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Experts warn yearly checkups carry risks and do not reduce mortality

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Re: Experts warn yearly checkups carry risks and do not reduce mortality

#142
post #121

Earlier quoted context omitted.

For someone who doesn't know, it's impossible. But being a patient advocate has a moral hazard that insurance companies (who provide them now) aren't equipped to deal with.

Which is why the GP is so useful IMO. Maybe they could be replaced with a nurse though. The administrative assistant matches their referral with someone in my network. You need that medical profession somewhere in the chain, otherwise people browsing insurance websites for in network providers just aren't qualified to decide if they need to see an orthopedist or a podiatrist or a physical trainer for example.

They are encouraged not to refer out. That's problematic.

Re: Experts warn yearly checkups carry risks and do not reduce mortality

#144
This seems to be a misdirect.

> After analyzing 17 clinical trials involving 230,000 people and comparing adults from the general public who got checked to others who did not, they found that general checkups had “little or no effect” on total mortality or cancer, cardiovascular, heart disease and stroke mortality.

So general checkups have a little or no effect on total mortality, but the studies themselves don't say anything about additional risks, they are more of an "opinion". And to add to it, “little or no effect” on total mortality or cancer, cardiovascular, heart disease and stroke mortality could mean a lot of things. Does it mean people die anyway, but get to live longer? Did the studies take into account effects of regular testing from a young age? The listed diseases are also closely related to hereditary problems, but is the finding the same for other health issues that may not have a genetic component to them?

Re: Experts warn yearly checkups carry risks and do not reduce mortality

#145
Medicine is still clearly medieval in this respect, and would be considered insane in any other field:

"Gosh I hope my SQL database still has enough storage, but I better not check because adding a disk to the RAID array might cause a failure on rebuild." It's not a factually incorrect statement, but the problem isn't with the checking.

Re: Experts warn yearly checkups carry risks and do not reduce mortality

#146
post #103
post #100

Earlier quoted context omitted.

Your expectations are unreasonable. This is not a problem that technology can solve. Large scale, long term human trials will always be expensive no matter how much technology we throw at the problem. If you have a suggestion for improvement then be specific. Vague complaints aren't helpful.

High-fidelity simulations to reduce the number of failed trials.

OK? Where can I buy a high-fidelity simulation? You might as well say that the solution to high energy costs is just to build fusion reactors. Great idea in principle but we don't actually know how to do it yet.

Simulations are already used in the early-stage drug development process and they're useful to reduce the number of substances that move on to animal trials. If you build a better one then you can make a fortune. But we are at least decades away from being able to accurately simulate the complex interactions in a human body. And I doubt that simulations will ever be useful for writing something like a clinical practice guideline for prescribing statins; that type of knowledge can only be gained by conducting human trials to see what works in the real world. Engineers accustomed to working with machines and electronics generally don't understand how messy biological research can get.

Re: Experts warn yearly checkups carry risks and do not reduce mortality

#147

Earlier quoted context omitted.

A lot of cancers have no symptoms at the beginning, but they can be flagged in blood tests performed as part of general health checkups.

Do annual checkups involve blood tests where you are? I've only had blood taken as part of one once, and that was in direct response to a new diagnosis of a health condition in a grandparent.

Mine do, yes. Kaiser in Northern California region.

Re: Experts warn yearly checkups carry risks and do not reduce mortality

#148

Andy Grove would completely disagree: https://money.cnn.com/magazines/fortune/fortune_archive/1996... MY FIRST PSA. It all started about a year earlier when my family doctor of 20 years retired. In the fall of 1994, my new doctor gave me a physical exam to establish a new baseline. The physical involved an assortment of blood tests, all of which were in the normal range, with one exception. The test called PSA came b…

PSA testing may catch prostate cancer early, but it may also lead to unnecessary -- and sometimes harmful -- treatment.

I found this analysis helpful for assessing the pros and cons:

https://www.hardingcenter.de/en/transfer-and-impact/fact-box...

Re: Experts warn yearly checkups carry risks and do not reduce mortality

#149
post #121

Earlier quoted context omitted.

Which is why the GP is so useful IMO. Maybe they could be replaced with a nurse though. The administrative assistant matches their referral with someone in my network. You need that medical profession somewhere in the chain, otherwise people browsing insurance websites for in network providers just aren't qualified to decide if they need to see an orthopedist or a podiatrist or a physical trainer for example.

They are encouraged not to refer out. That's problematic.

I wouldn't want a referral out of network. That's more money for me to pay.

Re: Experts warn yearly checkups carry risks and do not reduce mortality

#150

Earlier quoted context omitted.

That’s a great way to articulate the problem. Imho, a brilliant solution is direct primary care. For $80/mo, I have access to a dr that works for me, and not my insurance company. Absolute game changer in that he has a bias toward understanding and optimizing rather than gaming insurance metrics to be rated as a double-plus preferred provider or whatever. Also gets my lab work done at a fraction of what my insurance…

Is this the same thing as concierge medicine? I’m interested but it seems quite expensive. 80$ a month seems much lower than normal.

I don't know how to get around this problem but wife and I paid $1,500 for a year's worth of concierge care only to have the physician close up shop after 4 months. I suppose if we paid month-by-month that would have helped.
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