At this point we thought we had already checked off everything in the wellness industry’s bucket list of bad behaviors-gone-wild. But that was before we learned about AngioScreen, which offers the “perfect compliment [sic] to your health and wellness fair”: carotid artery stenosis screening, a test rated D by the US Preventive Services Task Force:
Keep in mind the “AngioScreen” is this company’s specialty — the only major screen the Nashville-based Angiology Corporation of America (ACA) offers. In an industry known for harming employees, this makes them the leader, as ACA is the only wellness vendor guaranteed to harm employees on balance, according to the federal government.
And, by the way, however stupid an idea this screen is for the USPSTF-described “general adult population,” it is stupider still for the <65 employed population, which has far lower incidence rates of stenosis than the seniors, and hence a far higher likelihood of false positives.
What makes ACA unique is, not only do they know they’re offering a D-rated screen, they say so right on their website. At the bottom of their list of 10-, 15- and 24-year-old articles recommending carotid artery stenosis screening, they link to the USPSTF “D” Recommendation itself, a first in wellness vendor history:
You might ask: “Is it honest to offer a service you know to be harmful, if way down in your website you disclose that it’s so harmful your customers shouldn’t buy your service in the first place?” Alas, we cannot answer that. That is a question for philosophers, philosopher-kings and philosopher-welders.
Three related questions can be answered, though:
(1) Would a doctor lose his or her license for offering this test to every adult who comes in the door and billing insurance companies for it? Yes.
(2) Are these people disclosing directly to employees that official clinical guidelines recommend against doing this test because they are more likely to be harmed than benefited? No.
(3) Do they also make up savings figures? Yes. Specifically they say this “pays-off” in ways that don’t come close to “paying-off”.
Additionally, their quality control doesn’t exactly inspire confidence.
Speaking of their Medical Advisory Board, despite the fact that AngioScreen is offering exclusively vascular screenings to “prevent your stroke and heart attack,” Dr. Alfred Smauel Callahan, III, M.D. is definitely not one of America’s, or even Nashville’s, leading vascular specialists or cardiologists. How do we know that? As it turns out, he’s not a vascular specialist or cardiologist at all. He’s a neurologist. Those are the guys who treat people after they’ve had a stroke.
This choice of a neurologist as their physician leader doesn’t exactly inspire a lot of confidence in AngioScreen’s ability to prevent strokes. Also, there don’t seem to be any other doctors on the medical advisory board, which is “headed” by him. Per the offer on their website, we wrote and called to see if we could “review the curriculum vitaes [sic]” of this alleged board, and got no response.
In Angioscreen’s defense, they are not alone in offering harmful screening services. Total Wellness, Star Wellness, HealthFair, and other vendors offer the same screens or — in the case of HealthFair — worse ones.
This all brings us back to the question we’ve been asking for years: where are the grownups? Why isn’t there any oversight of the wellness industry? How can vendors and employers be allowed to do things to their employees that doctors would be jailed for doing if they billed patients for them? And how can employees be forced to participate in programs that could injure them, with no business purpose whatsoever?
We propose a simple regulation to address those questions: wellness vendors must do no harm. Wellness vendors should be required to disclose the USPSTF rating before they run these screens, and if it isn’t an A or a B for the employee’s age and frequency of screening, employees should be able to opt out without losing their incentive or paying a fine.
Update 4:30 PM November 19: I received a call back from Rhonda Small, at the company, who says that they are no longer really in the business of selling screens to employers, but rather mostly to hospitals. Their website, she says, is wrong. This makes better business sense because many hospitals like to offer free or deep-discounted D-rated screens, as we have noted. It is an excellent tool for sucking patients into their revenue stream, which is largely paid for by the patients’ employers or Medicare.
She indicated that she would send me curricula vitae (Rhonda, that is the plural, not “curriculum vitaes”, so you might wanna add that to the list of things on your website that are wrong) for the medical advisory board. I will post further updates.
Update 5:00 PM November 19: Apparently AngioScreen’s marketing team has not gotten Rhonda’s message that the company doesn’t market to employers–they just exhibited at the largest human resources conference.