They Said What?

Home » screenings

Category Archives: screenings

Congressional committee votes to allow employers to genetically screen children

We cannot make this stuff up.  HR 1313, The Preserving Employee Wellness Programs Act, has a provision specifically designed to screen children for genetic defects.  Don’t take our word for it.  Here is the language of Section 3(b):

Notwithstanding any other provision of law, the collection of information about the manifested disease or disorder of a family member shall not be considered an unlawful acquisition of genetic information with respect to another family member as part of a workplace wellness program.

This wasn’t an oversight due to some obscure language — the entire bill fits on a page. It just passed the House Education and Workforce Committee and is headed to Ways and Means. We need to stop it now.  It basically says, you can ignore the Genetic Information Non-Disclosure Act as long as the genetic testing is part of a wellness program.

Tomorrow, Quizzify will become the first wellness (really, employee health literacy) vendor to formally oppose it, and tell Congress and the Business Roundtable to keep their hands off our children.

The US Preventive Services Task Force: what it is and why vendors hate it

Google on “Wellness vendor compliance with US Preventive Services Task Force guidelines” and here’s what you’ll see:

No results found for “Wellness vendor compliance with US Preventive Services Task Force Screening Guidelines”.


And there’s a reason for that. Most wellness vendors are out of compliance. Now, re-google that phrase sans quotation marks. Most of the front-page “hits” are me complaining how wellness vendors are out of compliance, with Bravo being the one that comes up first.  Another hit has Wellsteps saying:

The U.S. Preventative [sic] Services Task Force has established guidelines that indicate when it is appropriate to get screened, based on age, gender, and the presence of risk factors. It is NOT recommended that an entire employee population be screened every year.

And that’s an accurate assessment, a rare instance of Wellsteps being honest (under duress, of course). You might say, well, at least they’re in compliance…but ironically Wellsteps got outed for flouting these very same guidelines about two months after they posted this paean to the USPSTF.

In sum, the USPSTF is the “gold standard” for all things prevention, and wellness vendors are in the business of all things prevention. One would therefore assume the wellness industry would be in sync with the USPSTF prevention guidelines.  This posting (with two more to follow) explains how and why most aren’t, starting with a few basics.


Q: What exactly is the US Preventive Services Task Force?

This excerpt comes right off the USPSTF website, but given the apparent widespread vendor ignorance of USPSTF recommendations, perhaps vendor firewalls block their website.  As a public service to the wellness industry, I’ll cut-and-paste it here:

Created in 1984, the U.S. Preventive Services Task Force is an independent, volunteer panel of national experts in prevention and evidence-based medicine. The Task Force works to improve the health of all Americans by making evidence-based recommendations about clinical preventive services such as screenings, counseling services, and preventive medications. All recommendations are published on the Task Force’s Web site and/or in a peer-reviewed journal.

The government relies on the USPSTF to determine what should get 100% covered, to encourage prevention.


Q: What exactly is screening and how does it differ from testing?

A doctor or nurse practitioner might run a diagnostic test on a patient who should have one for clinical reasons. Like a doctor might say: “Your cholesterol was high last time, so we should test it again.” Or “You are overweight and have a family history, so I’d like to test you for diabetes.”

By contrast, a screen uses those very same tests (plus often a whole bunch of squirrelly ones) — but applies them to everyone, not just people who are indicated for them. Screening is a hunt for hidden disease in seemingly healthy, usually across an entire company, and screening vendors often get very excited when they can report how sick the employees are. This is called “hyperdiagnosis.” One vendor, Compass Health, calls this hyperdiagnostic process “I Feel Fine Syndrome.” They insist that feeling fine means you are probably sick, except that you haven’t been diagnosed yet. They’ve even trademarked the term. Think I’m making this up?

compass health title I feel fine syndrome

However, the fact is that, with a few clear exceptions like Pap tests, blood pressure, and the occasional cholesterol/glucose screen, the entire practice of screening is highly controversial. In Switzerland, for example, mammogram screens are no longer recommended at all. (You can get mammograms as a test, just not a screen.)  The problem of overscreening and hyperdiagnosis is so widespread that one of my Quizzify colleagues wrote an entire, excellent, book on the futility and harms of using screens to hunt for diseases in an asymptomatic, generally well population.


