Review of simonONE Whole Body Plus Scans and Perspectives on “Healthy” Patient Screenings

Full Disclosure: I’m not a doctor and I don’t play one on TV or this site.  However, I am a patient that’s impacted by these options and so I’m writing from my informed patient perspective.  I acknowledge this is a controversial topic which is why I think it’s worth exploring and learning together as this evolves.

One of the most controversial things in healthcare is whether “healthy” people should be doing regular lab tests, MRIs, and other diagnostics.  There are people that are really passionate on both sides of the issue.  One of the biggest proponents of healthy people being tested regularly if they can afford it is Mark Cuban. He suggested that people who have the means should do regular tests of their health including having that baseline data that’s specific to you.  When he suggested this on social media, the flame wars began as many people, including doctors, said that was awful advice.

For those that are pro testing of healthy patients, they offer a couple important view points.  First, doing this testing could lead to early detection of a disease and we know how early detcction of diseases can be key to treating those diseases.  That’s why we do colonoscopies and mammograms.  Wouldn’t more in depth detection of disease like labs and MRIs be treated similarly?  Plus, even if the tests don’t find any diseases, advocates of testing healthy patients suggest that having the baseline data could be helpful in knowing what your baseline levels or anatomy should be and how it is changing over time.  Plus, as technology advances, maybe that data can be used to really improve your health.

On the other side of this argument is a number of interesting perspectives.  First, they argue that all of these additional tests on healthy patients will discover issues that will lead to interventions that could cause more problems than they solve.  In fact, they point to the reality that if you’re not experiencing symptoms, then is the lab result or MRI really finding something that needs to be solved?  Plus, interventions and surgeries can often have their own issues.  In other words, the surgery could be more damaging to your health than the problem the surgery is trying to solve.  Of course, they also argue that all of these extra surgeries, drugs, or other treatments will balloon the costs of healthcare.

The cost discussion is a really big and complicated one.  On the one hand, all of this extra testing and imaging could lead to a lot of unneeded care and costs.  They’re not wrong about this.  However, it could also find diseases where early intervention saves costs later.  I won’t begin to evaluate in this article whether the extra tests drive more unneeded care or whether the early interventions save more money.  The challenge with that evaluation is that we can measure the costs associated with uneeded inteventions and the costs of complications from those interventions.  It’s much harder to evaluate the cost savings of discovering a disease early.  You have to predict what the future would have been for a patient if they hadn’t discovered the disease.  We don’t have a crystal ball to truly know what was prevented in healthcare yet or if the disease would have even appeared at all.

Of course, if you take the Mark Cuban billionaire perspective, money is not an issue, but that’s a seperate health equity issue that will save for another day.

The real problem with both perspectives is that healthcare has limited info and understanding.  If we had tools that would measure the body perfectly and we had a perfect understanding of all the billions or trillions of nuances associated with the human body, then this wouldn’t be a discussion at all.  We’d want to do all of the measurements so we had a perfect understanding of what our future health would be and how to treat it.  We’re not there yet.  In fact, I think it’s safe to say that we’re not even close on either account.  There’s science in medicine, but it’s a lot more art and science yet to be completed than many want to admit.

It’s fair to say that the testing and imaging we have now is incredible, but extremely limited compared to the problem.  Our understanding of what the values and imaging mean for each unique human is still quite limited.  Think about those two important axis.  First, do you understand what a value means for your health?  Second, do you understand how that value may be different for you versus someone else with different DNA, environment, etc?

Healthcare is stuck with limited data and limited understanding of what the data means.  We do the best with what we have.  I applaud the incredible doctors who deal with this reality every day and do the very best they can.

No doubt there are a dozen more angles to each side of this complex topic.  I just wanted to give a small flavor of both sides.  The simplest way for me to look at it is that both perspectives on testing and imaging “healthy” patients have potential risks and potential benefits.  Until we reach healthcare data and treatment nirvana, you have to just evaluate the risks and benefits on both sides.  Testing healthy patients has potential risks and benefits.  Not testing healthy patients has potential risks and benefits.  If you want to believe one way or the other, you can make both cases.

