Health check-ups: “Packages” are useless if not chosen carefully. So how do you get the most out of them?

 

A rigid “Package” of health-check tests is usually not a wise thing to do. What are the missing links? Read on to know why.

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Q. Should I just go for a fixed “package” of tests on my own? Labs, hospitals, even my bank is offering a fixed “package” of 30/ 50/ 100/ 200 “tests” at  unbelievably throw-away prices.

Generally, people do a “package” of tests with the belief that such tests are the most vital part of health check-ups.
For example, a “General” or “Executive” or “gold-ruby-platinum-titanium-whatever” health check may consist of detailed Liver function tests, Renal function tests, ECHO, Chest X ray, Stress tests, etc.

But such “packages” of tests may not suit each and every person individually.

There can be a common Health check “package” for the young and the old, male and female, but only limited to few basic tests.

What about specific risk factors associated with, for example, being man and woman, smoker and non-smoker, athletic and sedentary?

100, 200 ‘tests’?!
Go through them. Many of them will be parameters such as “Urine Colour”, “Urine Temperature”, “Urine appearance”, etc.

WOW!

How commonly do we, doctors, see green colored urine, or boiling hot urine, or “beautiful” urine, in normal people? 🙂

Another important question: What are the credentials of labs and hospitals, and of the people who are doing these tests?

Are such 100-200 parameter tests actually being done at all? Mostly, yes, but not always.

A few years ago, when I was in Mumbai, for a pre-employment fitness check, I, myself, had an experience  where my blood sample was never collected, and my X-Ray was never done, but my results were given to me, “all normal and fit for work”!

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Who decides whether you need all these or not? Are you sure you need them, at all?

Are you aware of risks associated with some tests, such as in case of X-Rays or stress ECG (TMT) tests?

Most importantly- some tests should be done only with a good reason.

For example, RA factor, ASO, PSA, CEA, cancer markers, etc. should be done ONLY after discussing with a doctor. If one does it “just like that”, and it comes out as positive, and you are not having any related symptoms or risk factors, how would you interpret it?

I worry for some of my patients who tend to consider each and every positive lab result a death-sentence.

Just seeing a few “positive” results is enough to scare the hell out of someone who doesn’t know a thing about it. It may cause needless, avoidable anxiety.

Interpretation of lab tests is an art that qualified doctors hone over the years. Things are not always straight-forward in medicine.

Do NOT interpret lab results if you DON’T know what to do about them.

Q. I get the idea now. There is something special about doing tests after seeing the Doctor, right?
Yes.

You share your past medical history; discuss your lifestyle and family history of diseases in detail. You can thus discuss your personal health-related concerns and clear any doubts about diseases, risks and tests. If there is a specific test you wish to do, you may frankly say so.

This is followed by a systematic physical examination.

Then, based on your age, sex, lifestyle, social factors, family history, your past medical history and the physical examination findings, the doctor will discuss what all your risk factors are.

Some risk factors can even be objectively quantified.

Based on these, you may be prescribed tests which you may both feel are necessary.

Q. OK, but how will that benefit me?

You don’t have to do tests which are almost surely not necessary for you. The cost associated with “routine” health checks come down significantly.

For example, if you are a 35 year old lady who has a healthy lifestyle and no risk factors for heart disease, you don’t need to undergo an X-ray, ECHO or stress test. Instead, if there is a likelihood of breast cancer, investigations can be planned accordingly.

Thus, many tests such as “routine” X rays, Liver/Kidney function tests etc can be avoided if there is no risk factor for such diseases at such an age. The resources can instead be diverted towards detecting issues that may be uniquely relevant to you, IF NEEDED.

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Q. Wait a minute! WHY should anyone have a health check at all?

Some conditions such as high BP, Diabetes, cholesterol, osteoporosis (weak bones) and some cancers start silently– i.e. in the beginning, one may not notice any symptoms at all.

By the time the symptoms of such diseases start, the disease may be several months or even years old, and may have caused damage to eyes, heart, liver, kidney, arteries, skin etc. Cancer, though not as common as diabetes or BP, may have spread to various areas if the diagnosis is delayed.

