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Gold, incentives and meh

Universal cardiovascular screening is simply dangerous

From Dr Philip Rathbone

Melton Mowbray

If Sir Muir Gray really believes his comments reported in Pulse 'GPs set to screen millions a year for cardiovascular risk' (News, 9 March) then there are important doubts about his understanding of the issues involved.

He states he would like health care assistants to do the work: can he really be serious? It is true that HCAs could take the blood samples and record blood pressures, but the interpretation of the results requires medical knowledge and experience and each case has to be interpreted individually. In my practice, a 'straightfoward' consultation about cardiovascular risk takes 10-15 minutes.

As for the idea about linking screening to birthdays, does this mean we are to send cards to all our patients with the message: 'Happy birthday ­ you're going to die. But now you can choose: heart attack or stroke vs cancer or dementia!'?

The whole concept of universal cardiovascular screening is dangerous nonsense. It will distract us from our proper job of tending to the truly sick by recruiting armies of worried well.

It would do well for health promotionists and screeners to heed these wise words from Henri de Mondeville in 1320: 'Anyone who believes that anything can be suited to everyone is a great fool, because medicine is practised not on mankind in general, but on every individual in particular.'

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