Q: How does the USPSTF rate screens?

Grades are A,B,C, and D (and “I” — not enough evidence).  They publish a summary recommended list of “A” and “B” screens.  “C” screens are recommended for “for selected patients under individual circumstances,” a level of nuance requiring clinical competence far beyond the pay grade of most wellness vendors.

Note among other things that only a few screens are recommended as “A” for all adults, like blood pressure.  Other are recommended only for people in certain age groups and/or with certain risk factors, like aortic aneurysm screening.  (Nonetheless, plenty of vendors offer those screens on everyone, as long as the employer will pay for them.)

An example of a “D” would be a prostate (PSA) test, which is a vendor favorite. Even the inventor of the test says not to use it as a screen because it misses a lot of cancers and “finds” a lot of cancers that aren’t there.  Last time I got screened, I specifically asked the vendor, Interactive Health, not to do a PSA because they are so unreliable, but the vendor did one anyway, along with about 40 other tests that are not recommended as screens.


Q: Whoa! You said the Swiss don’t like mammograms. Are you saying we shouldn’t encourage employees to get mammograms?

No. The USPSTF says employees over 50 should get them every two years.  These are screening recommendations. That means for women with no risk factors. If you have reason to believe you carry the BRCA gene or are at high risk otherwise (such as having had breast cancer in the past, or a family history), then by all means discuss a different schedule with your doctor.


Q: So the Swiss are wrong?  The Swiss are never wrong about this kind of thing.

They may not be. Really, no one knows.  And there is nothing to “know.” Breast cancer screening, like all other screening, involves a trade-off between benefits and harms. The USPSTF reaches a different conclusion than Switzerland does because “ties go to the runner” for USPSTF. If evidence isn’t compelling enough one way or the other, they draw the line in favor of more frequent screening.

If your average person understood biostatistics, the USPSTF wouldn’t have to publish recommendations.  Each person might look at the same data on harms and benefits and decide, presumably in consultation with their doctor, whether to shake the dice on testing and followup. Guys, would you get a PSA screen if there was a 1-in-20 chance that the follow-up would possibly ruin your life, but a 1-in-1000 chance that your life would be saved?

We can all reach different conclusions there. Women should see the next Q&A for the analogous screen.


Q: How can something as simple as screening cause harm?

Go back to that article on Switzerland and you’ll see some incredible data about overscreening harms from mammography. For every breast-cancer death prevented in women over a 10-year course of annual screening beginning at 50 years of age, 490 to 670 women are likely to have a false positive mammogram with repeat examination; 70 to 100, an unnecessary biopsy; and 3 to 14, an overdiagnosed breast cancer that would never have become clinically apparent.

Those are examples of the numerical harms of over-screening. Some of the harms are numerical, while others can’t be quantified. The ones quantified above include:

  • False positives, causing people to seek unnecessary, and possibly harmful, follow-up;
  • The harms or unreliability of the followup itself, such as prostate, breast or lung biopsies;
  • The possibility that the biopsy will itself be a false positive.

Other harms of screening that can’t be quantified include:

  • False negatives, causing people to become complacent if they see unexplained symptoms;
  • The possibility of missing the most-aggressive and fastest-growing tumors that grow between screening sessions, but catching those slow-growing or otherwise clinically insignificant tumors which may not do harm;
  • “Detecting” many cancers that are better left undetected because they will do no harm;
  • “Detecting” things you can’t or shouldn’t do anything about (for instance, prostate cancer is increasingly “treated” by doing nothing)
  • Findings that are not the focus of the screens, called “incidentalomas,” that have a very high chance of being clinically insignificant;
  • The harms of screening itself, such as radiation, or physical harm, as in colonoscopies;
  • The psychological harm of being told you’re sick when you aren’t, which vendors love to do — see the Nebraska case study, another perfect example of the aforementioned hyperdiagnosis.

Q: But most of these tests are at least 90% accurate, so aren’t misses rare?

There is also widespread misunderstanding of the arithmetic of misses. Consider this example.

Excluding people already diagnosed with coronary artery disease or already known to be at high risk for whom screenings are redundant, maybe 1 in 1000 employees will suffer a heart attack this year. Let us assume that there is a magic blood test, far beyond today’s technology and predictive potential, that would be 90% accurate for finding the unsuspecting employees who will suffer a heart attack this year.