If you want a deep dive into some research that really explores some of these topics, check out the book “Bone on Bone: An Orthopedic Surgeon’s Guide to Avoiding Surgery and Healing Pain Naturally” by Meredith Warner (we have an interview with her coming soon too).  She explores a lot of the research behind things like hip and knee replacements.  For example, she shares how MRIs can often show things like meniscus tears that aren’t actually causing problems for the patient.  Many patients have lived comfortable lives with these tears because not all tears or bodies are created equal.  Does that mean you should fix the tear just because it showed up on the MRI.  The point of her book looks more towards alternatives to surgery (although, she’s not against surgery for many cases) versus the question of testing a healthy patient, but it illustrates the challenge of treating a patient just because imaging or lab tests find something.  Good doctors understand these nuances and why you can’t just rely on lab results or imaging.

That said, the real change in mindset some need is that just because imaging find something doesn’t mean we have to operate or treat the finding a certain way even if that’s what insurance is going to pay you for.  The same is true with lab results.  Normal limits may be different for my body versus someone else.  As one radiologist told me, the MRI is so incredible at seeing everything that’s happening in the body.  The detail or an MRI is amazing.  However, a lot of those details need to be taken in context.  Everything looks like a nail when you’re a hammer.  Everything shouldn’t looks like a surgery when you’re a surgeon.  Even if that’s what our healthcare system pays for.  Shout out to the many clinicains who understand this nuance.  It’s also a really important mindset if you’re doing proactive screenings.

I say all of this as a preview to a company, SimonMed, reaching out to me with the offer of doing one of their simonONE Whole Body Plus Scans.  They offer these whole-body screenings nationwide at a pretty affordable price.  I personally lean more towards Mark Cuban’s view of more information and potential early intervention is better, so I was interested in doing it.  Plus, I kind of wanted to see what the process would be like.  I convinced them to let both my wife and I do it so I could compare both experiences.

I’ll admit that I was slightly nervous about the MRI.  I didn’t think I’d be claustrophobic, but I’d also never done an MRI before.  Luckily, the hour went quite smooth and I didn’t have any issues.  I imagine some won’t enjoy the experience, but I felt like I was in control the whole time.  I personally found the process fascinating including the various breathing and breathe holding you had to do.  My wife didn’t experience any issues with it either for which I was grateful.

I’ll admit that I was glad that I included my wife in this.  I went into the experience with no fear and excitement to see what it would find and realizing that I’d keep it in proper perspective.  I’m Pollyanna though and always see the good in things.  My wife had a quite different experience going into it.  You could see she was quite stressed by the unknown about what it could find and what it would mean.  Of course, we both shared that it would be better to find it early if something major was happening than to be ignorant to it.  I think managing a person’s thoughts and feelings on what the MRI could find should be an important part of this process that I didn’t consider as much since I wasn’t concerned.

Then, the wait was on for our results.  It didn’t take too long, but we did have to schedule a time for one of their clinicians to share the results with us.  As someone who’s followed open notes for a long time, I kind of felt like they should have just shared all the info with me rather than waiting for the appointment.  However, after having been guided through the results by SimonMed’s clinician, I realized that for this scan it was much better to wait for the person to put in context the findings of the MRI.

Going back to the potential issues with MRI scans of “healthy” individuals, the SimonMed clinician was key to processing the results of the MRI scan and keeping them in the proper perspective.  If they would have just dumped the MRI scan on me, it would have been a mess.  Either I would have thought the results were too complex to process or I’d be consulting Dr Google or Dr ChatGPT to try and understand what they meant.  The SimonMed clinician did an amazing job walking through the results and adding the context that was needed to understand the results in their proper context.

For example, at one point she showed one result that felt pretty concerning to me.  Then, she offered the context that every male that they scan had something similar.  Then, she offered the context of when this may become an issue and that it may be something we want to watch to see if and how it changes over time.  Without that context, I would have created all sorts of bad scenarios.

Turns out that the MRI didn’t find anything major on me that I should go and get extra evaluation on.  There were a number of things that she noted I may want to keep an eye on, but nothing that really required a visit to the doctor for more evaluation.

My wife’s scan on the other hand found three things that were worth noting and worth a follow up with a doctor.  One of them she knew about and the scan prompted her to finally get the examination she’d been planning to do.  One she kind of knew was happening but it didn’t necessarily think it needed examination.  And the third was something she didn’t know about and may be explaining some of the symptoms she’d been experiencing.  The MRI scan prompted her to seek medical care for all three.

