Would you pay $2,500 a year to scan your entire body for hidden diseases?
"I am considering offering full-body scans here at Sacred Heart. What do you think?" Dr. Bob Kelso, chief of medicine at the hospital in fictional San DiFrangeles, asks.
"I think showing perfectly healthy people every harmless imperfection in their body just to scare them into taking invasive and often pointless tests is an unholy sin," Dr. Perry Cox responds, echoing a sentiment many real doctors have toward high-end preventive scans.
It's been more than 20 years since that Scrubs episode first aired, and yet real doctors are no closer to settling their big debate about full-body MRIs.
Preventive full-body MRIs are now used in high-end longevity clinics and are available through a growing suite of direct-to-consumer offerings. Prices range from $2,500 or more for a one-hour scan to new AI-assisted offerings that cost $500 and only take about 20 minutes.
Stars and longevity fiends, including Kim Kardashian, tout these scans on social media, and everyday patients share real success stories, gripping testimonials of lifesaving insights they've gleaned from scanning their entire bodies for signs of danger.
Genetic sequencing pioneer Craig Venter previously told Business Insider that he diagnosed his own prostate cancer "that was about to metastasize" with a high-end MRI "after being told by the best medical system that I didn't have prostate cancer."
Full-body MRIs can detect cancer early. But they can also have you parting with thousands of dollars, scheduling numerous follow up appointments to chase little dots on your scans, and in the end revealing nothing.
A full-body MRI is like a security camera for your innards
The promise of a full-body MRI is that it can uncover dangerous things happening inside you that aren't bad enough — yet — to get picked up on other tests.
Danielle Hoeg is a perfect example of how this can work. A non-smoker in her early 40s and mom of three, she told Business Insider she decided to do a Prenuvo scan after some "wonky" blood work was taken at her doctor's office, which suggested something might be wrong.
She signed up for a $2,500 Prenuvo scan (not covered by insurance), which took about an hour. The scan highlighted a few things: some moderate spinal degeneration and a lingering sinus infection. It also flagged a "minor" white cloud on her lung, an "indeterminate lesion" that "appears at low risk of becoming problematic," her Prenuvo report found.
A blood test for lung cancer came back negative, but a CT scan her doctor ordered showed that, sure enough, that lung spot was likely cancer. She eventually had a stage 1 tumor removed, just three months after her Prenuvo scan.
Hoeg was in shock. She was a 43-year-old, healthy non-smoker with lung cancer. How could this be?
"I'm not out there smoking, asking for lung cancer, I'm not working in a coal mine," she told Business Insider.
Since she caught this cancer early, she didn't have to undergo any aggressive radiation or chemotherapy treatments. She tells everyone she can about her experience with Prenuvo.
"I have a little bit less lung, I have some scars, but I'm OK, and I'm here, and I'm with my kids, and swimming and running," she said.
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Emi Gal, founder of Prenuvo competitor Ezra, recently acquired by Function Health, says this is exactly what full-body scans are meant for. They're helping find cancer that either can't be screened for or won't get picked up on regular screening tests because it's not big enough yet.
"My mother passed away from cancer because she found cancer late," Gal told BI. "I've dedicated my career and my life really to helping everyone in the world detect cancer early."
The scans can also pick up back and spine problems, aneurysms, liver disease, and cysts.
Inevitably, they will also flag many things as worrisome that people don't need to worry about at all, like benign scar tissue or inflammation lingering from a recent illness or injury. The scan can't tell you definitively, "hey, this is trouble." It just shows you when something's there.
Are ultrasounds the real untapped medical tool of the future?
As the fictional Dr. Cox presciently said on Scrubs, "If you get this scan, the next year of your life is going to be a series of endless tests."
Prenuvo says that nearly half of its patients "find something to keep an eye on," but doctors want to know: Are they saving lives?
For now, you won't find major medical boards or cancer advocacy organizations recommending full-body MRIs. There isn't the hard evidence they'd need to back up a medical recommendation.
