Comment by kbos87
4 days ago
> You may need to push for comprehensive genetic testing. Some doctors were weird about this and didn’t order it promptly, even after telling me they would.
Honest question - when physicians steer their patients, do they have any specific instructions or obligations with regard to who and what they are optimizing for?
For example, if you visit any online space where (self-reported) physicians are sharing their opinions on any of the newer self-paid testing services (e.g., Function Health blood testing, Prenuvo MRI scans) you'll clearly see some of their internal calculus around why these services are good or bad. The thing that I've been surprised by in the past is that the "impact to the system" often comes up as a reason not to use these services. Yes you the paying consumer might learn something about yourself, but it's a bad idea on the premise that you might be crowding out someone who needs the care more than you do.
I can respect that point of view, but if that is part of what informs a physician's recommendation, it should be clear and explicit. Is this something that any code of ethics covers? Optimizing for the patient in front of you first and foremost?
I can speak from the radiology perspective:
My problem with Prenuvo is not the screening aspect; it’s that Prenuvo is poor value. For the cost you pay out of pocket, I can find you conventional imaging centers that will charge the same (or less!) for fully diagnostic images and a fully diagnostic report. And they will give you the images on disk (or a link to a portal) right there.
If you want to be screened and have the cash to pay for it, go right ahead! Knowledge (can be) power! With the caveat that imaging is step 1 and you may need further work up. Don’t go to the Theranos of imaging; go some place truly diagnostic.
It drives me crazy how many doctors are against elective screenings. When has having more data ever been a bad thing?
Agree that Prenuvo are crazy expensive compared to Mirovita ( https://mirovita.com) and others who offer the exact same service for significantly less.
There’s this idea that a false positive means screening is not working; it’s part of why health systems argue against screening at all.
See fights over: mammography, serum PSA, Lung cancer screening, colonoscopy, etc.
I wouldn’t say most frontline doctors are personally against screening, but they hate fighting with insurance companies over this stuff, and would rather not deal with it.
Prenuvo is nice but really expensive. You can do this way cheaper in Asia.
This Mirovita (https://mirovita.com) one looks decent. Anyone try it out yet?
2 replies →
I wish I had mentioned that I recognize there are some very valid reasons why a professional with a deeper knowledge than I have might steer their patient away from some of these offerings (completely separate from the reason I mentioned.) Thank you for making that point!