Ironically, the new thing that was found in the scans, the doctor she visited post scan initially didn’t believe she actually had that problem.  However, they decided to do a CT and some other tests to evaluate it.  Turns out the MRI was right and now they can work on a plan to address it.  Unfortunately, our healthcare system is so slow that she’s still working through all of the things the scan found.  So, I can’t share the final results, but I’ll say that we’re pretty grateful that the whole-body MRI found these things and encouraged her to get the care she needed for them.  We’ll see how the treatments for them work out for her.

A few other tech notes about the experience.  First, the check in process was kind of a mess.  I think I filled out the same forms 3 times.  At least they were electronic forms, but SimonMed was definitely leveraging a different radiology practice workflow together with these whole-body screenings.  That plus the fact that I was getting the scans from SimonMed for free made for a less than ideal check-in process.  It could easily be cleaned up though.

Also, I wanted to get access to the MRI images for my wife to take to the doctors she went to after seeing the results.  As you may know, MRIs are really big and it took me 3 times going in to get all the DVDs of the MRI (at least I hope it’s all of them).  That whole process was confusing and annoying.  It was nice they were willing to do it, but they didn’t process the idea that I wanted to have all of the images and not just a few.  That’s why I had to go back multiple times.  I told them they really needed to sign up with PocketHealth so I could just acccess them digitally.  Going in for DVDs and then finding a DVD player that could read them is a terrible workflow.

Needless to say, this was an interesting and insightful experience.  I think my wife and I are both grateful we did it.  It gave me a first hand experience on what this type of approach is like.  Plus, I learned how we all react to this proactive screening differently.  It also highlighted how sharing the results with the patient in the right way is one of the keys to doing this well and avoiding many of the things people fear about these screenings.  The clinician who walked us through the results was really key to understanding them and not spiraling to unneeded care.  I’m also grateful I now have a benchmark set of images I can use in case something else comes up in the future.  Hopefully they’ll make them more portable so I can leverage the technology that continues to come out.

As I said, this is a controversial topic.  We certainly welcome people to have differing views on this and their value.  I’ve only covered it at the surface level for sure.  We welcome any educational comments and perspectives including those that may differ from mine in the comments as long as they’re done respectfully in the comments or on social media.

Full Disclosure: I’m not a doctor and I don’t play one on TV or this site.  However, I am a patient that’s impacted by these options and so I’m writing from my informed patient perspective.  I acknowledge this is a controversial topic which is why I think it’s worth exploring and learning together as this evolves.

One of the most controversial things in healthcare is whether “healthy” people should be doing regular lab tests, MRIs, and other diagnostics.  There are people that are really passionate on both sides of the issue.  One of the biggest proponents of healthy people being tested regularly if they can afford it is Mark Cuban. He suggested that people who have the means should do regular tests of their health including having that baseline data that’s specific to you.  When he suggested this on social media, the flame wars began as many people, including doctors, said that was awful advice.

For those that are pro testing of healthy patients, they offer a couple important view points.  First, doing this testing could lead to early detection of a disease and we know how early detcction of diseases can be key to treating those diseases.  That’s why we do colonoscopies and mammograms.  Wouldn’t more in depth detection of disease like labs and MRIs be treated similarly?  Plus, even if the tests don’t find any diseases, advocates of testing healthy patients suggest that having the baseline data could be helpful in knowing what your baseline levels or anatomy should be and how it is changing over time.  Plus, as technology advances, maybe that data can be used to really improve your health.

On the other side of this argument is a number of interesting perspectives.  First, they argue that all of these additional tests on healthy patients will discover issues that will lead to interventions that could cause more problems than they solve.  In fact, they point to the reality that if you’re not experiencing symptoms, then is the lab result or MRI really finding something that needs to be solved?  Plus, interventions and surgeries can often have their own issues.  In other words, the surgery could be more damaging to your health than the problem the surgery is trying to solve.  Of course, they also argue that all of these extra surgeries, drugs, or other treatments will balloon the costs of healthcare.

The cost discussion is a really big and complicated one.  On the one hand, all of this extra testing and imaging could lead to a lot of unneeded care and costs.  They’re not wrong about this.  However, it could also find diseases where early intervention saves costs later.  I won’t begin to evaluate in this article whether the extra tests drive more unneeded care or whether the early interventions save more money.  The challenge with that evaluation is that we can measure the costs associated with uneeded inteventions and the costs of complications from those interventions.  It’s much harder to evaluate the cost savings of discovering a disease early.  You have to predict what the future would have been for a patient if they hadn’t discovered the disease.  We don’t have a crystal ball to truly know what was prevented in healthcare yet or if the disease would have even appeared at all.

