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At FACEmed we offer annual screening. The National Health Services does a great job with its resources and already offers screening for some conditions. But these screening programs are capped so that they target most vulnerable with a financially viable test, in order economical. They are not accessible to everyone and they are not all offered annually. This is not the case in other countries that have a differently-funded health care systems. For example, our American colleagues screen annually for conditions such as cervical cancer.

Mores tests = better health awareness right?

Online and through advertising you will also be aware of many health kits and offers of health screening. But are all of these necessary or beneficial to you?  Should you have full body scans? Should you have a colonoscopy every year? Should you buy a heart monitor?  What are the pros and cons of these? What about genetic testing, is that any use for you?  

Additional screening tests that are newer and more accurate than is currently feasible in the NHS are of benefit however. Your clinician at FACEmed will know which ones to choose for you. These tests may not be nationally available due to the large costs of supplying new-to-market tests to whole the population — for example, we have been using the FIT test  (faecal immunochemical test)  for colon cancer screening for several years now, but the NHS is only able to start offering later this year (still not fixed at time of writing). If you asked for it today, your NHS GP would not be able to provide it for you.

Medical tests have varying accuracy and pick up rates and very rarely do we find a test that is 100% accurate at diagnosing disease. They have to be used in conjunction with symptoms, and family history to get the best out of them. As experienced clinicians, we have met patients with low prostate antigen levels (described erroneously as the prostate cancer test), but that are strongly symptomatic of prostate disease ascertained from a thorough history and examination. These patients have subsequently gone on to receive quick treatment with consultant urologists.

Without skilled clinicians to discuss you and help you find your way through the myriad of tests available on the internet, it can be difficult and daunting to in determine which test to take up, and what results actually mean for you as an individual.

What we aim to do with an annual screening is;

1) Offer tailored and expert doctors’ advice on what our screening service can ascertain for you, the pros and cons of the tests, and discussion of the results to see what they mean for you as an individual.
2) Use additional evidence-based screening services to increase the detection rates of a disease. 
3) Increase the frequency of screening tests for you to pick up markers of possible disease early.

Dr Google

As clinicians we embrace the use of technology and welcome that information is readily and easily accessible to everyone.  However, there is much misinformation and speculation found on the internet or on blogs that is not validated nor based in evidence. Anyone can write what they wish on the internet and opinions are not facts.  For example, there is much misinformation about bio-identical hormones for HRT and what they actually are. These have been around for twenty years and are widely used in the UK but that’s not what you may think if you look at certain websites or blogs that present it as the as the ‘new thing’ for helping menopause be more tolerable. 

If you do prefer to do your own research, our clinicians can help you interpret information you have found and give you the true facts behind whether your symptoms fit with the conditions you have read about. I cannot recommend one use Google for diagnosis, for example depending on which browsers and key words you type in, symptoms of back pain and indigestion could result in diagnoses of pancreatic cancer, gallstones, gastritis, Barrett’s oesophagus, ulcers, abdominal aneurysms, irritable bowel symptoms etc. They are all very different conditions but the presenting symptoms can be the same. An examination and history is key in knowing which is likely to be present. It would concern me that someone was self-treating themselves for irritable bowel syndrome based on their online googling when a truly a leaking ulcer in the gut was present. 

The magic pill

We have concerns that much can be purchased online in terms of medication, in some cases without the assessment of you as the patient and an examination. What of the quality of the medication? Has the assessment of your health been accurate? The Care Quality Commission has sought to suspend many online providers of medication pending safety concerns.

Medications on social media and the press can often be reported to ‘the best thing’ and ‘top in trials’ when read about, but if you don’t know how to interpret the quality of a reference given, or the trial study itself,  then you do not know how decent the trial was that led to the article recommending medication. Trials can contain bias in measuring, reporting and randomising patients to different treatments. All of these affect the quality of the study that end up with. Articles in the press could be funded by the companies that produce the drug itself. One needs to be wary and seek unbiased advice on treatment read about online. Medical evidence of the highest level is available from the Cochrane database, a huge conglomeration of data from well-designed trials. A well-respected author to read is Dr Ben Goldacre if you wish to know more.

Supplementation:

Do supplements work and are they safe?

Some do work, some don’t, but it’s tricky to know which because sales tactics and blogs can be misleading. 

For example, a well know pharmacy sells Coenzyme Q for ‘pep and energy’. There is no evidence in the literature it has any effect of this nature.  And what of the quality of supplements and adverse effects? I myself have experienced two cases of liver failure with patients using the health food supplement black cohosh root for HRT without medical advice. A prescribing doctor is aware of the risks and is not likely to ever recommend it, but in health food shops and websites it is described as natural. Natural can still mean the medication is extremely potent.

A clinician discussing medication appropriate for you in real time, face to face allows for clear accurate advice. There is time for you to ask questions either in the room or in our aftercare support when medication is recommended and started for you. We all react slightly differently to medication. Some people are more sensitive than others and some individual risk factors or interactions with other mediation need to be evaluated by a specialist with specialist knowledge. For example, the over the counter St John’s Wort can stop the contraceptive pill from working correctly.  Of course, even prescribed medication can have side effects, but our GPs will be able to offer advice of expected side effects and warn you of what is not acceptable or what is shows that the medication does not suit you as an individual.

Do you pass me back to the NHS with the results for my NHS GP to deal with?

Unlike big companies that offer ‘health checks’  – if there is an issue with your medical, we won’t ask you to return to your busy NHS GP (unless of course you wish to). If there is medication required, we can prescribe it safely after a consultation with you. Or if onward referrals are needed we will guide you and refer you to the requires scans and the best private clinicians countrywide, You can choose to do this with or without insurance.

Dr Jo Josson McConnell