Joey Wahler (Host): They're vital to maintaining good health. So we're discussing preventative screenings. Our guest is Dr. Katrina Barnes. She's a primary care physician. This is a podcast a Day from Memorial Health System. Thanks so much for joining us. I'm Joey Wahler. Hi there, Dr. Barnes. Welcome.

Dr. Katrina Barnes: Hi.

Host: Great to have you aboard.

We appreciate the time. So first, what are the main, most common preventative screenings that are missed by adults in the Mid-Ohio Valley? And why do these gaps persist from your experience?

Dr. Katrina Barnes: I think the biggest screening That is missed is the low-dose CT scan, and That is done for a lung cancer screening. It's not new, but it's definitely newer in the last—I don't know. Time is crazy how fast it goes. but we've definitely been doing it at least 10 years. I would think they've changed the parameters a little bit, but I think that's one that not everybody is aware of because it's not for all patients where a lot of like mammograms are for all women.

Colonoscopies or colon cancer screening is for everyone. prostate screening is for men, but. Lung cancer screening is for smokers, And so it's not, every person of a certain age or a certain gender. And so I think That is one that tends to get missed, quite a bit.

Host: So regarding the other two, you mentioned, colonoscopy and mammogram. Are people doing a better job with that? Because it seems like conversations like this are happening more in recent years and like This is really being driven home by the healthcare world more than ever. Yes.

Dr. Katrina Barnes: Well, especially with colon cancer screenings. because we used to screen at 50, but now we're screening at 45. And You know, the rationale behind That is, why did we change that? Well, because. More people were probably getting diagnosed prior to age 50, so we had to shift that screening. And so we can't screen for all cancers.

And This is what I tell patients all the time, like we can't screen for all of them, but we can screen for the common ones. And the reason we screen is because we want to find disease if it's there as soon as possible. So that means it's early stage. We're not waiting for you to develop symptoms. And we're able to make a better, an earlier, change.

where maybe the treatment is less, maybe, you don't have to have as many modalities of treatment. Maybe it's surgery versus surgery and chemoradiation and your outcomes are better. we're finding it earlier before it has spread, so your outcomes are better. So, I think that with.

Colonoscopy. Sometimes Those are a little bit challenging for patients because, a lot of patients especially a little bit older, they might not have family. They might not have friends that can take them in transportation to and from and, know, you really can't, get an Uber or a taxi to take you home from that because you've had anesthesia.

So it is frowned upon a little bit. mammograms. I still feel like we have to, encourage those. A lot of women, feel like, I'm done at a certain age, or I've had them this whole time where they're uncomfortable. And so, do, we still have to encourage, all screenings, but I think the one that probably gets missed the most is the low-dose.

Host: Gotcha. And you mentioned logistical issues for some patients and getting screenings. I was going to ask you more about that in a moment or two. But first, what are some of the things that indicate to physicians that patients most at-risk are delaying these necessary preventative screenings? How do you pick up on that?

Dr. Katrina Barnes: I think You get to know your patients but you really just ask the questions. if I'm seeing a brand new patient or a patient that I've seen for a while, you don't want to assume that because they haven't had the screenings, it's because they don't want them. It could be that

they've never been talked to about it before, or maybe they had questions and they didn't get answered, or maybe they didn't have insurance. So you never want to assume that because they haven't had them done that they don't. so you just have to ask the question. You just have to ask, you know, have you had these screenings?

And some patients are good about coming in for like their yearly visit, which is when we focus heavy on those screening items. But you have to catch the ones that. if they're coming in and you haven't seen them in a while, even if it's not their well visit, you kind of still try to, address those kind of screening things.

And so identifying the patients I think is as easy as asking, just, I don't see, you've had your colon cancer screening. you haven't had a mammogram. Have you had it somewhere else? I think it's just as easy as, asking the question And then you kind of get to know your patients as the ones that They're very minimalistic, they don't want to do a lot of the screenings, they don't want to do a lot of the testing. And so I do my spiel. I explain again, why we recommend the screenings, And then I tell them you think about it and I'll ask you next year. So, That helps I think a little bit so they don't get super aggravated I ask them once a year, you know, well, hey, why aren't we doing this?

