Virtual colonoscopy and the message President Obama sent

President Obama had a well-publicized routine health exam last week.

One of the more controversial issues was the virtual colonoscopy he received. It’s been well covered here that virtual colonoscopy doesn’t have the same diagnostic accuracy as a traditional colonoscopy, and in fact, is not covered by Medicare or most third party payers.

With the President obtaining one, does that send out the wrong message?

Of course, radiologists — who stand to benefit financially from increased use of virtual colonoscopies — are applauding his decision. Mark Klein, writing in The Wall Street Journal, says,”He and his physicians correctly recognized virtual colonoscopy as an excellent alternative to screen for colon cancer. Why undergo a traditional colonoscopy—a procedure that carries a risk of serious complication and requires sedation—when a safer screening method is available?”

Dr. Klein neglects to mention that virtual colonoscopies may miss smaller polyps, and exposes patients to radiation as well as the possibility of unrelated false positives that a CT scan can find. In fact, the USPSTF recommends against virtual colonoscopy as a way to screen for colon cancer.

Perhaps more interesting is the message it sends to millions of Americans during this tenuous time of health reform:

[Virtual colonoscopy] is not a covered service under Medicare and many third party payers . . . The president is receiving medical care that the average American cannot and probably should not receive, he is being treated in a way not recognized by many medical societies, and he is avoiding a test — colonoscopy — that millions of Americans are avoiding wrongly. Not a great way to lead by example.

Indeed.

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