Why I Work for Health Care For All and Say “No” to Screening Tests For Me (at Least Some of the Time)

 By Cynthia Pearson, Executive Director

A few weeks ago, like lots of busy working women, I had to schedule my well-woman exam during the middle of a work day and had to hop from the doctor’s office right back to work. As it happened, that day I was preparing for a presentation about Raising Women’s Voices for Health Care Reform — a collaborative project the NWHN is working on with Merger Watch and the Avery Institute to build a network of women leaders who will push for health care for all that truly meets the needs of women and their families. Raising Women’s Voices will work for high quality and affordable health care that includes preventive care, comprehensive reproductive health services, choice in the type of provider one sees, and respectful treatment for everyone.

But first, I had to take care of my annual exam. I went through the physical and then sat down with my practitioner so that she could tell me her findings (all good), and her recommendations (not so good, at least in my opinion!). Based on my age (53) and sex, my doctor recommended blood pressure screening (the nurse had already taken care of that), a blood test for cholesterol, fecal occult blood test for colon cancer, a colonoscopy (also for colon cancer), mammography for breast cancer, DEXA bone scan for osteoporosis and an EKG for … actually, I’m not exactly sure what she thought the EKG would be used for, because that’s when I interrupted and told my doctor that I knew that EKGs weren’t recommended as a screening test for anyone my age and I wasn’t about to have one. She seemed surprised (it was our first time seeing each other) but accepted my outburst calmly.

We didn’t have time to talk for long, but I tried to explain my biggest concerns. All screening tests produce at least some false positive results, and the tests to follow up on any positive results are often invasive and sometimes risky. None of that seems worth it to me if the screening test hasn’t been shown to give information that enables women my age to reduce their risk of either dying or developing a serious condition. If I’d had more time with my doctor, I would have also said that too often, screening tests lead to drug treatment that has only been shown to help the risk factor, not the ultimate outcome.

So, what’s my personal take on which screening tests are worth it? Blood pressure checks, mammograms, and colon cancer screening for women over 50 — thumbs up. Cholesterol tests every year — no. EKGs for women who have no symptoms of heart disease — no way. Bone density screening — again no, because I’m 53, not 65 or over.

And, how do I reconcile my own choosy approach to screening tests with my political advocacy for health care for all? Very easily. As the NHWN works to expand health care access to everyone, we’re also working to improve the quality of the care we receive. Screening everyone with every test isn’t good care. The NWHN is working for a system in which respect for all and sensible uses of proven technologies go hand in hand. In the meantime, if you’d like more information about which screening tests are recommended for women in your age group^*, check the US Preventive Health Service Guidelines for Periodic Screening(http://www.ahrq.gov/clinic/uspstfix.htm).

* Click here for detailed steps on how to navigate the U.S. Preventive Health Service Guidlines web page.