If an employee tests positive, his odds of a false positive are not 10%, as would be expected if a test is 90% accurate. Quite the contrary, despite the magical accuracy of this hypothetical screen, testing 1000 employees will result in about 100 positive findings, only one of whom will have a heart attack. Meanwhile, the other 99 employees testing positive will be subject to unnecessary follow-up tests, drugs, and possibly stents.

That’s why it costs a million dollars to prevent a heart attack via screening.

While patients could be expected not to understand this arithmetic, even doctors appear to vary greatly in their understanding of false-positive arithmetic.  If doctors, following many years of college, medical school and supervised training, cannot understand these harms and this arithmetic, how is it possible that wellness vendors could do better, despite the industry’s lack of requirements for education, training, testing, licensure, compliance, and ethics?


Coming up: Part 2 — Wellness vendors vs. the USPSTF

 

Corporate Care Management Rounds Up 25 Times the Number of Usual Suspects

You may recall Phantom Tollbooth, a classic of children’s literature. Among other things, the book features a dish called “subtraction stew,” where the more you eat, the hungrier you get. Likewise  the more cancer cases Corporate Care Management  (CCM) finds, the more money they save.

With math like that, it’s no wonder that 5% of their case study population of 600 was told they have cancer or precancer. And that was just in 2015 alone.

In Casablanca, Captain Renault told Major Strasser: “Owing to the seriousness of this crime I’ve instructed my men to round up twice the usual number of suspects.” Turns out Inspector Renault had nothing on CCM. In a typical year maybe 0.2% of the working-age population would get a valid cancer diagnosis for the cancers they screen for. That means CCM rounded up 25 times the number of usual suspects. To put this in perspective, at this rate we’d all get diagnosed with cancer twice during a 40-year career.

casablanca

 

 

 

 

 

And the savings?  Over $20,000 per alleged cancer victim. That means CCM saved more than $1000 per covered employee, which is more than most employers spend on cancer — simply by finding more cancer cases to spend money on. (Care for a second helping of Subtraction Stew?)  And, yes, of course, this screening includes the USPSTF D-rated prostate screens, a staple of the wellness industry.

ccm-prostate

This cancer-finding is all accomplished on the basis of a letter-writing campaign. (For instance, men were instructed on three different occasions in 2015 to get their prostates screened.)

One other nuance: the 5% cancer incidence rate — 30 people — is based on the total 600 employees. Yet the company sent out only 146 “welcome packets,” meaning that less than a quarter of the employees actually responded to the letters.  Of those 146, almost a quarter (30) allegedly had cancer or precancer.  This proportion even tops the previous high for cancer hyperdiagnosis, which was the Nebraska wellness program (before Ron Goetzel and Health Fitness Corporation admitted they had made the whole thing up).

ccm-cancer-statistics

While it wasn’t clear what the other 454 people did with those letters, here is a question for your consideration: would you even open a letter with a return address of: “Corporate Care Management” ?  As a patient, those are three words I hope never to see adjacent to one another over the course of my natural lifetime.

Lest I forget, here is what the actual letter looked like. I don’t know about you, but if I ever received letters with this design from an outfit with this name, I’d get a restraining order.

ccm-new-years


And apparently I’m not the only one who would prefer to be left alone.  The Maytag repairmen used to be the loneliest people on earth.

maytag-repairman

But CCM’s nurses might give them a run for their money.  Here are the utilization statistics they presented to this very same client with 600 employees:

ccm-outreach-title

ccm-outreach

Yes, that’s correct. they completed one conversation.  Although that may be because the other 599 employees are too worried that if they talk to these people, they’ll get treated for cancer so CCM can save even more money.

 

Ever wonder what it’s like to actually participate in a wellness program?

Do you know anyone who is actually in a “pry, poke and prod” wellness program run by one of the 50 vendors “profiled” on this site?  If so, try asking them what they think…and then compare those opinions to what the vendors want them to think. A few tidbits of the latter are listed below:

But none of these vendors ever ask the flesh-and-blood employees how they feel. Turns out there’s an excellent reason for that: employees hate “pry, poke and prod” programs. Here are four sets of vignettes to that effect.

