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In this blog I write my observations on how disease and paranoia may be generated in the guise of preventive ‘full body check ups’.

Nowadays, people are more aware and proactive about their health. We like to identify any disease early and stay safe. However, the way this is happening in India defeats the purpose and creates more harm than good.

In India, there is a mushrooming of ‘diagnostic centres’ and 5 star hospitals offering ‘Master Health Check Ups’. Most of these check ups are a fixed set of tests, when it should actually be individualized considering the person’s health, symptoms, age, family history etc. A good physician should talk to the person first.

A perfectly healthy person who needs only a few specific investigations ends up getting a whole battery of tests which are completely unnecessary and expensive. The lay person is satisfied thinking that he has been ‘thoroughly checked’ but actually and unwittingly spends his hard earned money and time to ‘open a can of worms’.

People need to realize that annual medical checks are good, but they are NOT like annual car servicing. Medical Investigations need to be treated with caution. Medical tests may often show some ‘normal variants’ or ‘borderline abnormalities’ which are not of any danger to health but create a dilemma on how to tackle it. If a dubious abnormality is picked up, one cannot help but repeat it, worry about rare possibilities and indulge in further investigations.

A common example is a very flippant use of angiographies, suggested after some questionable abnormalities picked up in health checkups. This may lead to angioplasties, stents, or even bypass surgeries. A ‘person’ now turns into a ‘heart patient’. The ‘Just To Be On the Safe Side’ line of thought often traps a normal person into a never ending cycle of expensive tests, hospitals and multiple ‘super’ specialists.

Another common scenario is when people walk into expensive ‘Diagnostic Centres’ asking for a ‘complete check up’. Often some abnormality is picked up. Many diagnostic centres will take no responsibility of counseling or guiding the person (now a patient) in the right direction. People are left with the abnormal reports in their hands, huge bills in their pockets and worry in their heads. Then starts the ‘doctor hopping’ and the dealing with a variety of opinions on what to do about the abnormal results.
What we really need is very simple. A well trained physician/ family physician, who is the regular doctor for that person should have timely health check consultations. The choice of investigations needs to be based on evidence, rationale and discussion with the person about ‘the possible dilemmas’ being created with some abnormal tests (like PSA). This takes a bit of time and an interest in the persons welfare (on the doctors part) and a change of mindset of people who opt for these check ups. This is how we can make these check ups serve us well.

In summary, a ‘complete health check’ up is good only if there is a pre-test and post-test consultation with a good & sensible physician. Otherwise, you may be asking for trouble!

 

Guest blog contributed by Dr. Gaurav Beswal who blogs at Dr. Beswal’s blogs

 

Dr. Gaurav Beswal : Diabetologist, General/ Family Physician, Advocate & Dreamer for a sensible, ethical and quality healthcare system for all. After doing MBBS from K.E.M Hospital in Mumbai, He did his specialist training in the UK. He completed the MRCGP (UK),  gained entry onto the CCT (Consultant Grade) register and practiced there for a few years. After working for about 7 years in the UK, He decided to return to India. In the UK, He did additional training in Diabetology, Sexual Heath & Women’s Health. He is currently doing a ‘Post Doctoral Fellowship in Diabetology’.