Monday 5th January 2026

Newsletter Monday

Hello Reader,

Every few weeks there’s a familiar kind of article in The Times (or another broadsheet): glossy photos, soft lighting, a calm Scandinavian aesthetic, and a shiny private health clinic promising more than you get on the NHS.

More data. More tests. More reassurance.

More “control”.

It taps neatly into a very modern anxiety - that if something is missed, it’s because you didn’t look hard enough.

But more isn’t always better.

And more testing does not automatically mean better health.

There’s something deeply attractive about modern screening clinics.

They promise clarity, control, and early answers.

They look serious. They sound scientific.

They borrow the language of radiology and prevention and wrap it in calm lighting and tidy graphs.

And yet - we need to be honest about what usually follows.

Even when these clinics tell you that you’re “high risk”, the advice almost always collapses down to the same few fundamentals:

• Improve diet quality
• Move your body more
• Lose some excess weight if relevant
• Reduce alcohol
• Manage stress
• Protect sleep

Occasionally, a statin enters the chat.

That’s it.

No secret lever.

No hidden intervention.

No magical early fix unlocked by the scan.

Which brings us to the uncomfortable question.

If the advice is the same, why the scan?

This is where Dr Margaret McCartney has been consistently clear for years, she writes for the BMJ and appears often on Radio 4's Inside health.

She wrote about it in her book, The Patient Paradox which I read with interest, years ago.

(Published in 2012 - and nothing since has meaningfully invalidated its central argument.)

We still have no convincing evidence that broad, untargeted health screening improves all-cause mortality.

What it reliably does is:

• Find more “risk”
• Create more patients
• Generate more follow-up
• Increase anxiety and medical activity

Outcomes, stubbornly, don’t shift in the same direction.

Thats not my opinion, thats what the data shows.
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And crucially: knowing you’re high risk doesn’t magically make lifestyle change easier or more sustainable.

If anything, fear is a poor long-term motivator, you get a tiny window for change, but it runs out in weeks.

The statin question (the quiet grey area)

Statins clearly help some people, in specific risk categories.

But for many asymptomatic, low-to-moderate risk individuals, the absolute benefit is at best, modest, long-term adherence is variable, and the decision is nuanced - not a slam dunk unlocked by a scan.

They’re not a substitute for lifestyle change.

They’re an adjunct, sometimes.

Which means even the “medical escalation” option is less dramatic than people imagine.

The uncomfortable truth

Most people don’t need more information.

They need support, structure, time, and consistency.

They already know:

• They drink more than they should
• They move less than they could
• Sleep is compromised
• Stress is unmanaged

No scan reveals this.

No AI uncovers it.

No clinic surprises them with it.

A more honest use of the money

If you already suspect your lifestyle needs attention — and many adults do — then the most evidence-based move is boring, unsexy, and unfundable by glossy clinics:

• Spend less on reassurance
• Spend more on implementation

None of that comes with a PDF report.

All of it has better evidence behind it.

Bottom line

These clinics aren’t evil.

They’re not scams.

But they sell reassurance dressed as insight, and reassurance is seductive.

Just don’t confuse being told you’re at risk with doing something meaningful about it.

The latter was always available, no scan required.