  1. Last month, we collected some comments from an article in Slate about wellness. Just when we thought the news cycle on that article had run, more employees weighed in.  Still, those are just comments, not in-depth experiences.
  2. Getting into the belly of the beast, Vik Khanna posted a ten-part series on the Provant program he and his wife were forced to submit to subject to a major forfeiture. This program sucked up 6 hours of his time and provided tidbits like “drink 8 glasses of water a day,” which of course is a total myth . This myth dates from a misinterpreted finding from 1945. It is now perpetuated only by some wellness vendors (not all of them — incredibly a few have now procured internet connections), as well as presumably Poland Spring, Aquafina, Dasani, Kohler and American Standard.  Obviously if the human race were that dehydrated we would have gone extinct long ago.   Provant water
  3. In addition to Vik’s regular journal entries, every now and then, someone writes in detailing their own experience in being forced to submit to one of these programs. Here is one of our favorites, someone complaining about Optum’s program. No wonder Optum is so opposed to the Employee Health Code of Conduct. I’d be opposed too, if I offered Optum’s program.
  4. Finally, here is the program du jour.  In their alleged attempts to create a culture of health, these vendors are creating cultures of resentment, distrust, and deceit.  We’re copying-and-pasting the opening paragraphs of this rant, but would encourage you to click through to the whole thing.

News Flash, The Dodo Bird is Still Alive

Well another year has rolled around and I was talking to the person who’s experience with their wellness program I had discussed below. Lo and behold, the problems I had originally documented continue unabated. This is a common example, and explains why so many wellness programs should be discontinued.

It was time for next years enrollment period for her insurance and she needed to get a number of points, schedule a coaching visit and get her biometrics and lab work completed to qualify for the premium differential.

The lab work requirement upset her as she had just gotten all the lab work done by her PCP the month earlier, but no, those lab results couldn’t be used. So the vendor repeated all the lab work her PCP had done and more, most of which were absolutely unnecessary based upon USPSTF guidelines. But hey let’s go ahead and waste some money and do a few unnecessary tests.  That’s become the norm for many a wellness program.

The story continues here.

HealthFairs USA: A wellness program that defies description

The English language contains 450,000 words, the most of any language, but apparently it needs a 450,001st.  Why? Because whoever invented the first 450,000 words had obviously not reviewed HealthFairs USA’s wellness program, which no existing word comes close to describing.

First, they test for cancer — with 99% accuracy!  This precision may seem impossible but their claim is correct in that 99% of the words in the clipping below are indeed spelled accurately. (This is actually a better track record than the rest of their website, in which they describe their “unparallelled” customer service and how they “minimize your companies risk” and “build company moral.”  They also advertise “less call-outs for sickness,” by which I suspect they mean “fewer absences.”)

preventest-check-swab

Besides the slight problem that this statement is beyond absurd about a zillion different ways, Preventest lacks FDA approval (and — equally surprisingly given their accuracy — a Nobel Prize). That doesn’t stop HealthFairs USA from submitting claims to insurance companies and promising “no out of pocket cost” in most cases:

preventest-insurance-reimbursement

By the way, there is no FDA-approved genetic “check swab,” or test of any kind, let alone one with 99% accuracy, for any cancer. And few cancers on this list even have a genetic component. (Bladder cancer, for example, is 100% environmental.)


But wait…there’s more. Now how much would your insurance company pay?  HealthFairs USA is selling worthless nutritional supplements and submitting insurance claims for those as well:

preventest-supplements

Let’s review what they’ve told us so far: they perform useless, non-FDA-approved tests and sell useless, non-FDA-approved supplements to employees who don’t need them, and then submit bills to third party payors.  Can anyone spell insurance fraud? I doubt they can, since they can’t even spell “alleviates.” (So much for their 99% accuracy target.)


How does this benefit employees?

preventest-how-does-this-benefit-me

Lots of ways. Employees can submit to more frequent screenings.  And I’ve always said the problem with the US healthcare system is that employees don’t get screened enough. (not!)

Or, they can take medications. It’s not clear which ones, and there aren’t any “medications” that are FDA-approved for preventing most cancers in any case. But whichever ones you take, I’m sure they’ll figure out how to bill the insurance company for them. Most importantly, you can “have risk reducing surgical procedures.” Hmm. What word can describe a wellness vendor recommending surgery for employees tagged by non-FDA-approved cancer screens for a possibly elevated risk of cancer?