These damages may be irreversible. Such diseases are rightly called “Silent Killers”.
To detect these diseases in earlier, more easily manageable stages (of course, with much less expenses and suffering), it is recommended that everyone has a regular medical check-up.

Q. How frequently should I do a routine health check-up?

Clearly, the frequency of check-ups (and tests, if required) will vary, based on age, sex and individual risk factors. It may be once every 3 months or once every 2 years, depending on what you are likely to have- or not.

Q. WHO should have it?
Everyone should have it- Newborn babies, children, adolescents, and especially adults and the elderly.

Children may have undetected anemia, nutritional problems, vision and hearing problems, behavioural issues, poor school performance, etc, which, if evaluated early, may be very useful. But usually most children make one or two doctor’s visits a year, and are assessed by the doctor during such visits anyway, hence a separate visit only for assessment of health, growth and development may not be necessary.

Adolescents may have anemia, growth and development related concerns, nutritional deficiencies, difficult-to-tackle psychological issues etc. This is an important group, since a large number of adolescents go through needless suffering– only due to lack of awareness of the support systems available to them.

Adults may have issues as mentioned above. Females, in particular, should get themselves periodically screened for cancer of cervix and breast, and weakening of bones.

Q. But is there any guarantee that my illness won’t be missed?
No. Unfortunately, medical science is not perfect. There are innumerable unexplained mysteries in the human body and mind.
Even if all tests possible are done, still there remains a possibility that diagnoses can be missed in small number of people.
The Doctors’ advice is based on your discussions, current scientific medical evidence and clinical judgement. It focuses more on what is likely to be discovered, rather than casting a “net” of investigations over a person and waiting for an abnormal lab value (!) which will decide your disease probabilities.

Q. What after the tests are done?
You must have another consultation with the doctor. The results and implications must be discussed. Your risk factors may be reviewed in light of the results. Further management, if needed, may be suggested.

Q. What will be the cost?
Costs depends on the time taken discussing with your doctor, and tests depending on your specific health risks, based on age, sex and individual risk factors.

The cost is hence variable, but usually lower, and much more beneficial than a pointless “package” containing hundreds of irrelevant lab parameters.

Remember: THE MOST IMPORTANT COMPONENT OF A HEALTH-CHECK IS NOT LAB REPORTS, BUT A DISCUSSION WITH YOUR DOCTOR. 

And let this point be clear: Detecting diabetes, and managing it early with diet, exercise, and simple medicines is much safer, not expensive, and does not cause as much suffering as managing diabetes-related kidney disease, diabetes related blindness, or a diabetes-related heart-attack does. Same holds true for ANY disease.

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Discuss with your doctor, and YOU decide. Make sure your doctor knows YOU, and not only about your disease.

If possible, and if you’re lucky enough to have one in your area, get hold of a qualified Family Doctor- of the good old fashioned kind.

Do NOT hesitate to check the doctor’s credentials.

And yes, please be polite with healthcare workers. It helps in ways you may NEVER realise.

Most often, with such a doctor monitoring your well-being from time to time, your expenses will remain low, and peace of mind will be much greater.

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Wish you a long, healthy, happy life.

Take care! 🙂

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About drbijayraj

Physician l Learner l Learning facilitator l Satirist
This entry was posted in Family Medicine, General, Medical Policies and tagged , , , , , , , , , , , . Bookmark the permalink.

3 Responses to Health check-ups: “Packages” are useless if not chosen carefully. So how do you get the most out of them?

  1. Peethan says:

    Health check up’s packages!!!!!!!!!!! Nice thoughts

    Like

  2. dr.k.v.bhagawat says:

    Many a times pt.come with these package lab reports for consultation.I say to them,these lab reports got value , when I examin and detect some illness in you and relavant lab reports are positive. Otherwise they are useless.when I do not find clinically typhoid fever , widal positive does not got any value

    Liked by 1 person

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