Science/Tech

Inside-Out

The fight for medical control

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Sometimes a little bit of information can be worse than no information at all. But is that really true when the information is about your own health? The Food and Drug Administration and the American Medical Association think it's dangerous and inconvenient for patients to look inside their own bodies on their own initiative and at their own expense.

CT (or CAT) scans and X-rays have become standard medical diagnostic tools. These non-invasive body scans are prescribed routinely by doctors to look inside a patient's body and discover what is causing symptoms from headaches to chest pains. This body scanning technology has become so well known, easily available, and inexpensive that some clinics are offering preemptive screening exams for people without any specific symptoms at all—and advertising directly to the consumer.

Companies like Heart Check America and LifeScore offer patients direct access to medical scanning procedures. They do not require a doctor's prescription, and usually do not provide detailed analysis or consultation about the results of the scan. The patient gets a copy of the scan results, which he can take to his own doctor if abnormalities are found. Patients are drawn to the clinics by the possibility of stopping a life-threatening illness before symptoms are even felt, and by the peace of mind that a scan with no abnormalities can bring.

The FDA and AMA are outraged by this. They argue that CT scans have not been proven to be effective as screening tests—that normal results don't equal perfect health and abnormal results can cause a lot of worry over something that turns out not to be serious. And they worry that people will use body scans as a substitute for regular medical care.

Americans are savvy enough to know that a high-tech scan is no substitute for the personal care of a family doctor. And people willing to spend hundreds of dollars of their own money to check their health from the inside out are not likely to skimp on a visit to the doctor that is paid for by insurance. Instead, these patients are not satisfied with the passive role that traditional medical practices has scripted for them. They want to take control of their health situation, and now technology and the free market are providing that opportunity.

Pregnant women want to peek under their skin for non-medical reasons, too. In recent years, "keepsake" ultrasound photo clinics such as Fetal Fotos have sprung up in shopping centers around the nation. These clinics can take 3D pictures and videos of babies-to-be that are much more viewer-friendly than the fuzzy 2D ultrasound pictures obstetricians are specially trained to analyze.

Prenatal ultrasound has been around for decades, and is safely used to check a baby's gender and spot possible birth defects. Better pictures mean higher exposure to ultrasound for a longer time than routine medical checkups, but even the FDA admits that there is no evidence that ultrasound can physically harm a fetus. Nonetheless, the medical nannies at FDA caution against the use of ultrasound for "medically unnecessary" purposes.

Once a medical device is approved, the FDA cannot regulate how doctors use the device, so access to body scans and prenatal ultrasound is not likely to be restricted outright. Yet the battle for consumer control of medical choices is raging on many grounds, from high-tech scans to contact lenses to contraception. With so much information readily available about the benefits and risks of medical procedures and devices, consumers are increasingly likely to have their own opinions about what is best for them. Doctors, and the government, need to adjust to that new reality.