Host: Right. Certainly makes sense to me. So you touched on earlier the fact that there are certain challenges with people getting screenings done, even if they want to. You mentioned transportation, sometimes someone's age or condition. Can, make, just getting around, a challenge. So whether it be transportation condition, demographic factors like income, rural versus an urban residence, even, what insurance they have, if they have insurance.

Overall, how much of an impact does this make in participation in screenings And what can you, if anything, as a physician do to ease that?

Dr. Katrina Barnes: So I think what I can do as a physician, mean, I can't help their costs, but I can ask why they don't want it. And so sometimes that clues me in, well, I don't have transportation or My copay is. Higher for this test versus that test, which most people that have insurance, the screening things are covered, but sometimes you never know with insurances, sometimes they could still have a copay.

but most screenings are decently covered. I, there's going to be those patients I think that have maybe a very high deductible. But again, trying to reassure them that screening tests are typically covered. With the insurances, I think helps, again, asking why are they aren't doing it well.

I've had patients that, I don't have a ride to get my colonoscopy okay, so are you eligible for the Cologuard, which is a different screening test? Are you eligible to do the FIT testing? some people don't want a procedure. they would rather do the stool samples. Cologuard or the FIT test. So asking why, and not just assuming, well, they just don't want to have it done, And then some people have. incorrect beliefs about why they shouldn't have screenings. Well, if I have this screening, you're going to find something. And that's my favorite because I'm like, well, I don't conjure up, it was there.

We just happen to find it, which is the point of the test. Right. so just trying to figure out the why behind it. some people tell me. even if you told me I had cancer, I wouldn't do anything different. And so that's a tough one. But we still try and I'm like, but if again, less treatment, you could do well with this and not necessarily have to have, a big involved treatment.

So I think the biggest thing to identify is why For the, mammograms I know Marietta has a, breast fund where, if your insurance doesn't. Cover them, we can cover those mammograms. the colon cancer screening is a little bit harder because it's a procedure, so that's a little bit harder to cover.

And I don't think, like Cologuard, from what I could tell, I don't think they have any kind of discount program. I'm not a rep for the company, so I can't say I'm unaware of one, CT scans. Again, we haven't had a lot of issues with coverage on those when we first started doing them, I think there was, but now they seem to be pretty well covered.

And then like the PSA for the prostate screening, that's covered on insurance. And then the health system does do health fairs couple times a year, for like low-cost lab work, which includes a PSA.

Host: couple of other things for you besides conversations like this to raise awareness despite, you doing your spiel as you put it, there's still a gap here people getting screenings enough of a regular basis. So how about families? Loved ones encouraging their people, especially older adults, to attend screenings without creating fear or resistance.

What's your advice there?

Dr. Katrina Barnes: So that can be really helpful. The key is, that the family has to come with them, right? Because I can't call up the family and be like, Hey. Tell your mom she needs to have this screening done. But they do. And I see that in the office, like husband and wives come in, or parents and kids and the husband's like, or the wife, don't want to generalize here—they're like, no, I don't want that. And the other one's like, yeah, you do. I look at them and they're like, yeah, I do So, It does help, to have the family encourage them to have those screenings. And then, I guess I would say to families is a lot of times we don't talk about our medical history.

We don't talk about what we're doing and not doing. And so, I mean, I don't know a lot of people that meet, You know, family dinner and say, Hey, when was your last colonoscopy? Or how was your last mammogram? and it's a little weird, but I guess being an interested party and encouraging Family members, especially those that have history. if you have a family history of colon cancer, breast cancer, prostate cancer, checking in with your loved ones and making sure that, Hey, why aren't you doing this screening and encouraging them to do that, for all the right reasons.

Host: Great advice indeed that anyone can use. Folks we trust you're now more familiar with the importance of preventative screenings. You just heard the doctor say, even my husband needs a little bit of a nudge every now And then. So none of us are immune. To learn more and connect with a provider, please visit mhsystem.org/services primary-care.

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