk is not the one that is generally recommended since the risk is best assessed with measurements of the spine and hip (the video shows an ankle measurement). The 6 for life thing sounds like weight measurement, blood pressure, cholesterol, fasting glucose, and something else?. The fact that they don't just list out what you are getting makes me a little wary.

rated:
If you want to get an idea of how that company operates, look at their glassdoor reviews. I think they make money by upselling services, particularly services that you might not need.

rated:
I see ads for full body scans at about $1000. While a lot more expensive, it could detect issues that show no symptoms until it's it too late to treat. That might be more important.

rated:
BNizzle said:   No, I don't believe you will be able to get a price of less than $178. That's a great deal if it's real. Let us know if there are any gotchas. I think normally just the carotid ultrasound would run a few hundred, but you might not have a good idea the what they report out and whether the information is useful to a doctor or if it is watered down like those test at home genetics companies.

The heart rhythm screening is an EKG (you might just get a printout of the interpretation rather than the actual EKG). Peripheral arterial disease screening is a blood pressure measurement of the arm and the leg. The type of bone density screening that they do for osteoporosis risk is not the one that is generally recommended since the risk is best assessed with measurements of the spine and hip (the video shows an ankle measurement). The 6 for life thing sounds like weight measurement, blood pressure, cholesterol, fasting glucose, and something else?. The fact that they don't just list out what you are getting makes me a little wary.

  Pretty much agree with the above. It's a cheap price but I don't know that these are real diagnostic medical exams. There may not be a physician/radiologist involved with the interpretation.You could certainly check with them and see. You should think about your specific risk factors including age, gender, medical and family history, etc and decide if you want cheap or better quality. Lives have been saved by ultrasound screening but using a 20 year old ultrasound machine that someone perhaps not formally ultrasound trained, drags around in the back of a van and interprets based upon their "training"....ehhhhh. While I have no idea if this is what this is, those things do exist. Of course first you should consider if you really even need them. And guess what, if anything comes back positive, the first thing any doc is going to do is send you to get a repeat at reputable imaging center/hospital.

As far as whole body MRIs go, they are very popular with wealthy individuals in certain countries but I'm not sure there is much evidence that they actually save lives. Be careful what you look for, you may find it.

rated:
Freakazoid said:   
As far as whole body MRIs go, they are very popular with wealthy individuals in certain countries but I'm not sure there is much evidence that they actually save lives. Be careful what you look for, you may find it.

  It was also common years ago in some euro countries for doctors not to tell patients if they have a terminal disease until near the very end. Not sure it that's still the norm, but seems better to find something early when it's still treatable.

rated:
atikovi said:   
Freakazoid said:   
As far as whole body MRIs go, they are very popular with wealthy individuals in certain countries but I'm not sure there is much evidence that they actually save lives. Be careful what you look for, you may find it.

  It was also common years ago in some euro countries for doctors not to tell patients if they have a terminal disease until near the very end. Not sure it that's still the norm, but seems better to find something early when it's still treatable.

Just be aware that screenings for diseases/disorders with no symptoms can result in more harm than good.  May result in minor issues being treated when no treatment is actually needed.

Somewhat related article: https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0072602/

rated:
caterpillar123 said:   
Just be aware that screenings for diseases/disorders with no symptoms can result in more harm than good.  May result in minor issues being treated when no treatment is actually needed.

Some of deadliest cancers have no clear symptoms until it's too late to treat effectively. Pancreatic, ovarian, kidney, etc. Pretty sure a competent doctor can discern the minor issues compared to the serious ones and treat accordingly. 

rated:
atikovi said:   
caterpillar123 said:   
Just be aware that screenings for diseases/disorders with no symptoms can result in more harm than good.  May result in minor issues being treated when no treatment is actually needed.

Some of deadliest cancers have no clear symptoms until it's too late to treat effectively. Pancreatic, ovarian, kidney, etc. Pretty sure a competent doctor can discern the minor issues compared to the serious ones and treat accordingly. 

  A doctor is rarely the decision maker though.  The doctor will usually give the patient an option of biopsy and treatment.  Most patients will get follow-up care if they have the resources.  The PSA test for prostate cancer is a good example of why testing may have a negative effect.  https://www.cancer.gov/types/prostate/psa-fact-sheet

rated:
Gee...what is your life worth? People will spend $800 on the latest iPhone but resist spending money
on their own preventative heath.. NUTS

rated:
caterpillar123 said:   
  The PSA test for prostate cancer is a good example of why testing may have a negative effect. 

  I was referring to whole body scans which have nothing to do with this.

rated:
atikovi said:   
caterpillar123 said:   
  The PSA test for prostate cancer is a good example of why testing may have a negative effect. 

  I was referring to whole body scans which have nothing to do with this.

  The possibility of false-positives also applies to whole body scans.

"No one disputes that multislice CT can detect and measure some disease processes earlier than routine history and physical examinations can, and some patients—a
few—would benefit from CT screening. But others would be harmed, owing to drawbacks inherent in any screening process, including:
• False-positive results, which lead to mistaken labeling and unnecessary workup
• False-negative results, leading to wrong reassurance and delayed treatment
• Discovery of latent or nonprogressive disease, leading to unnecessary workup and treatment."
Cleve Clin J Med. 2004 Jan;71(1):47-56.

