Health Care thought: Cost versus Benefit
Health Care thought: Cost versus Benefit
Sixteen year old Wes Leonard made a dramatic last second shot to win a tournament game for Fenville High School in Michigan.
Then he fell on the floor and died from cardiac arrest due to an enlarged heart.
Every year young athletes die during and after games, many in basketball games, many from cardiac arrhythmia . Although the absolute numbers appear to be very small, the tragedy of a young person dying in front of a crowd is almost too much to bear.
So, should every high school athlete, or at least every basketball athlete (the pace of the game is torrid) have an EKG before the season begins? Many sports physicals are done at little or no cost by physicians in the community, but mandatory EKGs would be costly even if done at no charge to the athlete.
Would this be a good use of our resources? Who should decide?
(free advice: If you have a high performance student athlete pay for a thorough physical and have a discussion with the physician on the advisability of an EKG.)
Tom aka Rusty Rustbelt
Arrythmias sneak up on you and can be triggered by extreme exertion of the kind caused by football and basketball. I don’t think it’s too much at all to expect kids who are going to participate in these sports to have medicals and EKG’s. What’s the kid’s life worth? Surely this kind of elementary precaution is the least we should do to protect them from unnecessary harm. NancyO
Dan
how frequently does this happen?
are there other signs to watch for that cost less than an ekg.
i had an ekg when i was young and we had no money and i wasn’t sick or participating in intense sports.. .so i think it can’t have been all that expensive.. or shouldn’t be now.
probably “we” could pay for it. but if you are going to have “us” pay for all the medical care and preventive care that anyone could ever possibly need its going to get expensive. my bet is that when it gets “too” expensive, you will find out what people’s priorities really are.
i am not, i insist, a Republican in this, but I think there is some danger in just assuming “we” can afford it. maybe we can. maybe we should. but maybe there’s a limit.
I live in Austin, admittedly not your average city, and have a son who was ridiculously fit as a child. He played club soccer at a reasonably high level in Texas heat that was uncomfortable to sit in. The Heart Hospital had a program some years back where they offered a free screening to young athletes one Saturday. The place was swamped and they screened hundreds via echo cardiogram. I recall they found a small number of young athletes with a problem. My son was fine. We had to wait for a few hours and it was definitely production line medicine, but the procedure itself took very little time. The facilities and staff were great and the information was, as the commercial says, priceless. I believe this only needs to be done once for most young athletes, although the timing is important. The athlete needs to reach a certain level of maturity before certain problems are detectable.
Of course we can afford this. The Heart Hospital no doubt contributed a considerable in kind contribution to the community. However, there were other sponsors and I would have gladly contributed financially or as a volunteer. But the key to the project was getting the news out and the organization in the production line. This sort of screening does not require 500 appointments with a cardiologist, a nice waiting room and insurance paperwork. But it does require a community commitment to cost effective preventive medical care.
EKG may not been a good screening test. Ordering an EKG or any cardiology test(s) may not an good idea. Just go look ACC guideline on perioperative cardiology testing/consultation.
A person that got tested with an EKG may not show any arrythmia and/or cardiac conduction problems. The arrythmia may need to be triggered by an event such as stress or vigorous exercise, but then you will need an holter monitor to record such an event.
Again, this is why testing may or may not be benificial, it really depends on circumstance, history, and unfortunately, scientific evidence… Number needed to treat, detect…
Screening millions of young athletes may detect hundreds of problems, or it may not detect the critical problems. Or we might need multiple tests and genetic screening. Or maybe we just don’t know….
Nat
thanks.
Nat,
Cook’s Children in Fort Worth did this about two years ago. The response was overwhelming also. We had a child at my kids High School just drop over dead after a football practice last year. The docs basically said he was gone before he hit the ground. Genetic heart defect, EKG may/may not have caught it. He had had a full physical before football started (he was from a well off family, money was not a factor). I beleive they screened the entire football, baseball, track, and soccer teams shortly there-after. I didn’t hear of anyone else found with an issue (it is rare).
Considering that well over half of the kids in my kids HS are in some kind of sports I doubt this would cost effective if very expensive. But it does point out an avenue for a medical entrepreneur to build a cheap screening test for this. If you could screen for say $5 a pop it might be cost effective to screen ALL kids as they enter High School. Even at my kids big public HS it cost less than $6,000/year even if the test cost $10/child. Like getting your vaccinations.
Islam will change
I lost my Father, a Brother and my oldest son, all to a heart attack. In each instance, it came within an hour after they had consumated a big deal, which occured during the Christmas holidays. Each had been healthy, hadn’t shown any signs beforehand. Also, they didn’t have annual checkups. My self, I have hi-B.P., take medicine for it, keep a close watch, try to avoid stress, have annual checkups That seems to be the killer. Perhaps certain families are predisposed to having such run in the family. I think a thorough examination as a teen, especially in sports should be a requirement, as it is for any imployment today.