ROUTINE BLOOD WORK AND ANNUAL PHYSICAL EXAMINATIONS
NOT AS “ROUTINE” AS ONCE THOUGHT
My opinion of “routine” blood work has for years been about the same as I feel about bone-density tests for OSTEOPOROSIS — it’s mostly used as a tool to get more people taking more medicine and making more visits to more doctors. It seems that this thought process is gaining traction in academic circles. I say academic circles because just like we saw with practicing physicians and physical examinations, they will probably push back to the bitter end (HERE), ignoring their own “EVIDENCE“.
Enter Dr. Ken Lin of the U.S. Preventive Services Task Force (a practicing GP who also acts as a professor for preventive medicine at the Georgetown University School of Medicine, Uniformed Services University of Health Sciences, and Johns Hopkins University. After addressing routine CT SCANS, Lin said the following, while writing for the American Academy of Family Physicians in an editorial that was published one decade ago today (Are Some Screening Tests Doing More Harm Than Good?).
“Big-ticket tests are easy targets for those seeking to reduce waste in health care. But what about the seemingly innocuous practice of performing routine tests such as a complete blood count (CBC) or urinalysis? Both are far less expensive than CT scans and can often be performed in the office at the time of the visit. More than one third of family physicians in the United States think that CBC and urinalysis should be offered routinely at health maintenance examinations, and these tests are ordered for 25 to 37 percent of patients who present for such visits. Many physicians have anecdotal recollections about detecting a serious disease with routine CBC or urinalysis. In fact, large prospective studies performed in the early 1990s concluded that these tests rarely identify clinically significant problems when performed routinely in general outpatient populations. Like unproven big-ticket screening tests, screening CBCs and urinalyses waste time and money, interfere with providing worthwhile tests, and may end up doing more harm than good.”
There is an increasing number of physicians and researchers coming to similar conclusions. Writing for one of the journals that fall under the umbrella of the British Medical Journal (this one BMJ Opinion), three physicians (two orthopedists and an public health official from Cambridge) authored an article just a few months ago called Should We Abandon Routine Blood Tests? I’ll try to sum up the gist of this short article by cherry-picking you a conclusion.
“Historically, blood tests in secondary care were requested for defined indications and only after a detailed clinical history and examination of the patient. Every investigation required justification. However, requesting a standard battery of blood tests without due regard to clinical indication has become the norm. Figures from the Department of Health for England show that over 230 million biochemistry and 47 million hematology investigations were requested in 2014-15… with some estimates of up to £3 billion (four billion dollars) for the NHS [Britain’s national healthcare system] as a whole. [Routine blood work has become a] psychological comfort blanket for clinicians, masking an over-reliance on investigations or a lack of confidence in clinical judgment.”
In other words, not only are these tests expensive when taken as a whole, running them on everyone is a relatively new phenomenon that does not pay the huge dividends the public has been led to believe it does. What has this done? Just ask older doctors. It has created a dependency (these authors used the term “over-reliance“) on technology and diagnostic testing. What’s the solution? Easy. You must understand what the term “preventative medicine” really means (HERE); not our perversion of the term (HERE, HERE, and HERE). Unfortunately, we are using it in a way that expands medicine (it doesn’t really “prevent” much of anything), while doing little to actually help corral said problems or help people actually get healthier.
If you are interested in getting healthier and getting your life back, most of you are going to have to quit relying on your doctor(s) to save you. The proof that this seemingly harsh statement is true has to do with the fact that even though America (at a population of about 5% of the world’s total) is consuming almost three quarters of the world’s medications; we consistently rate around 30th as far as overall health, and about 90th when it comes to CHRONIC INFLAMMATORY DEGENERATIVE and / or AUTOIMMUNE diseases (HERE). It’s a travesty that proves just how UNSUSTAINABLE our healthcare system really is, whether controlled by democrats or republicans.
If you are interested in getting your life back, getting out of pain, and starting a journey back to true health, just remember that your doctor can’t do it for you. It’s largely up to you to do it yourself. You have to do the heavy lifting here. The promises of medicine are empty in this regard. So why not start today? I have actually created a free (generic) protocol that could help you turn the tide and start winning the fight (HERE). No matter what your problem is (even many of you who have been told there is no solution because your issue is “GENETIC“), this is information that you should at least take a look at. And the doubly cool thing is that I am not trying to sell you anything.