Not every health check-up is necessary: Doctors explain why testing must be personalised
Speaking at the India Today HealthWealth Summit, Dr Navin Dang, Founder and Director of Dr Dangs Lab; Dr Harsh Mahajan, Founder and Managing Director of Mahajan Imaging; and Dr Arvind Lal, Honorary Brigadier and Executive Chairman of Lal PathLabs, discussed the changing landscape of preventive healthcare, the importance of early diagnosis and how people can choose the right diagnostic tests.
The discussion covered everything from routine health check-ups and genetic testing to whole-body MRI scans, coronary calcium scoring, antimicrobial resistance and artificial intelligence in healthcare. The doctors emphasised that while medical technology is making it possible to identify health risks earlier, people should not assume that undergoing more tests automatically means better healthcare. Investigations must be selected according to a person's age, symptoms, family history and existing medical conditions, with guidance from qualified doctors.CHOOSING THE RIGHT PATHOLOGY LAB IS IMPORTANT
Dr Dang said accurate diagnosis is the foundation of effective treatment. He advised people against choosing a diagnostic laboratory only because it offers lower prices or advertises attractive packages.
He said patients should check whether a laboratory has qualified medical professionals, including pathologists and microbiologists, appropriate accreditation, external quality assurance programmes and good equipment and infrastructure. Transparency and access to doctors who can explain reports are also important.
"If we do not diagnose correctly, we cannot identify correctly. If we cannot identify correctly, we cannot treat correctly," he said, highlighting how errors at the diagnostic stage can affect the entire course of treatment.
Dr Dang also stressed the importance of patient communication, saying that people need someone who can listen to their concerns and explain their reports. He shared an experience of contacting Dr Mahajan late at night for an urgent patient evaluation. Mahajan arranged for the patient to be assessed promptly, and the case eventually turned out to involve a brain malignancy.
Dr Mahajan said health investigations broadly fall into two categories: preventive screening for people who may not have symptoms and diagnostic testing for those who are already sick.
He cautioned against being influenced by packages advertised as Silver, Gold or Platinum. Some advertisements also inflate the number of tests by counting individual components of a single investigation separately.
According to him, the tests required by a 20-year-old may be different from those needed by someone in their 30s, 40s or above 50. Family history, previous medical records and existing conditions should guide the choice.
He also warned against adding tests simply because a blood sample has already been collected. While people with chronic conditions may need monthly or quarterly monitoring, such frequent testing is generally unnecessary for healthy individuals.
"Testing is important, but appropriate testing is even more important," he said.LIFESTYLE CHANGES AND EARLY SCREENING CAN HELP
Dr Lal said people should not judge their health only by how they look or feel. Conditions such as diabetes and high blood pressure can remain undetected for a long time.
He highlighted the importance of monitoring blood sugar, cholesterol, blood pressure and kidney function, particularly among people with a family history of chronic diseases. He also urged people to pay attention to diet and physical activity to reduce cardiovascular risk.
He advised limiting excessive sugar, salt, fried foods and unhealthy fats, including excessive consumption of ghee and vanaspati. Portion control and regular exercise were also important, he said, recommending at least 30 to 45 minutes of walking every day.
Dr Lal remarked that "a movie ticket costs more than a thyroid test", urging people not to ignore essential investigations because of their cost.ADVANCED TESTS CAN HELP IDENTIFY HEALTH RISKS
Dr Dang discussed how diagnostic testing is moving towards predictive and preventive medicine. He explained that HbA1c helps identify diabetes and assess blood sugar control, while the HOMA-IR test uses fasting insulin and glucose measurements to estimate insulin resistance.
He also spoke about gut microbiome testing, the tissue transglutaminase or tTG test used in assessing coeliac disease, homocysteine testing and inflammatory markers. He discussed cortisol testing as another investigation that may be considered where clinically appropriate.
Dr Dang also referred to emerging multi-cancer detection technology and a system he called HUNO, which combines information such as biomarkers, diet, physical activity, environmental factors and wearable-device data to build a broader picture of a person's health. He said such information could be shared with doctors with the patient's consent.
However, the speakers stressed that these investigations should not become routine tests for everyone. Their usefulness depends on individual risk and medical requirements.GENETIC TESTING NEEDS COUNSELLING
Dr Mahajan said genetic testing can help identify people who may have a higher risk of certain diseases, particularly when several family members have been diagnosed with cancer. However, patients must receive proper counselling before undergoing such tests.
He said people need to understand what positive and negative results mean and how they could affect future decisions. Genome sequencing has become more accessible over the years, but it remains expensive for many people in India.
The discussion also covered whole-body MRI scans and early cancer detection. Dr Mahajan said early diagnosis can improve treatment prospects, but scans must be performed for appropriate reasons, using suitable equipment and following medical guidelines.
Dr Lal cited Angelina Jolie's decision to undergo preventive surgery after learning about her BRCA1 mutation and inherited cancer risk. He emphasised that having a genetic predisposition does not mean a person will definitely develop the disease. Major decisions should be taken only after consultation with an informed medical practitioner.advertisementWIDAL TESTS AND ANTIBIOTIC RESISTANCE RAISE CONCERNSAn audience member raised concerns about the use of Widal tests in rural areas, where false-positive results may lead to unnecessary antibiotic prescriptions.
Dr Lal said the Widal test may be negative during the early stages of typhoid and should not be treated as a reliable substitute for blood culture, which is used to confirm the infection. He said doctors must select investigations according to the patient's symptoms and clinical presentation.
Dr Dang raised concerns about inappropriate diagnostic tests and discussed efforts to discourage the use of unreliable tests. He also warned that antimicrobial resistance, in which bacteria stop responding to commonly used antibiotics, could become a major public health challenge.
The doctors said unnecessary antibiotic use and incorrect diagnosis can contribute to resistance. They urged doctors to prescribe medicines based on appropriate investigations and communicate with laboratories about the tests required.HEART SCANS AND TESTING ANXIETY
The discussion also highlighted coronary calcium scoring and CT coronary angiography. Responding to an audience member who reported a calcium score of 1,013, Dr Dang explained that calcium scoring can help assess plaque build-up in the arteries supplying blood to the heart.
He said CT coronary angiography uses contrast dye to visualise coronary arteries and can identify soft plaque that may not be visible on a calcium score. Such plaque can rupture and lead to a blood clot, potentially triggering a heart attack. He stressed that the choice of investigation should be guided by a cardiologist.
The doctors also discussed people who avoid medical tests because of fear and those who become excessively focused on readings from continuous glucose monitors and fitness trackers. Dr Dang said a normal test result should also be seen as useful information, while Dr Lal noted that severe anxiety around testing may need professional attention.AI CAN SUPPORT DOCTORS, BUT CANNOT REPLACE THEM
In the concluding discussion, Dr Mahajan distinguished between general AI tools such as ChatGPT and specialised medical AI systems designed for healthcare. He said people can use general AI to understand medical terms and improve health awareness, but should not rely on it for self-diagnosis or treatment.
He highlighted the need for medical AI systems to undergo appropriate validation, testing and regulatory evaluation. He also discussed Carpel.ai, a platform developed to help hospitals and diagnostic centres validate, test, fine-tune and monitor AI systems.
Dr Mahajan said responsible use of AI could improve report turnaround times, efficiency and productivity, while potentially reducing errors and healthcare costs. The doctors concluded that technology can strengthen healthcare, provided it is used ethically and under appropriate medical supervision.