Other links: http://www.acpm.org/page/pschoosingwisely and https://www.ncbi.nlm.nih.gov/pmc/articles/PMC156117/
 

rated:
caterpillar123 said:   
Cleve Clin J Med. 2004 Jan;71(1):47-56.


But of course there hasn't been any medical advances from 13 years ago to suggest that still applies. And of course many in medicine would benefit financially if diseases were caught later than sooner. More medical treatment. More pharma. More hospital stays.

rated:
atikovi said:   
caterpillar123 said:   
Cleve Clin J Med. 2004 Jan;71(1):47-56.


But of course there hasn't been any medical advances from 13 years ago to suggest that still applies. And of course many in medicine would benefit financially if diseases were caught later than sooner. More medical treatment. More pharma. More hospital stays.

  And many both within and outside of medicine benefit financially and otherwise by convincing everyone that they need studies/procedure they may not. False positive results are highly overlooked in medicine... "sure we spent $5000 to find out that you don't have the disease we had no reason to suspect in the first place. Isn't that great?"   I would guess this is much more common than the doc that wants people to get sicker so they could bill more.  

rated:
Neither one is a routine screening.
Do you have some underlining symptoms or history of disease?

rated:
Rubl said:   Neither one is a routine screening.
Do you have some underlining symptoms or history of disease?

  Prior test showed trace plaque -> carotid scan
Father had abdominal aneurysm -> abdom scan

rated:
Rubl said:   Neither one is a routine screening.
Do you have some underlining symptoms or history of disease?

  The whole point of these screenings is to detect problems before they manifest symptoms. At that stage they are significantly more treatable with much better prognosis. 

rated:
atikovi said:   
Rubl said:   Neither one is a routine screening.
Do you have some underlining symptoms or history of disease?

  The whole point of these screenings is to detect problems before they manifest symptoms. At that stage they are significantly more treatable with much better prognosis. 

  The point is that more test doesn't always lead to better outcome.  It's not a very easy concept to grasp but the science of it is very clear.

https://www.scientificamerican.com/article/medical-procedures-pr...

rated:
atikovi said:   
Rubl said:   Neither one is a routine screening.
Do you have some underlining symptoms or history of disease?

  The whole point of these screenings is to detect problems before they manifest symptoms. At that stage they are significantly more treatable with much better prognosis. 

 The current best practices do not recommend routine screening for what OP mentions unless there are symptoms on examination, current or past history, or increased risk such as combination of age, gender and smoking.
Buy hey, I'm sure you know something that AMA, AHA, CMS, ACC, and SVS don't know.

rated:
Yea, I know they base much of their findings on statistics. If your think of yourself as just a statistic, ok. All I can add is, find someone that was diagnosed with stage IV xxx cancer. Ask them if they would have found it 6 months ago as stage I, how they would feel.

rated:
Rubl said:   
atikovi said:   
Rubl said:   Neither one is a routine screening.
Do you have some underlining symptoms or history of disease?

  The whole point of these screenings is to detect problems before they manifest symptoms. At that stage they are significantly more treatable with much better prognosis. 

 The current best practices do not recommend routine screening for what OP mentions unless there are symptoms on examination, current or past history, or increased risk such as combination of age, gender and smoking.
Buy hey, I'm sure you know something that AMA, AHA, CMS, ACC, and SVS don't know.

  Agree however I did find some places that suggest AAA screening based upon 1st degree relatives that had AAAs. That might be why it's not covered by insurance. If you are a smoker, that and age seem to be the major risk factors. The trace carotid plaque thing... that's you and about 1/2 of the population over 50 I would guess. For $200, if it makes you sleep better, go for it.

rated:
atikovi said:   Yea, I know they base much of their findings on statistics. If your think of yourself as just a statistic, ok. All I can add is, find someone that was diagnosed with stage IV xxx cancer. Ask them if they would have found it 6 months ago as stage I, how they would feel.
you do know that's how medical science works, right?  Otherwise we still be doing voodoo and beat the evil spirit out of stupid people... or maybe we should.

If that's your line of "reasoning", let's put it this way

find someone who lost a love one due to complication during an biopsy, all because an unnecessary test shows something of concern that turned out to be nothing but the biopsy procedure ended up killing him.

rated:
Your complication analogy is flawed. I don't pretend to know the numbers so I'm just putting it out there for sake of argument, but 80% of those diagnosed with stage IV will be dead in 5 years, only 20% of those diagnosed with stage I, and less than 2% from complications during a biopsy.

rated:
tuphat said:   
Rubl said:   Neither one is a routine screening.
Do you have some underlining symptoms or history of disease?

  Prior test showed trace plaque -> carotid scan
Father had abdominal aneurysm -> abdom scan

  The sensitivity for either test is high, so as long as you get a copy of films in addition to reports for your records, should be fine. If anything is amiss, you'll be getting a CT scan anyway.

  • Quick Reply:  Have something quick to contribute? Just reply below and you're done! hide Quick Reply
     
    Click here for full-featured reply.


Disclaimer: By providing links to other sites, FatWallet.com does not guarantee, approve or endorse the information or products available at these sites, nor does a link indicate any association with or endorsement by the linked site to FatWallet.com.

Thanks for visiting FatWallet.com. Join for free to remove this ad.

While FatWallet makes every effort to post correct information, offers are subject to change without notice.
Some exclusions may apply based upon merchant policies.
© 1999-2017