Make that 450,002.

Indeed, a true wellness program might consist of warning employees not to get anywhere near HealthFairs USA, so clearly these people don’t have any accounts of any sophistication, right?  Right?

Wrong.

They claim a household name company as one of their accounts. That means they are submitting insurance claims to their insurers on behalf of their employees, as directed and incentivized by their human resources department. I’m not a practicing attorney, but I am a practicing non-idiot, and as such my opinion would be that they look into this posthaste.

Yes, I know it’s not like me not to name names…but any whistleblower fee is not applicable if the information is already public. And, incredibly given the rather modest readership of this blog, being in TSW counts as public information.

And plus, it’s not like they’re completely fraudulent. They have references from stellar companies with outstanding reputations:

healthfairs-wells-fargo

Full disclosure: I’m not 100% sure that it is actually illegal to submit insurance claims for useless, unapproved, possibly harmful, USPSTF D-rated screens and useless, unapproved, probably harmful, supplements for employees who have no diagnosis, no recognized medical necessity and aren’t seen by a real doctor.

Quite the contrary, my opinion may only be 99% accurate.

 

 

Why do employee wellness industry leaders hate employees so much?

I would like to express my gratitude to the editor of the American Journal of Health Promotion, Michael O’Donnell.  He recently decreed that “despite common lore, I am not an idiot.”  Coming from a man brilliant enough to singlehandedly create entire alternative universes of arithmetic and statistics, “not an idiot” is mighty praise indeed.

michael-odonnell-not-an-idiot-quote

I’m unsure exactly what “common lore” he is disputing, unless he means that the Phi Beta Kappa committee at Harvard also thinks I am an idiot, relatively speaking, because they snubbed me until I was a senior.

I will return the compliment.  Michael O’Donnell is not an idiot either.  Quite the contrary, he and his Koop Committee buddies knew exactly what they are doing when they gave their friends at Wellsteps awards for harming employees.  Bottom line is, these people simply hate employees, and happily throw them under the bus whenever it’s profitable to do so. While Boise is a great example, Penn State still reigns supreme.

While we could write a post about almost any member of that Committee, this post focuses only on one member, Mr. O’Donnell.  Still, it’s hard to dislike the man given all the kudos he throws my way. For instance, in addition to not being an idiot, I am also praised above as: “close to being accurate.” Since we disagree on everything, he is therefore acknowledging that he himself is many light-years from accurate — as Wellsteps and every other Koop award demonstrates.


Michael O’Donnell’s Anti-Employee Jihad

Michael O’Donnell also said, as you can see above, that I am not a “misanthrope.”  However, in this case, I can’t return the compliment.  His new editorial is a misanthropic anti-employee jihad.  First, he says prospective new hires should be subjected to an intrusive physical exam, and hired only if they are in good shape.  OK, not every single prospective new hire — only those applying for “blue collar jobs or jobs that require excessive walking, standing, or even sitting.”   Hence he would waive the physical exam requirement for mattress-tester, prostitute, or Koop Committee member, because those jobs require only excessive lying.

Second, he would fine people for not meeting “outcomes standards.” In an accompanying document, he defines those “outcomes standards.” He specifies fining people who have high BMIs, blood pressure, glucose, or cholesterol.

Finally, he wouldn’t hire smokers at all, because they are so unworthy and untalented. Meaning Humphrey Bogart never should have been cast in Casablanca.  Ernest Hemingway and George Orwell should have piled up rejection letters. Roger Maris should get his asterisk back.*  Rihanna, Simon Cowell, Adele, Brad Pitt, Obama, Churchill, Einstein. Sinatra, Twain, Kidman.  Sheesh!  I agree with you, Michael. What a bunch of losers.

And thank goodness Watson didn’t smoke or Moriarty would likely still be at large.

sherlock-holmes


A Unique Way to Charge Employees for Health Insurance: By the Pound

Almost every nonsmoker would be caught in his dragnet too, as he would “set the standard for BMI at the level where medical costs are lowest.”  Since people with very low BMIs incur higher costs than people with middling BMIs, Mr. O’Donnell would fine not only people who weigh more than his ideal, but also employees with anorexia.