"Your end goal is saving years of life, helping people live longer," Dr. Samir Abboud, the chief of emergency radiology at Northwestern Memorial Hospital in Chicago, told BI.
If annual scans are overkill, our annual check-ups are often not enough. Independent reviews consistently show that yearly health checks have little to no effect on preventing deadly diseases.
Dr. Tim Arling, who runs a concierge medicine practice focused on longevity, says he only occasionally recommends full-body MRIs to his patients. What he's started doing more often is spending a few extra minutes waving a little medical wand over parts of a patient's body as a preliminary scan for trouble.
He's using a portable ultrasound machine, the same device doctors use to look at a fetus as it's developing in utero. The technique is common in Japan, where doctors often glide ultrasound wands over a person's thyroid, as an initial screen for cancer.
In addition to the thyroid gland, Arling sometimes glides his ultrasound over a patient's liver, kidneys, or aorta, "as a little extension of the physical exam."
"If I see something, I'll have a discussion with the patient, we'll decide if we want to do something in real time," he said.
The move costs nothing extra to the patient and takes just a few extra minutes. Critically, it also includes the doctor in the discussion from the get-go.
Hoeg's stage 1 cancer was graded as a "minor" finding by Prenuvo. If Abboud, who's both a doctor and a friend, hadn't said she should get it looked at ASAP, would she have known to take the finding so seriously?
Arling said he went through a "very bizarre three-week period" last year where he ended up flagging a case of early-stage liver cancer, plus another case of early-stage kidney cancer using ultrasounds.
"If primary care is trying to catch things earlier, the question comes down to how can we do it in a way that doesn't necessarily add a whole bunch of extra cost or a whole bunch of extra waste?"
Maybe "we can start just sort of waving wands over people and getting a little more information," he said.
How to decide if you should get a full-body scan: 5 questions to ask
For some people, doctors are already in agreement that full-body cancer scans are a good thing. If you have a rare condition called Li-Fraumeni syndrome, which puts you at greater risk of developing all sorts of cancer, annual full-body scans are a go-to, and they're covered by insurance.
For everybody else, the jury — a jury full of practicing physicians — is still out.
If you're interested in a full-body scan, Dr. Arling recommends weighing a few key factors:
1. What's your family history?
You might want to consider a full-body MRI if you've got a family history of cancer.
But that scan should be in addition to other recommended cancer screenings you're already doing, Arling said: "paps, mammos, PSAs, colonoscopies, the standard stuff."
Another option is a cancer blood test like Galleri. It costs $950.
2. What's your medical anxiety level?
If you are anxious about medical care or testing, full-body scans may not be for you.
"If you already have that health-anxious person, I'm not super enthusiastic about recommending this test, because they're going to find something," Arling said.
3. What's your level of concern?
On the other hand, full-body scans are good at "looking for trouble," Arling said.
"If you're really trying to find the thing, not rule out the thing, then the MRI is going to have better data. It has higher sensitivity," he said.
It'll be more sensitive than a Galleri test, for example.
4. What's your budget?
Is this the best use of a few hundred to a few thousand bucks of your cash?
Might you derive more health benefits from putting those dollars into things we know will improve healthy aging, like more exercise, some personal training, better nutrition, or less stress (a nice vacation, perhaps?)
"If it gets people being healthy, great, but if it's just a thing that rich people do to flaunt that they're healthier than you, it doesn't quite achieve the goal," Arling said.
5. Is there metal in your body?
Finally, full-body MRIs may not be for you if you have metal in your body (sorry).
That's because they work by harnessing the power of magnets. There's no harmful radiation involved, but you generally can't wear anything metal, inside or out. (Discuss this with your doctor, though — many surgical implants are designed to be MRI-safe).
"A typical three tesla MRI is 60,000 times the strength of the magnetic pull of Earth," Gal said.
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