Such centers exist now, he noted. “They hire counselors and [conduct] an hour-long prescreening visit that happens with a counselor to talk about lung cancer screening, [the length of which] could never happen in a primary care setting.”
This model does not take advantage of the physician/patient relationship, he added. “There is an opportunity for a familiar provider to engage patients around counseling, so the more that we move CT screening outside of primary care, it takes away from the long-term relationship that providers have” with their patients, he said, including knowing more deeply the risks a patient has, as well as the patient’s history with smoking and attempts to quit.
It also takes away opportunities to maintain conversations about smoking cessation, which could be important as screening sometimes deemphasizes the need to quit in patient’s eyes because patients “feel protected by screening.”
The CMS is soliciting comments on the proposed national coverage decision until Dec. 10.