AARP, you lost whatever presumed credibility you thought you had with one article in the current issue of your magazine. I am talking about the hard copy of “All the President’s Scans: Our Commander in Chief Regularly Gets An Extensive Physical: Should You?” – part of your Spring 2016 Health Special in AARP: The Magazine, out this weekend. The hard copy is far more slick and glossy than what’s online, replete with pics of the three most recent presidents getting comprehensive physicals for everything under the sun, with smiles on their faces. These were not online. BTW, readers, you can get a copy of it at your local library if you don’t see it at your doctor’s office or are not getting it as an AARP member. Readers note: to get a Medicare Supplement, AARP requires that you join AARP.
Pitching High
Readers over age 50 (AARP’s target audience) might be tempted to look for an executive physical after reading this article. AARP tells you right away where to go for it in the first paragraph: “Cooper Clinic, Cleveland Clinic, UCLA, Duke and many other major hospitals offer them,” the author writes, warning you that “you could pay upward of $2,000 to $3,000 out of pocket for this.”
Like concierge care before this, executive physicals can embellish a doctor’s base considerably and enlarge what people pay for healthcare. First, a sliver of the upper middle class is conned to pay for these tests because, after all, what’s more important than your health? Pretty soon, demand increases broadly and prices go up for all.
As Good as a Cruise
The nuts and bolts of this executive physical are written about like brochures for a cruise. Nothing but upbeat information, you’ll find here. No downsides. It’s clear that AARP will satisfy many of its funders: for example, academic medical centers, providers looking for volume, and purveyors of imaging and screening tests. But those groups have their own stake and it conflicts with that of aging Americans, no matter what their health status.
Here’s the potpourri of tests that AARP claims “could help” you and provide superlative care:
- Blood pressure readings taken all day long;
- Blood test and urinalysis;
- A thorough head-to-toe physical exam instead of the “old-fashioned once-over;”
- Specialist exams all done in one day;
- Multi-expert Q&As;
- Body fat tests;
- Cancer screenings, including mammography, colon, and PSA – and even a total-body CT scan, with the caveat that “some detractors think that ultra-early detection can lead to unnecessary treatments.”
- Eye exams, which could lead you to “new medications that may help stop the spread of macular degeneration, one of the leading causes of blindness in older people” and blood vessel changes in the eyes, suggestive of uncontrolled hypertension.
- Strength and flexibility assessment, which can lead you to physical therapy for pain relief, balance improvement, and strength improvement;
- A stress test – EKG showing early heart problems;
- A sit-down to summarize all the above.
Harm and The “Detractors”
The absence of attention to how so many of these tests have been demonstrated to be wasteful and even harmful is concerning.
AARP, you owe it to your readers to not masquerade advertisements as journalism. Aging Americans have shrinking pocketbooks and this “advice” is a disservice to readers. You scoff at the so-called “detractors,” as if they are few when they are many, completely overlooking the body of scientific research, clinical practice guidelines, and state of knowledge about these tests, which many, as opposed to few, question. Major health authorities question many of these tests, discussed a bit in this blog in numerous posts, and many other places. Overuse is concerning, harms are unacceptable.
For policymakers looking for stakeholders to represent aging Americans, please look outside of AARP. It does not represent us. I submit that AARP’s voice is with waste and the moneyed interests in healthcare, the providers, the establishment, and white Americans aspiring to be part of it.
##
Readers might be interested in more nuanced discussion of these issues, as covered previously in this blog:
Cardiovascular Care and the Bush Effect
MR Imaging, Electronic Test Ordering Creates Waste
Back Pain Trends Worth Reversing
What’s Next for Prostate Cancer Screening and Treatment?
Caveat Emptor: Testosterone Replacement Therapy Ads Soar
..and many more.
Finally, my shameless self-promotion here, but PLEASE take this seriously.
I need more paid, honest work to do! Please contact me! I am not ready to retire.