You slip into a robe and sip a coconut water as you wait patiently for your morning to begin.

Just as you’re lying back thinking, “What a great vacation,” a nurse comes in and tells you she’s ready to draw your blood.

She guides you as you rotate through specialists, get imaging, exercise testing, and have a whole panel of blood work done.

Is this a spa day or check-up? The lines have blurred as destinations across the globe are offering preventive and longevity testing, ditching the traditional clinic for a backdrop of luxury and relaxation.

Many Americans are willing to spend on the promise of health optimization but are frustrated with lack of access, long wait times, and bloated prices in the U.S. This has led consumers to seek preventive treatments abroad.

Typically for a fraction of the price even with the plane ticket included, you’re able to get just about any evaluation you would want back home, on-demand.

With real concerns about healthcare affordability and anxiety about their health it makes sense why people are traveling to places like South Korea, Thailand, or Mexico to get screening.

But hold on, before you go booking a flight it’s worth thinking about whether these tests provide meaningful value or if it’s all just trends and hype.

Let’s break it down so you can understand the evidence, weigh the tradeoffs, and decide for yourself.

It’s likely you’ve heard about whole body screening MRIs over the past few years.

You can get a whole body scan for around $2000-$4,500 in the US, with the studies being touted as life-saving and promising to catch early cancers and disease. This has become a global practice with international centers offering testing from $300-$1,200.

The Medicine:

Whole body MRI has limited evidence when screening asymptomatic healthy people, meaning that there are not many large studies supporting its use in this capacity.

The studies we do have demonstrate that there are high numbers of incidental false positive findings (incidental meaning a benign finding without significance). More worrisome, there have been a substantial amount of reported false negatives, which provide undue reassurance.

The American College of Radiology does not recommend full body MRI.

Generally speaking, most medical professionals don’t recommend these as useful screening tools. The main concerns being that false positives will cause unnecessary testing, benign findings will lead to anxiety for patients, and that normal tests will cause people to ignore their recommended preventive screens.

Consumer Take:

People like the idea of a comprehensive evaluation that feels proactive in a healthcare system that’s rushed and reactive.

The marketing works. Whether normal scans provide reassurance or they catch something early on, even an inconsequential finding, that’s a happy customer.

A random doctor’s “Well, actually the stats!” argument is going to have a tough time beating that.

My Take:

Do I think whole-body MRI is the lifesaving tool it’s presented as? No. That being said, I understand why people want it.

There are people who have benefited from these tests by finding something early. From a public health perspective that doesn’t justify MRIs for all, but it’s pretty hard for me to say “no don’t do that” to individuals who are, understandably, not thinking about guidelines.

But if you’re thinking that this is a crucial test, integral to being a happy and healthy person, it’s most definitely not. It isn’t something you “need” and you should absolutely not feel like you can’t be healthy without it.

If you feel that a full body MRI will add meaningful peace of mind, or it encourages you to take a more active role in your healthcare, go for it.

Know what you’re paying for and acknowledge the limitations of the test. Understand there’s a decent chance you’ll see incidentals that are entirely benign. Recognize the risk of false negative and positive results and have a good plan for what to do about it.

Coronary Artery Calcium (CAC) scoring is a CT scan that detects calcified plaques in the coronary arteries. In practice, CAC testing is being used by doctors to help refine cardiovascular risk and guide decisions for preventive therapies like statins for patients without symptoms.

Results are reported as a numerical score, with 0 meaning no detectable calcified plaque and higher scores reflecting increasing coronary plaque burden.

The Medicine:

CAC scoring has real clinical evidence and adds meaningful predictive value beyond our traditional risk factors cardiovascular disease.

It's currently used in clinical practice and supported by ACC/AHA guidelines as a support tool (though not a general screening test) for asymptomatic patients who have “intermediate risk” for cardiovascular disease, typically ages 40-75, with risk factors like family history, or high cholesterol.

Consumer Take:

People worry about their hearts. Especially with how often we hear stories about young and “healthy” people having heart attacks and that fear drives behavior.

CAC testing feels tangible, low risk, and relatively low cost. For many, a score of zero feels like peace of mind, whether or not it meaningfully changes anything.

My Take:

CAC has strong evidence behind it and helps guide practical care.

