For-profit Life Line clinics offer medical tests

BANGOR – Many area residents received letters recently from television celebrities Tom Bosley and Marion Ross, stars of the 1980s sitcom “Happy Days.” But their message was no laughing matter: Because doctors often cannot or will not order certain diagnostic medical tests without a specific reason, they say, savvy health care consumers must take matters into their own hands.

Bosley and Ross are promoting Life Line Screening, a Cleveland-based for-profit company that offers vascular and bone density scans to just about anyone willing to pay out of pocket. The company says its service empowers consumers and saves lives, but area physicians and health officials sound a cautionary note.

Life Line Screening clinics are organized rather like a blood drive. Moving their equipment from site to site in company vans, the firm’s ultrasound technicians set up at churches, country clubs, community centers and other accessible locations. Direct mailings, posters and word of mouth provide the publicity.

The company buys customer contact lists from pharmacies, grocery stores and public utilities.

Life Line has been in business since 1993 and has performed scans on more than 2 million people, according to its brochure. The company says it saves lives by providing affordable diagnostic tests before a patient exhibits any symptoms, by which time the condition may be far advanced and the risks much greater.

Because private insurance companies and public programs such as Medicare and Medicaid won’t pay for tests that aren’t deemed medically necessary, customers must pay for the early screening tests themselves.

Life Line is coming later this month to St. John’s Catholic Church in Bangor. For just over $100, consumers can purchase three vascular tests as a special package deal:

. A scan of the carotid arteries in the neck to identify any buildup of fatty deposits and the risk of having a stroke.

. An abdominal scan to detect enlargement of the abdominal aorta, called an aneurysm, which might cause a fatal hemorrhage.

. A scan of the legs to test for restricted blood flow and the risk of peripheral vascular disease.

For about $20 more, technicians also will perform a bone density scan to determine the risk of osteoporosis.

The technicians interpret the images on-site and counsel customers as to what they should do next. The interpretations are verified later by board-certified physicians.

“If someone shows a significant blockage or an aneurysm, we’ll send them straight to their doctor’s office from the screening site,” said Life Line spokeswoman Paula Motolik. By this, she means patients will be advised of their condition, given a copy of their results and strongly urged to contact their physician as soon as possible.

Motolik said Wednesday that anyone over age 48 is at risk for vascular disease; the risk goes up if an individual has a family history, smokes, has elevated blood pressure or has diabetes. Younger people, with or without risk factors, won’t be turned away if they request screening, she said.

Ultrasound imaging involves no injections or radiation. As its name implies, the technology uses sound frequency to map structures in the body.

Gordon Smith, executive director of the Maine Medical Association, which represents Maine physicians, said Wednesday there’s no reason consumers should pay out of pocket for tests that aren’t medically necessary. The tests themselves are low-risk and in some cases may provide valuable information, he said, but performed outside the context of the doctor-patient relationship they may raise anxiety levels needlessly, while false findings may lead to unnecessary interventions and spending.

In the big picture, Smith said, “the state of Maine is trying to create a system of health care where everyone has a medical home. But this is the worst kind of fragmentation.”

Smith said consumers’ dollars would be better spent on a good physical exam.

Bangor vascular surgeon Charles Dixon was more conciliatory. Measuring plaque deposits in carotid arteries can be a good way to derail a potentially deadly problem before the patient starts exhibiting symptoms of an impending stroke, he said. Abdominal aneurysm is rare – only one case in every 300,000 Mainers, he estimated. But a ruptured aneurysm is so deadly, it’s probably worth the out-of-pocket cost to know whether you have one, particularly if you have risk factors such as obesity, smoking or a family history of aneurysm, he said.

On the other hand, Dixon said, using ultrasound to map peripheral vascular disease is of little use; he prefers to take a patient’s detailed personal history and uses a series of blood pressure measurements and specialized X-rays to determine the best treatment.

He added that it’s important for patients to maintain a close relationship with their physicians after they get tested. “My main concern is that it may make people more concerned about themselves than they need to be,” he said.

A retired Bangor neurosurgeon, Dr. Dennis Shubert, heads the Maine Quality Forum, an organization with a mission to define, measure and reward the delivery of effective, efficient health services in the state. Shubert said the Life Line testing is “a good deal if you’re in the high-risk group,” adding the same caveat – patients who choose to take advantage of it must stay in touch with their primary care doctors.

Beyond the value of the tests themselves, Shubert said, Life Line and other private companies offer Maine health care consumers a choice about the care they get.

“We want active consumers who think for themselves,” he said. “If you’ve got the money and the intellectual ability to understand the process, then go for it.”

Life Line Screening will be at St. John’s Catholic Church on York Street in Bangor from 8:30 a.m. to 5:30 p.m. Tuesday, June 21. The church provides the space as a community service, according to office manager Nancy Long. For more information, call (800) 597-3759 or visit the company online at www.lifelinescreening.com.