Of course, if you take the Mark Cuban billionaire perspective, money is not an issue, but that’s a seperate health equity issue that will save for another day.

The real problem with both perspectives is that healthcare has limited info and understanding.  If we had tools that would measure the body perfectly and we had a perfect understanding of all the billions or trillions of nuances associated with the human body, then this wouldn’t be a discussion at all.  We’d want to do all of the measurements so we had a perfect understanding of what our future health would be and how to treat it.  We’re not there yet.  In fact, I think it’s safe to say that we’re not even close on either account.  There’s science in medicine, but it’s a lot more art and science yet to be completed than many want to admit.

It’s fair to say that the testing and imaging we have now is incredible, but extremely limited compared to the problem.  Our understanding of what the values and imaging mean for each unique human is still quite limited.  Think about those two important axis.  First, do you understand what a value means for your health?  Second, do you understand how that value may be different for you versus someone else with different DNA, environment, etc?

Healthcare is stuck with limited data and limited understanding of what the data means.  We do the best with what we have.  I applaud the incredible doctors who deal with this reality every day and do the very best they can.

No doubt there are a dozen more angles to each side of this complex topic.  I just wanted to give a small flavor of both sides.  The simplest way for me to look at it is that both perspectives on testing and imaging “healthy” patients have potential risks and potential benefits.  Until we reach healthcare data and treatment nirvana, you have to just evaluate the risks and benefits on both sides.  Testing healthy patients has potential risks and benefits.  Not testing healthy patients has potential risks and benefits.  If you want to believe one way or the other, you can make both cases.

If you want a deep dive into some research that really explores some of these topics, check out the book “Bone on Bone: An Orthopedic Surgeon’s Guide to Avoiding Surgery and Healing Pain Naturally” by Meredith Warner (we have an interview with her coming soon too).  She explores a lot of the research behind things like hip and knee replacements.  For example, she shares how MRIs can often show things like meniscus tears that aren’t actually causing problems for the patient.  Many patients have lived comfortable lives with these tears because not all tears or bodies are created equal.  Does that mean you should fix the tear just because it showed up on the MRI.  The point of her book looks more towards alternatives to surgery (although, she’s not against surgery for many cases) versus the question of testing a healthy patient, but it illustrates the challenge of treating a patient just because imaging or lab tests find something.  Good doctors understand these nuances and why you can’t just rely on lab results or imaging.

That said, the real change in mindset some need is that just because imaging find something doesn’t mean we have to operate or treat the finding a certain way even if that’s what insurance is going to pay you for.  The same is true with lab results.  Normal limits may be different for my body versus someone else.  As one radiologist told me, the MRI is so incredible at seeing everything that’s happening in the body.  The detail or an MRI is amazing.  However, a lot of those details need to be taken in context.  Everything looks like a nail when you’re a hammer.  Everything shouldn’t looks like a surgery when you’re a surgeon.  Even if that’s what our healthcare system pays for.  Shout out to the many clinicains who understand this nuance.  It’s also a really important mindset if you’re doing proactive screenings.

I say all of this as a preview to a company, SimonMed, reaching out to me with the offer of doing one of their simonONE Whole Body Plus Scans.  They offer these whole-body screenings nationwide at a pretty affordable price.  I personally lean more towards Mark Cuban’s view of more information and potential early intervention is better, so I was interested in doing it.  Plus, I kind of wanted to see what the process would be like.  I convinced them to let both my wife and I do it so I could compare both experiences.

I’ll admit that I was slightly nervous about the MRI.  I didn’t think I’d be claustrophobic, but I’d also never done an MRI before.  Luckily, the hour went quite smooth and I didn’t have any issues.  I imagine some won’t enjoy the experience, but I felt like I was in control the whole time.  I personally found the process fascinating including the various breathing and breathe holding you had to do.  My wife didn’t experience any issues with it either for which I was grateful.

