Today in the chart

Does Preventative Healthcare Ever Go Too Far?

When wellness trends and concierge services masquerade as preventative care, it's hard to sift through what can truly make us better and where the money flows.

Photo by: Marcelo Leal

As a healthcare professional, you’ve likely seen countless occurrences when preventative care has failed your patients. There are plenty of system failures, from scheduling barriers to insurance claim denials to inadequate mental healthcare access.

On the other end of the spectrum, there are times when wellness trends and concierge services masquerade as preventative care. Marketed as magic bullets to remedy our fears of being sick or unknowingly carrying a dormant or debilitating disease, it’s hard to sift through what can truly make us better and where the money flows.

The Intent of Preventative Care

A mistake we often make when framing preventative care is thinking that more testing is more preventative. However, this isn’t always the case.

Take the colonoscopy, for example. It’s often a life-saving procedure to screen for colon cancer, a disease expected to take the lives of over 50,000 individuals in the United States alone in 2023. Yet, the screening is only recommended for individuals older than 45 or those with specific genetic or lifestyle risk factors. Why doesn’t everyone get a yearly screening if it’s so preventative?

Screening too frequently for disease can lead to overdiagnosis of minor abnormalities. This can cause:

  • Unnecessary additional follow-ups.
  • Nonessential treatments.
  • Additional healthcare costs to the patient.
  • Undue emotional stress and hardship.

The US Preventative Services Task Force creates guidelines that balance the risk of a preventative procedure with the potential reward of the procedure. With their stamp of approval, you can be sure the procedure or service has been thoroughly reviewed.

Health and Wellness Trends in 2023

When individuals receive preventative measures outside of evidence-based recommendations, it can result in anything as innocuous as minorly overspending on a wellness product to something as serious as death. Preventative services range from non-prescription products under $10 to expensive procedures that must be done in a provider’s office. Here are some trending preventative measures and their possible oversights.

1. Preventative MRIs

Recently re-popularized by Hulu’s The Kardashians, preventative MRIs involve the practice of full-body scans to rule out asymptomatic cancers, premature aging, or other abnormalities. Dr. Geeta Nayyar, Zocdoc advisor and author of Dead Wrong: Diagnosing and Treating Healthcare’s Information Illness, says, “Scans like this more often than not produce false positives or inconclusive results that require potentially unnecessary follow-up or intervention.” The preventative scans aren’t covered by insurance and usually cost at least $1,000 or more.

2. Colon Hydrotherapy

Colon hydrotherapy involves flushing the colon with water, hoping to remove toxins or waste. The procedure hinges on the idea that the colon can’t cleanse itself, which isn’t usually the case. Medical professionals are skeptical of how effective the procedure is for the average person and have concerns it may disrupt the gut microbiome.

3. Hair Mineral Analysis

Hair mineral analysis is often used as an effective measure to test for drug use. It’s also used in wellness to diagnose nutritional deficiencies or heavy metal toxicity. Dr. David Berger, a board-certified pediatrician and owner of family practice Wholistic Pediatrics & Family Care and health education company, Dr. David, MD, says he’s not convinced hair analysis is an accurate test. He recommends follow-up with other blood and urine tests. He adds that because the hair is an excretory organ, if a toxin is showing up on a person’s hair, it’s going to be unclear if it’s because the body is properly excreting it or if there is too much of the toxin and it’s showing up in the hair. “I can think of a reason for a false positive, false negative, true positive, and true negative,” he adds.

4. Concierge IV Treatments

This is another treatment recently shown on Hulu’s The Kardashians. Some PRN concierge IV treatments, like electrolytes when you’re sick or saline therapy for POTS patients, are very necessary, says Berger. However, excessive IV treatments can be costly and unnecessary. And when regulars need essential healthcare, they could have done extreme damage to their veins through those unneeded treatments.

Oftentimes, concierge IV treatments are a way to administer additional vitamins. Nayyar says, “One of the most abused recommendations found on the internet and then translated into real life is the use of unnecessary and expensive supplements. These are often sold as methods to “keep you healthy.” But supplements, when taken excessively, can have effects on your liver. And often, eating an orange instead of a Vitamin C tablet can be just as effective and less costly.”

5. Alkaline Water

The alkaline water trend is less harmful, as the worst-case scenario involves wasting a few hundred dollars on overpriced water. Why doesn’t it work? Berger says that alkaline water advocacy is based on the idea that it can change blood pH, which we know is tightly regulated and shouldn’t be influenced by an ingested beverage. If it is, there’s another very serious underlying issue.

Approaching Trends with Skepticism

As nurses, sifting through misinformation is important to educate patients and keep ourselves informed.

Three key principles to remember when fact-checking wellness claims and considering a preventative care measure:

1. Follow the Money

See if the person endorsing a product is making money off it. On the other hand, Berger says it’s also important to remember that some aspects of functional medicine may lack funding because they aren’t inherently money-making. Don’t write off treatments completely without digging a bit deeper.

2. Understand That Your Opinion Can Change As More Evidence Surfaces

Evidence-based practice is a lens to approach healthcare, but that lens can shift as more studies are done and patient outcomes change.

3. Utilize Critical Thinking

Intellectual humility, fairness, logical consistency, and other aspects of critical thinking are useful when evaluating preventative treatments.

In addition, Nayyar suggests:

  • Have a relationship with your doctor and the medical professionals you work with.
  • Ask your medical provider who they follow on social media and what websites they use for medical decision-making.
  • Recognize that everybody is different, and healthcare decisions are best made with a medical professional who understands your health situation personally.

Making Empowered Decisions

As Nayyar says, “None of us wants to be the fool. And most of us want to be healthy.” When considering preventative medicine, remember that more isn’t always better. Before thinking about the next wellness trend, ask yourself if there’s a hidden cost.

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