Is it just me or has there been a deafening silence from the wellness proponents of forced HRA/biometric screening since Dr. Atul Gawande’s article Overkill appeared?
Two salient quotes from the article capture the issue. The first about over screening and testing in general, not specific to wellness but applicable:
“Often, these are fishing expeditions, and since no one is perfectly normal you tend to find a lot of fish. If you look closely and often enough, almost everyone will have a little nodule that can’t be completely explained, a lab result that is a bit off, a heart tracing that doesn’t look quite right.”
Now, read the article and Dr. Gawande’s story of how he treated a patient who’d been diagnosed with thyroid cancer. Please-read it, this is what overscreening leads to and can do to your employees. It is not an academic issue, real people are impacted. His quote here is especially impactful
“All the same, she thanked me profusely for relieving her anxiety. I couldn’t help reflect on how that anxiety had been created. The medical system had done what it so often does: perform tests, unnecessarily, to reveal problems that aren’t quite problems to then be fixed, unnecessarily, at great expense and no little risk…An entire health care system has been devoted to this game.”
Now an example from the wellness industry. I recently corresponded with a staunch defender of the Koop award-winning Nebraska state wellness program, the one the consultant Al Lewis outed as having falsely diagnosed 500 cases of cancer that-oops-weren’t really cancer. This person said the report should have read “pre-cancerous lesions.” He insisted the program was sound, and well-deserving of the award notwithstanding conflicts of interest that have been covered elsewhere and the cancer misdiagnosis. Really.
Now re-read Gawande’s quote. How many of the 500 people were treated, suffered, or at best experienced anxiety at the thought of having “cancer?” Would ANY of them have been worse off without the program? Has the cost of misdiagnosis, lost productivity and over treatment been factored into the program?
This should be a concern for those purchasing, monitoring or approving wellness programs that utlize forced HRA’s and biometric screening. Does your program follow the preventive screening task force’s recommendations?
Mitch Collins is an executive who advises corporate clients on health, wellness and fitness issues facing their businesses.