Are cancer centers pushing too many tests? See what the NY Times says and some advice from Dr. C.

A couple of months ago, my wife had a mammogram that had something that was partly suspect and was difficult to read.   The test was rerun at the Barnabus outpatient center (which we were billed for twice) only to be told that the second test showed a possible something.  As a health care provider, I read the test and there was nothing I saw that showed any irregularity.

As I always tell everyone, don’t worry unless someone gives you something to worry about.  Until then, you have concerns, rather than worries.   As she came out of the session the staff who originally was going to schedule a biopsy was interrupted by the radiologist who said that she should do a breast MRI first.  While this is very strange, they scheduled her for the MRI instead of the biopsy, for which the hospital that had a machine only a year old was charging over 3K, while other hospitals in the city were charging under $800 for the same test.

Inevitably, she then had a biopsy which was negative for any pathologies.

Was the MRI necessary or was the radiologist part of a large corporate problem patients are dealing with as profits first and patient care second becomes the norm and our insurance premiums continue to rise due to bad behavior?   In my professional opinion, the MRI was unnecessary and was likely recommended due to quotas rather than need and their pricing was ridiculous.  Now I am paying off my bills as I reached my insurance 5K deductible.

According to the NY Times, overtesting and overpricing of cancer services are becoming a larger concern.  Dr. Efrig of the recent Stansbury and Associates newsletter wrote that we are entering into what he calls the platinum age of healthcare where testing leads to diagnosis which leads to expensive treatments.  He was referencing recent research on a colon cancer trial that resulted in all participants going into remission. Of course, we now need to see if this is reproducible.

A rational person would ask if all this is really necessary.  Unless you have been told that a test can help you save your life, you may not even think about the cost until you get the bills in the mail.

Healthcare is better by being less invasive and about being healthy, yet our system continues to want to use the next disease to drive us using fear to more tests and procedures that are expensive as compared to other countries and may not be helpful.   In fact, often, over-testing has done both physical and psychological harm to many of us and then we get billed for it.

Check out the NY Times article which is timely and raises legitimate concerns regarding the healthcare system’s deep dive into our wallets by using fear of our own demise as the driver for irrational healthcare spending.

Do Cancer Centers Push Too Many Tests?

Studies found that centers provided incomplete or unbalanced information, which could lead to unnecessary screenings and health complications in older adults.

By Paula Span Published July 17, 2022

Say a postcard arrives in the mail, a reminder to make an appointment for a mammogram. Or a primary care doctor orders a PSA test to screen a man for prostate cancer, or tells him that because of his years of smoking, he should be screened for lung cancer.

These patients, trying to be informed customers, may look online for a cancer center to learn more about screening, when it is recommended and for whom.

It might not be the best move. Medical societies and the independent U.S. Preventive Services Task Force publish guidelines about who should be screened for lung, prostate and breast cancers and how frequently, among many other prevention recommendations. But websites for cancer centers often diverge from those recommendations, according to three studies published recently in JAMA Internal Medicine.

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