I’ll admit that I was glad that I included my wife in this.  I went into the experience with no fear and excitement to see what it would find and realizing that I’d keep it in proper perspective.  I’m Pollyanna though and always see the good in things.  My wife had a quite different experience going into it.  You could see she was quite stressed by the unknown about what it could find and what it would mean.  Of course, we both shared that it would be better to find it early if something major was happening than to be ignorant to it.  I think managing a person’s thoughts and feelings on what the MRI could find should be an important part of this process that I didn’t consider as much since I wasn’t concerned.

Then, the wait was on for our results.  It didn’t take too long, but we did have to schedule a time for one of their clinicians to share the results with us.  As someone who’s followed open notes for a long time, I kind of felt like they should have just shared all the info with me rather than waiting for the appointment.  However, after having been guided through the results by SimonMed’s clinician, I realized that for this scan it was much better to wait for the person to put in context the findings of the MRI.

Going back to the potential issues with MRI scans of “healthy” individuals, the SimonMed clinician was key to processing the results of the MRI scan and keeping them in the proper perspective.  If they would have just dumped the MRI scan on me, it would have been a mess.  Either I would have thought the results were too complex to process or I’d be consulting Dr Google or Dr ChatGPT to try and understand what they meant.  The SimonMed clinician did an amazing job walking through the results and adding the context that was needed to understand the results in their proper context.

For example, at one point she showed one result that felt pretty concerning to me.  Then, she offered the context that every male that they scan had something similar.  Then, she offered the context of when this may become an issue and that it may be something we want to watch to see if and how it changes over time.  Without that context, I would have created all sorts of bad scenarios.

Turns out that the MRI didn’t find anything major on me that I should go and get extra evaluation on.  There were a number of things that she noted I may want to keep an eye on, but nothing that really required a visit to the doctor for more evaluation.

My wife’s scan on the other hand found three things that were worth noting and worth a follow up with a doctor.  One of them she knew about and the scan prompted her to finally get the examination she’d been planning to do.  One she kind of knew was happening but it didn’t necessarily think it needed examination.  And the third was something she didn’t know about and may be explaining some of the symptoms she’d been experiencing.  The MRI scan prompted her to seek medical care for all three.

Ironically, the new thing that was found in the scans, the doctor she visited post scan initially didn’t believe she actually had that problem.  However, they decided to do a CT and some other tests to evaluate it.  Turns out the MRI was right and now they can work on a plan to address it.  Unfortunately, our healthcare system is so slow that she’s still working through all of the things the scan found.  So, I can’t share the final results, but I’ll say that we’re pretty grateful that the whole-body MRI found these things and encouraged her to get the care she needed for them.  We’ll see how the treatments for them work out for her.

A few other tech notes about the experience.  First, the check in process was kind of a mess.  I think I filled out the same forms 3 times.  At least they were electronic forms, but SimonMed was definitely leveraging a different radiology practice workflow together with these whole-body screenings.  That plus the fact that I was getting the scans from SimonMed for free made for a less than ideal check-in process.  It could easily be cleaned up though.

Also, I wanted to get access to the MRI images for my wife to take to the doctors she went to after seeing the results.  As you may know, MRIs are really big and it took me 3 times going in to get all the DVDs of the MRI (at least I hope it’s all of them).  That whole process was confusing and annoying.  It was nice they were willing to do it, but they didn’t process the idea that I wanted to have all of the images and not just a few.  That’s why I had to go back multiple times.  I told them they really needed to sign up with PocketHealth so I could just acccess them digitally.  Going in for DVDs and then finding a DVD player that could read them is a terrible workflow.

Needless to say, this was an interesting and insightful experience.  I think my wife and I are both grateful we did it.  It gave me a first hand experience on what this type of approach is like.  Plus, I learned how we all react to this proactive screening differently.  It also highlighted how sharing the results with the patient in the right way is one of the keys to doing this well and avoiding many of the things people fear about these screenings.  The clinician who walked us through the results was really key to understanding them and not spiraling to unneeded care.  I’m also grateful I now have a benchmark set of images I can use in case something else comes up in the future.  Hopefully they’ll make them more portable so I can leverage the technology that continues to come out.

As I said, this is a controversial topic.  We certainly welcome people to have differing views on this and their value.  I’ve only covered it at the surface level for sure.  We welcome any educational comments and perspectives including those that may differ from mine in the comments as long as they’re done respectfully in the comments or on social media.