Saturday, March 26, 2011

Common Sense Family Doctor: Coronary CT: nonindicated and costly screening test

Another excellent post by Common Sense Family Doctor Kenny Lin, MD, on the incredible fact that Texas, bankrupt largely due to Medicaid costs and limiting elective Caesarean sections to decrease Neonatal Intensive Care Unit (NICU) costs, will pay for the non-indicated (but very profitable) coronary artery CT screening test. Dr. Lin also calls to task Texas Senator Kay Bailey Hutchinson for her inaccurate article criticizing the US Preventive Services Task Force (USPSTF) for "interfering" with decisions that should be made by a patient and doctor.

Some years ago, after the sudden death of St. Louis Cardinals' pitcher Darryl Kile of a heart attack at age 33, I met someone who asked me if he should get a coronary CT. I said I didn't recommend it, and wondered why he wanted it. He said if it was negative he wouldn't have to worry. I pointed out that he was very overweight and smoked, and that what would help him to live to see his children graduate from High School was not a coronary CT, but eating less and stopping smoking and beginning to exercise.

He was hoping that a negative CT had would mean he wouldn't have to do the hard work of changing his lifestyle.

Sorry, Charlie. It's not a good screening test for coronary artery disease and it is certainly not protective against developing it.

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