A new Lancet study had researchers looking at the number of deaths over 10 years among more than 20,000 people, aged 40 to 69, in England. All of them were at high risk for diabetes. The patients were divided into three groups. One group underwent a round of diabetes screening that was followed up by routine care for those diagnosed with diabetes; another group had a round of screening followed by intensive management for those diagnosed with diabetes; and a third group did not undergo diabetes screening. Over an average follow-up of nearly 10 years, the overall death rates in the groups that had diabetes screening were no lower than in the group that had no screening. There also was no significant difference between the groups in the number of deaths specifically from diabetes, cardiovascular illness, cancer or other causes.
I know these results seems counterintuitive and it is just one study but 20,000 people is a lot of research subjects to look at. What if it is right? Would our government and insurance companies heed the new recommendations? There are bogus quality indicators that pay doctors who screen such measures. If screening for type 2 diabetes does not appear to reduce the risk of death in the general population, it would make this performance measure obsolete. One more reason that P4P, quality initiatives, and benchmarks are not good for healthcare! Doctors need to be allowed to treat patients as people and not numbers. You cannot industrialize medicine.