21st Century Medical Tests Or Toys?

You’re at your doctor’s for an annual physical. He checks your blood pressure, listens to your heart, takes some blood and may even have you cough. He tells you that you’re as healthy as an ox, but just shrugs his shoulders when you complain of low energy, joint pain and lowered libido.

The health care professionals at the December 2000 conference of the American Academy of Anti-aging Medicine stated that this type of treatment is outdated. 3100 doctors from 30 different countries listened to researchers from Harvard, Scripps, Stanford and Brown schools of medicine. Some of their views seemed revolutionary. “The stethoscope should be relegated to the Smithsonian,” says Dr. Harvey Eisenberg, former professor of Radiology at U.C.L.A. The new full body CT scan, “Can, in seconds, uncover the earliest stages of disease that traditional tests would not see for years.”

Even blood tests are taken to task. “Blood tests, as typically ordered by most doctors, checks for diseased organs but will not catch the early abnormalities seen in functional laboratory tests,” says Dr. Bradley Rachman, director of the department of medical sciences at Great Smokies Laboratory (a leading functional laboratory).

Dr. Ronald Klatz, M.D., D.O., founder of the American Academy of Anti-aging Medicine agrees with the need for functional laboratory testing but laments that most doctors, “Don’t learn functional medicine in medical schools.” Dr. Klatz continues, “If we want to keep people well, we have to test and optimize their metabolism …not just check for disease as has been done in the past.”

Samual Fink, M.D., internist and spokesman for the Los Angeles County Medical Association, disagrees with this untraditional approach. “ ‘High-tech’ and expensive procedures and tests are no substitute for spending time with the patient.” He feels that a thorough case history and such time honored protocols as colonoscopies (for those over 50 years old), chest x-rays in smokers and baseline E.K.G.’s may not be glamorous, but have proven value. He feels that much of the newer tests show many positive findings that lead to unnecessary, dangerous and expensive follow-up procedures.

Alan Mintz, M.D., director of Cenegenics, one of the nations largest anti-aging centers, is adamant about using the latest examining tools. “We are at our best around 30 years of age, having the lowest incidence of disease, accidents and other health concerns. Later our beneficial hormones drop and others may rise to our detriment.” He asserts that this leads to a decrease in muscle mass, mental alertness, bone density, libido, energy and mood. So what should one expect from their doctor when going for their yearly physical exam?

Most practitioners agree on the basics:

A. Checking the vital signs.

B. Palpation (examining) of the breasts, prostate, lymph nodes and testis.

C. Auscultation (listening) to the heart, lungs and bowel sounds.

D. A complete blood count and chemistry panel.

E. Cancer screening tests such as PSA, mammograms, testing for occult blood and colonoscopy.

But this is where the consensus ends. The use of these new “high-tech” methods often is determined by the philosophy of the doctor that you choose.

Dr. Alan Mintz feels that a comprehensive exam should include:

A. Sophisticated cardiopulmonary stress tests which includes nuclear imaging. “It is the most thorough way to check for heart disease (the number one cause of death in our country).”

B. Full body bone density and body composition analysis which are “excellent biomarkers and are extremely important indicators of overall health and possible early aging.”

C. Blood tests to comprehensively measure hormone levels. Dr. Mintz asserts that “normals change with age, but optimal levels don’t.”

D. Neurocognitive Chronometric Analysis—a computer, interactive program that detects early signs of dementia.

Jeffrey Bland, PhD., president of the Institute for Functional Medicine and Chief Science officer of Metagenics, Inc., suggests the following tests as part of your yearly examination:

A. Homocystein blood level which is an excellent predictor of cardiovascular diseasee, stroke, cancer and psychiatric illness (including Alzheimer’s and Dementia).

B. Genetic markers to find your predisposition towards various diseases allowing the patient and doctor to be more vigilant about prevention.

With the advent of such advanced and sensitive testing as full body CT scans, genetic markers and neurocognitive analysis, today’s physical examination is going through a renaissance. Whether your doctor makes use of them appears to depend more on his philosophy, education and your financial ability than probably your need.

As in all forms of consumerism, the buyer should be aware, informed and ask a lot of questions. Years from now the sensitivity and reliability of these tests will be known and others will be called into question. Our office uses the latest tests and information and makes our patient’s aware of their benefits and limitations. It’s the partnership between us our patients, and their medical physicians that guarantee their best health and longevity.

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