For people who have intermediate cardiovascular risk, this can help you be proactive about your health and make meaningful changes in your lifestyle to help you reduce your cardiovascular risk. You’re not going to hear me arguing with the cardiologists here.

For younger and otherwise low risk individuals who are optimizing for longevity, the clinical value is more limited, since a score of 0 is expected and doesn’t mean no long term risk.

So basically, if you’re a totally healthy 25 year old biohacker working out 6 days a week, I’d skip this one.

Comprehensive lab screening is another part of the wellness wave. Longevity panels and direct-to-consumer services are marketing comprehensive lab panels, with some companies offering more than 100 tests a year.

People are paying up to $500 for these extensive tests offering the promise of health optimization and saving lives.

The Medicine:

Evidence-based medicine generally rejects blanket lab panels for healthy, asymptomatic adults, instead favoring targeted screening based on individual age and risk factors.

Broad lab testing has been shown to add little value and increases false positives which can lead to further unnecessary follow-up testing, increased patient healthcare costs, and fear.

Many longevity and wellness panels aggregate these tests into bundles, including tests that laboratory stewardship literature recommends against as routine testing. For example:

While there age and risk-based screening labs do exist like lipid panels, A1c, etc.; there are currently no broad screening labs recommended by US Preventative Services Task Force.

Consumer Take:

Another area of misalignment in consumer sentiment and the medical establishment. In an age where information is king, people want more data.

“Targeted screening” tends to sound a lot like “Wait until you have symptoms,” which is not what anyone wants to hear.

My Take:

As an ER doctor, I order a ton of labs, it feels like it’s my entire job at times. But preventive medicine is looking for problems before they come up, which gets more complicated.

Decades of data suggest that most healthy people will see no meaningful change in outcomes by getting shotgun preventive screening labs.

Even when abnormalities occur, there’s not always clear action to take. That’s true for many of the labs included in wellness and longevity panels.

But, did I ask for a Vitamin D level and blood counts at my last primary care visit. Absolutely.

I know the evidence hasn’t proven that testing or supplementation improves outcomes, low vitamin D is consistently linked to worse health. In that gray zone, I chose to act rather than ignore.

That said, I don’t think paying hundreds of dollars for these broad screening tests is useful.

A handful of labs (Vitamin D, lipid panels, metabolic panels, A1c) are reasonable for optimization and they make me feel better to know. Your PCP should be able to order these often covered by your insurance so I’d skip the travel on this.

If you’re really keen on getting a full panel, remember a lot of this stuff has limited evidence and similar local options are available.

An exception may be full bundled evaluations, where labs are included as part of the whole assessment, may be more cost-effective overseas, but know what’s included and why.

Invasive testing like colonoscopies, stress tests, or biopsies are important when indicated for either diagnostic workup or preventive care.

People have been using medical travel for years to get around bloated U.S. prices and long wait times.

When invasive tests are necessary getting them abroad can be a valid strategy. But these should not be a “just because” add-on.

Real risks come with invasive screening, so if you’re pursuing it, there should be a clear reason why— ideally that it’s been recommended by a physician or age appropriate screening.

If you’re flying out for an invasive study, discuss this with a doctor you trust, whether at home or at your destination. It’s important to confirm you’re healthy enough to undergo these evaluations and that you’re educated on the risks involved, and have a follow up plan.

We’re shifting to a consumer-based health model and people want information and proactive care.

Some of this is marketing driven, companies understand people’s anxieties, but there’s also a real feeling of let down with our healthcare system.

A large part of that is due to our failures in medicine: we’ve been too paternalistic, stopped listening, and haven’t found answers to some big problems like access to preventive testing and specialists.

Ultimately, as long as you understand the benefits and limitations, and are choosing tests intentionally, not out of fear or marketing, there’s nothing wrong with a more comprehensive check up.

Just know what you’re paying for.

Bad tests are bad everywhere, affordable doesn’t mean necessary. Before asking where you should get testing done, make sure the test is worth doing.

If you’re considering testing—especially abroad—talking to a physician to help you decide what’s worth it and what’s not can prevent unnecessary risk and cost. No matter what go in with a plan, understand the tradeoffs, and compare your options intentionally.

That’s all for today, I’ll be back in your inbox next Wednesday.

Have a question about a specific test you’re thinking about? Send a quick reply, I read them all.

Thanks for reading,

Kyle

Other Posts: https://welltraveled.health/archive

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