If employees didn’t already have an eating disorder, what better way of giving them one — and hence extracting more penalties from them — than to levy fines based on their weight?  Hopefully, he would allow people with wasting diseases like cancer to appeal their fines.

Employees above his ideal weight would pay per pound, sort of like they were ordering lobster or mailing packages.

Yes, I have a hard time believing anyone would disdain employees that much too, so here is the screenshot:

odonnell-bmi

He claims that all these fines will “enhance morale” for employees, whether they like it or not.


How would Michael defend his anti-employee jihad?

The Wellness Ignorati don’t engage with me, for obvious reasons given their self-immolating comments when they do. So I’ll provide his rebuttal. It would be, as he said in the first screenshot above, that I am once again “creating controversy where it does not exist.”  Clearly, his editorial and white paper are mainstream, and I’m just causing trouble again for no reason.

Michael wonders why, in his own words (echoed by Ron Goetzel), 90% to 95% of wellness programs fail.  He says it’s because employers don’t spend remotely enough money on them. He recommends up to $300/employee/year…and what better way to reach that spending target than to make them go to the doctor, and set up expensive weigh-ins, inspections and fining procedures?

While Michael O’Donnell may not be an idiot, I’m not sure I could say the same about any CEO who takes his advice.



*Maris should get his asterisk back because, as a smoker, he still holds the record for “Most home runs by a player who never should have made the team.”

Are you smarter than a wellness vendor? Take the Interactive Health IQ test and find out.

I’ve raised the bar for getting “profiled” on this site. Life is too short to simply highlight every wellness outfit that tests inappropriately and then lies about their outcomes.

Nor can you get on this list simply with bold proclamations of fatuous statements, like Interactive Health does:

interactive-health-sitting-smoking

Hey, Interactive Health, we get that you don’t understand statistics in general, based on the mind-boggling excuses your consultant offered about your completely invalid savings report (“Al, the [massive] savings on Page 4 have nothing to do with the [trivial] risk reduction on Page 9. It’s a completely separate analysis.”).

Even so, maybe you can find a smart person to explain this particular statistic to you:

  • According to the CDC, the number of annual deaths caused by smoking: 480,000
  • According to the CDC, the number of annual deaths caused by sitting: 0

Here are some other differences between the two activities: Chairs don’t carry excise taxes or warning labels. If you’re under 18, you can buy a chair without a fake ID.  Workers are allowed to sit inside the building. Chairs don’t make you clothes smell, cause lung cancer or dangle from the lips of gunslingers in old John Ford westerns. Sitters aren’t assessed health insurance penalties. Your Match date will not feel misled if he or she catches you taking a seat, even if your profile didn’t disclose that you sit.


The Interactive Health IQ Test

Which of these images is most unlike the others?

interactive-health-iq-test

 


No, these days to get into this column, you need to soar above and beyond ordinary wellness vendor stupidity and dishonesty, because Wellsteps has totally raised the bar…and yet Interactive Health has cleared it.


I was recently screened by Interactive Health.  They were supposed to send me a standard summary writeup, which I asked for repeatedly but never received.  Instead, weeks later, their lab sent me a lab report, with no interpretation. There are one of three explanations for this:

  1. They are too incompetent to send out summary writeups in a timely way;
  2. They think an unadorned, highly technical, lab report sent three weeks after the fact constitutes a useful summary writeup;
  3. They were about to send out their standard summary writeup, before someone noticed my name and said: “Whoa! That’s Al Lewis. He is nowhere near stupid enough to find our usual nonsense acceptable. He has already exposed our savings lies in the Wall Street Journal, and if we give him our usual writeup on his screening, he will expose our stupidity on his blog. We need to cover that up. So let’s just send him a lab report.”

By process of elimination, I originally landed on #3.  Quite flattering really. I’d make a few observations.

First, I specifically asked them, in accordance with USPSTF guidelines, not to measure my PSA. They interpreted that — as you can see from the top of that page reproduced at the very end — as a request specifically to measure my PSA. (It is on Page 2 of the report, which I can’t put my hands on right this very moment. However, the Wellness Ignorati, who still think it predicts cancer, will be disappointed to learn that it was quite low.)

