Preventive health screenings tend to fall between the cracks of our lives, despite our best intentions.
OK, OK. Dental exam, check. Bone density, check. Mole exam, check. Colonoscopy. ...
Few topics are as hamstrung with "woulds" and "shoulds" as regular health screenings. We know that they're for our own good, don't hurt, save money -- could even save our lives.
Yet almost a third of American women haven't seen their regular doctor or had a mammogram or a Pap test in the past year, according to a survey by the National Women's Health Resource Center. Of those, 20 percent said they didn't think such checks were important; about half of those think screenings are a waste of time.
Most, however, just can't find the time.
Dr. June LaValleur, a gynecologist and women's health specialist at the University of Minnesota, remembers walking across campus one day and running into one of the mammogram technicians who gently scolded, You know, you need a mammogram. You're behind.
It's tough getting busted when you're one of the pros, but a voluntary screening lurks somewhere near the bottom of the weekly to-do list for anyone who works long hours and still tries to have a life.
"It's a big issue for women who work full time when mammogram machines are on an 8-to-5 schedule," LaValleur said. Yet evening office hours aren't necessarily the answer. "People don't want to take time away from being around family." And that goes for both patients and providers. "When you try to make it easy for one person, you're making it difficult for another."
Which test when?
Just keeping track of which tests we need when can seem daunting. Some people vow to use their birthday as a medical cattle prod to schedule doctors' appointments. When the actual day arrives, though, most of us would rather not be thinking of metal stirrups or drinking Fleet.
Getting an annual physical is one strategy because the electronic medical record will pop up the need for certain screenings, LaValleur said. But doctors and some medical organizations differ on whether yearly visits are necessary anymore.
Some doctors notify patients of tests for which they're due, but fewer do as rising medical costs have cut into an office's ability to call or send postcards to people's homes. Lucky you, if you still get such a nudge.
Patient, schedule thyself
Bottom line -- and you knew there'd be a bottom line, right? -- keeping track of the necessary medical screenings is our job. "It's a shared responsibility," LaValleur said. "You need to keep track, you need to know."
Clinics, in turn, need to make visits efficient and the environment as pleasant as possible. Witness the shift in decor at some mammogram clinics: Rooms are warm, robes are cushy. You hardly notice getting squished.
Need another motivation? The American Cancer Society reported last year that the number of deaths from cancer had declined two years in a row, crediting cancer screening tests for much of the drop.
Screening rates are understandably lower among women who don't have health insurance, but the National Women's Health Resource Center (NWHRC) points out that low-income, uninsured women ages 18 through 64 can get free mammograms and cervical cancer screenings in all 50 states under the National Breast and Cervical Cancer Early Detection Program. To find out if you're eligible, call 1-888-643-2584.
The accompanying chart aims to help you develop a screening routine. There have been some changes over the years, especially regarding Pap smears to track cervical health. Women with three consecutive negative screenings and no new sexual partners need tests only every three years. The shift has met some resistance, LaValleur said. "Women won't come in for a colonoscopy, but they won't give up their yearly Pap smear."
New screening tests are being developed, as well. Thyroid function and bone density are getting closer scrutiny in women at midlife. Better ways to detect ovarian cancer are the holy grail.
Dr. Pamela Peeke, a medical adviser to the NWHRC, writing in its latest newsletter, urges patients to schedule an appointment with a health care provider that's more about talking than poking. Help develop a screening schedule based on your personal history; an incidence of diabetes or heart disease in your family will guide how often you should get certain tests.
And don't come in demanding tests based on e-mail campaigns, advertisements or what your neighbor said. Not every malady can be detected; some tests are unnecessary if you're healthy and aren't experiencing any symptoms.
Then keep track of your own health history. Write stuff down. Make a chart. Update it after every medical visit. There's nothing magical or easy about it. Then again, nothing so hard, either.
Check, check and ... check.
Kim Ode • 612-673-7185