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Total Wellness’s Total Package of Totally Inappropriate Tests

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Total Wellness is very concerned about “fostering a positive culture in your office.”

total wellness culture

And what better way to “foster a positive culture,” and “recruit talented employees to your workforce” so that they can “improve relationships with one another” than by screening the stuffing out of them?

To start with, don’t just ask your “talented employees” that you just “recruited” if they smoke.  That would be too easy and obviously they would all lie, right?  Isn’t lying exactly what talented employees do the day after you hire them?  Of course!  And isn’t deceit what a positive culture is all about?  Of course!  That’s why you have to test their nicotine 7 ways to Sunday.

total wellness nicotine

And if those tests are too easily gamed, here’s another one — just in case a few of those lying, cheating employees manage to pass the first set of tests, a la Lance Armstrong.  And we wouldn’t put it past them to game the test.  After all, they are “talented.”

total wellness cotinine

When you’re done with nicotine, screen them for body fat.  Nothing spells “talented employee” like an absence of body fat.

total wellness body fat

But wait…there’s more.  Total Wellness offers a package of seven additional tests that aren’t recommended by the US Preventive Services Task Force.   Now how much would you pay?

A lot, as it turns out (not even including follow-up from false positives). The more inappropriate tests you authorize, the more money they make.

Total Wellness is able to do this through their “partnership with Clinical Reference Laboratory.”  Translation:  they charge you, send some of the money to this other outfit, and keep the rest.

Let’s go test by test down their list.

First are two sets of tests that the USPSTF doesn’t even bother to evaluate because it would never occur to them that anyone, even a doctor, would use them as a screen.

total wellness cbc

total wellness chem 20

Chem-20s aren’t even recommended as screens by the doctors who get paid to do them.

No one bothers to recommend against CBC screens…because CBC tests aren’t screens. A CBC is a test that actual doctors, not wellness vendors, order for patients who are not feeling well.  Get it?  As has been well-established for two decades, it’s not a screen.  it’s a test.  It’s useful for finding the sources of symptoms in a patient who presents in an actual doctor’s office, not for telling healthy people they’re sick.  By analogy, if you think you broke your arm, the doctor might x-ray it.  That’s a test.  But even the dumbest wellness vendor wouldn’t propose X-raying all your employees as a screen to see if their arms are secretly broken.

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Helping employees achieve health shouldn’t include lying to them. Quizzify them instead.

Assuming a CBC were used as a screen, it would be much more potentially hazardous than if a doctor were to do the test. Since apparently Total Wellness doesn’t understand the concept of false positives anyway (a prerequisite for being in the screening business is not understanding false positives), they would likely misinterpret the results.

How did Total Wellness manage to get a license as a wellness vendor without knowing the difference between a screen and a test?  Simple — you don’t need a license to be a wellness vendor.  That means wellness vendors are allowed to charge employers to perform screens on employees that would get doctors in a lot of trouble if they tried to bill insurers for them.

We’d encourage you to visit their site to see a few more proposed screens that the USPSTF doesn’t recommend doing, like TSH, homocysteine, CRP.  But let’s end with the mother lode of the screening industry:  screens that the USPSTF specifically recommends not doing, but are very profitable for vendors.

total wellness ovarian

The good news is, Total Wellness isn’t overselling this test.  They say it is “possibly an indicator of ovarian cancer cells,” which makes the test literally less than useless, due to the overwhelming number of false positives and false negatives from such a test.  That’s why no grownup doctors use it as a screen and that’s why the USPSTF says:

total wellness ovarian

You may say: “Yes, but this ‘D’ recommendation doesn’t apply to women with the BRCA mutation.”  Alas, by law, wellness vendors aren’t allowed to ask an employee whether she has a BRCA mutation or any other family history question, dramatically the reducing the already abysmal odds that a screening vendor might do something useful.

Let us close with my favorite test:

total wellness carotid

Ask vendors why they do it and they’ll say exactly what this one says:  this test is “non-invasive and painless.”  Sure.  In that respect it’s not unlike palm-reading.  The more relevant adjective that applies to both:  useless.

uspstf stenosis

If you want to get technical, “D” means less-than-useless.

We do like to close on a high note.  Total Wellness is right in that this screening program would indeed help your employees “improve relationships with one another.”  Forcing your employees to participate in this costly and misanthropic jihad might lead them to use their “talents” to all get together and revolt–just like at Penn State.


6 Comments

  1. Mitch says:

    Hmmmm….xray all of the arms to see if they are broken. Good one:)

    Like

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