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If you have ever taken a CT scan or MRI, which is most likely the case, you would know just how costly these tests are. And, do you realize that at the facilities where these tests are conducted, the scan rooms are always marked out with huge “danger” signs, and everybody scrams leaving you alone with the machinery? Yes, the radiation and magnetic fields are damaging to health!

These are two of the most worrying aspects of the fact that the number of medical imaging tests conducted is on the rise.

Two Good Reasons to Reconsider Scans, such as CT and MRI

by Reuben Chow

When was the last time you had a CT scan or an MRI scan, and how often do you have them? Do you even know what the letters “CT” and “MRI” stand for? A recent study conducted by a team from the University of California-San Francisco has found that the use of such medical imaging tools is playing its part in rising health care costs, while at the same time subjecting patients to increasing levels of radiation exposure.

One fact we cannot deny is, the development of these technologies have allowed physicians and patients to have a very detailed look at the internal structures of one’s body, something which would otherwise be quite impossible without these scans. Not only are the images three-dimensional, they can capture both bone and tissue.

Details of Study

The study team, led by Rebecca Smith-Bindman, an associate professor of radiology at University of California-San Francisco, looked at data over a 10-year period of almost 400,000 patients who were part of a large-scale health maintenance plan in the state of Washington, called the “Group Health Cooperative”. The findings of the study were then extrapolated to apply to the entire United States.

Findings of Study

According to the study, which was published in the journal Health Affairs, CT and MRI scans have become part of the cocktail of common tests used for diagnostic purposes. In the last ten years, the use of imaging tests like CT and MRI scans have nearly doubled. While there were 260 tests per 1000 patients a decade ago, the figure has since risen to 478. In 1997, only 13.5% of the study subjects had taken a CT scan, an MRI scan, or both. By 2006, however, it had become 21%.

Prices have soared, too. A decade ago, the average imaging cost for each patient every year was $229, while the more recent figure was $443. That’s also almost a twofold jump. All in all, diagnostic imaging is a lucrative sector, bringing in tens of billions of dollars every year.

Indeed, according to consulting firm Booz Allen Hamilton, medical imaging is the most expensive health care technology and plays a huge role in rising health care costs in the US, behind only prescription drugs. Not only that, it is a ballooning sector, too, growing at three times the rate of other services in health care.

On the other hand, the use of x-rays remained rather stable, instead of going down, as the team had expected. This statistic, put together with the CT and MRI figures, imply that the newer and more advanced medical imaging technologies are used in addition to the more traditional tests, instead of in place of them.

And because the Group Health Cooperative plan did not provide financial incentives to carry out extra imaging tests, the trend of rising numbers of such tests may be even more pronounced in fee-for-service practice health plans, said Dr Smith-Bindman. All these seem to add up to an overall trend of over-imaging.

The study team did not examine whether or not the rise in number of advanced imaging tests conducted was linked to better patient care.

Why the Increase in Use?

Imaging tests like CT and MRI scans are routinely used to check out issues such as respiratory infections. And the increase in their use is fuelled on both sides of the coin, by both physicians and patients alike.

Patients somehow associate such advanced scans with high quality health care. “It feels like you’re doing something,” said Dr Smith-Bindman. On the other hand, such tests also give doctors the reassurance that they have not overlooked anything. A survey of doctors in the Journal of the American Medical Association reported that over 50% asked for imaging tests just to protect themselves from potential lawsuits.

What Supporters of Scanning Say

Advanced medical imaging, as expected, has staunch supporters from within the industry.

Professor Geoffrey D Rubin, a professor of radiology at the Stanford School of Medicine, feels that what may seem expensive and excessive might actually bring huge benefits. “If imaging resulted in a more expedient or accurate diagnosis leading to earlier or more appropriate treatment - then overall health care costs, time away from productive lives and jobs, and general quality of life could have substantially improved,” he said. Using an analogy of air bags in cars, he said that installing such contraptions in all cars would seem excessive, until we realize that air bags can actually save lives.

Others, like Arl Van Moore president of the American College of Radiology, feel that imaging can, overall, actually cut costs and save lives. For example, three decades ago, open surgery was needed to diagnose pancreatic cancer, while today, a CT scan can do the trick. He added that mammograms have helped to cut down on deaths from breast cancer.

To Scan Or Not To Scan, That Is The Question

“CT”, by the way, stands for “computed tomography”, while “MRI” is the short form for “magnetic resonance imaging”.

And one of the main problems, in my book, is that we cannot effectively quantity the damage done by advanced medical imaging. How many cases of breast cancer, for example, are caused in large part by excessive exposure to radiation from annual mammograms?

Some research has also suggested that such tests uncover problems which might have gone away on their own anyway, and carrying out the tests could have unnecessarily opened a can of worms. Recent research in Norway, for example, suggested the “possibility that the natural course of some screen-detected invasive breast cancers is to spontaneously regress”. Once discovered, however, the medical-go-round usually begins – more tests, surgeries, chemotherapy, radiation, the works. In this scenario, how many women are actually hurt by the results of the scans they went through?

These questions must be answered to have a fair and balanced view of the entire big picture. In the meantime, people like us need to take personal responsibility and make informed decisions.

When it comes to medical imaging, is more necessarily better? As Dr Smith-Bindman said, “The new technologies are fantastic, but they should be used judiciously.”

She suggested that, before taking such tests, patients should ask their physicians some questions. What will we learn from this test? How will it improve my care? When is this really helpful?

Do not be afraid to ask, and to find out more. Doing so, I am sure, will help cut some unnecessary medical costs, on top of lowering one’s exposure to dangerous radiation.

Main Source

Study finds increased use of medical imaging, raising costs and health concerns (http://www.mercurynews.com/ci_10928755?nclick_check=1&forced=true)

Read more Current Health Articles by this author on Natural Health, Nutrition, Alternative Medicine, etc.

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