Vhi screening project causes problems for GPs and their patients

Dear Editor,

I am writing in relation to the Vhi Healthcare Diabetes and Health Assessment Project. Like other GPs, our practice is currently receiving a lot of these reports from the local Vhi Medical Centre.

However, most of the tests done have already been undertaken within my practice as a co-ordinated part of the patients’ ongoing management.

These reports can create problems for patients and GPs. For instance, many patients who are informed that their blood pressure is too high are unnecessarily alarmed, as they have previously had this monitored in the practice using the much more accurate ambulatory blood pressure monitor.

Likewise, many blood results, like elevated cholesterol, have already been managed in the context of ‘secondary prevention’ or ‘primary prevention using the European Score Risk’ and the Vhi report simply increases confusion and concern for these patients.

Other comments in the patient reports received have included items such as ‘slightly elevated Gamma GT’, with no explanation as to what this means in the context of this individual patient or what further needs to be done.

While I appreciate that there may be some value in screening for diabetes and cardiovascular risk, there is no logic to this blanket screening with:

No understanding of the patient’s prior medical history and investigations;
No consideration of screening already undertaken in primary care; and
No plan for managing the abnormal results found.

It appears that the Vhi is undertaking this screening, then absolving itself from all responsibility for the management of abnormalities found by sending a copy to the patient’s GP (without ever consulting the GP with regard to this).

These three-page reports create quite a large workload for GPs, usually with little or no benefit to the patient. I also wonder what legal responsibility the Vhi and GP will have where abnormalities are discovered and not followed up. I have to wonder if this is purely a public relations exercise on behalf of the Vhi.

Might I suggest to Vhi Healthcare that there is value in some screening, but it must occur as part of an ongoing management plan and should ideally occur in primary care.

Dr Frank Hill,
Friars Walk,
Cork.