Second, the glucose is slightly high because some very generous folks had just treated me to a large and delicious breakfast. A classic false-positive, the type of reading that makes wellness vendors’ hearts go all aflutter, because then they can do a followup reading and show that they improved the outcome, after it improves on its own.  Interactive Health’s lab report was completely unhelpful on this high reading. No advice offered.

Third, Interactive Health shattered the record, previously shared by Total Wellness and Star Wellness, for most USPSTF non-recommended blood tests. I don’t know what half these things are, which means neither does Interactive Health. (Total Wellness might win a second-place tiebreaker because they would still be testing for ovarian cancer — it’s still advertised on their website —  except that the only company that makes the test has pulled it from the market following FDA warnings not to use it. Hopefully, Total Wellness stockpiled some assays ahead of the recall, like Elaine did with the sponges.)

Interactive Health also tested me for calf tightness, as I mentioned in an earlier blog. It turns out my calves are tight, and right on-site they loosened them. I could feel my productivity soaring…until the left one went into spasm that night. Still, loose calves are a useful trait for some jobs, such as first baseman.


Interactive Health may have also just assumed that because they don’t like me, no one else in the industry does either.  That’s actually a fairly accurate assumption, one I am quite proud of given the integrity of most of them, with their trade association, the Health Enhancement Research Organization, leading by example in the pants-on-fire department. Indeed a good rule of thumb to determine if a wellness vendor is honest is to ask them what they think of me.

Nonetheless, I was able to find someone who was screened at a different screening and said he received an actual wellness outcomes report from these people, someone who likes me well enough to send it to me. Coincidentally, this individual had been urging me to post on Interactive Health for quite some time.  I figured, cool, I could see what a real report from Interactive Health looks like, the kind that changes employee behavior enough to explain their whopping savings claims of $54,000 for each employee who reduced a risk factor.

No such luck. He sent me exactly the same lab printout that they sent me. Only he hadn’t lost the second page, so I could count the total:  43 lab values.  “Knowing your numbers” could be a full-time job. One would think they had covered all the risk factors with all those lab values, but, curiously, the guy said his blood pressure was quite high, and they missed that altogether.

Hmm…how come he got the same completely unhelpful report I did? Did Interactive Health view my linkedin profile — as their executives are wont to do on a regular basis bordering on the obsessive –and decide that it wasn’t safe sending any of my connections their typical employee printout, on the theory that if I’m not stupid, neither are most of my connections?  If so, that would be their second fairly accurate assumption.

The only other explanation is that everyone receives the same unadorned lab report, full of letters and numbers and signifying nothing, at least to the average person without a PhD in biochemistry. My feelings were shattered. I wasn’t special. Do they send everyone else incomprehensible lab reports with 43 different numbers in them along with assortments of letters most people would associate with Scrabble…and no interpretations or advice?


Whether incompetence or botched coverup, the explanation itself remains a mystery. Nonetheless here are a few numbers and letters from his report.

interactive-health-alkaline-phosphatase

Maybe Interactive Health could interpret this for us, but I would be more confident of their ability to distinguish (for example) AST-SGOT from ALT-SGPT if they could distinguish (for example) a chair from a cigarette.


Another one:

interactive-health-cholesterol

How is anyone supposed to make any sense out of this? Most employees would think a “negative risk factor” is a bad thing,” as in “telling the truth is a negative risk factor for the profitability of wellness companies, which is why most of them never do it.” And what does “VLDLCH” mean and why isn’t it reported?  Still no interpretations.


And then of course there is the PSA test. If you don’t speak up — or even if you do speak up, as I learned — they’ll do one on you, even though the USPSTF rates it “D”, not to mention that the actual inventor of the test says the test is “inaccurate and a waste of money.”  My friend’s PSA result is listed at the bottom of this apparently random number and letter generator…

interactive-health-psa

And, yes, finally, an interpretation!

“Values obtained with different assay methods or kits cannot be used interchangeably. Results cannot be interpreted as absolute evidence of the presence or absence of malignant disease.”

In other words, the interpretation is that this test doesn’t explain anything, so we recommend ignoring the result.

It would have been even more helpful for them to recommend ignoring Interactive Health altogether– the calves, the chairs, the cigarettes, the AST and ALT, and, to be discussed in a future posting, the fabricated outcomes report.

 



Here is the entire first page of my own results, so that you know we are not taking this out of context…

interactivehealth

 

 

%d bloggers like this: