In 2009 more than $100 billion dollars were spent in the U.S. on high tech medical scans like MRI, CT, and PET. Unfortunately, new studies show up to 50 percent of the scans should never have been done because the results didn’t help with diagnoses or treatments.
We have said time and again on Patient Power programs that there are significant players on your medical team you may not even think about. Two key ones would be the radiologist, and even the radiology technician. It’s up to the technician – hopefully using the most modern equipment – to produce a clear image. And it’s up to the radiologist to report what is significant about the image. Outdated equipment or a sloppy job done in radiology could mean bad things for you – missed cancers, wrong orthopedic assessments, poor understanding of whether chemotherapy is working.
Surprisingly, outside of breast cancer, there is no good regulation of quality that you and I can make use of. There are accredited radiology centers, but there’s no list. Beyond that, it’s hard for the patient to know if the equipment used is state-of-the art. Ten-year-old MRI machines, for example, do not give as clear a picture yet many are still around. If that is coupled with a less-than-qualified radiologist, your physician may not be getting accurate information about you and poor decisions may be made.
Then there’s the greed factor. It seems some doctors have set up their own imaging centers to make money on the scans as well as the rest of your care. Some practices make an additional $500,000 to $1 million a year this way. You have to wonder, when they order a scan, is it really necessary for you or their bank account?
To be fair, there are many terrific radiologists, amazing imaging devices, and people alive today because of their great work. But for the patient, it can be quite variable. So now with all the other questions you need to ask as a powerful patient you need to ask: Is this scan really necessary? What are the qualifications of the radiologist and the accreditation of the center? How up-to-date is the equipment?
If you are not comfortable, tell them you are getting the scan at another center in town. Usually, you have a choice about where non-emergent scans are performed.
Above all, I wanted to remind you of the “art of medicine.” That is true in at least two key behind-the-scenes specialties: radiology and pathology. In both cases the experience and expertise of the practitioner can make all the difference, even if they don’t have the latest high-tech tool. And your life could depend upon their expertise.
The news this week about the high cost of bad radiology is troubling. Apparently new Federal rules for Medicare reimbursement will put pressure on the field to police itself. I hope the radiology community takes heed. Just as our best hospitals are competing to claim the highest quality, the radiology centers should too.
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