Saying no to CT

Saying no to CT

Advanced CT scanners have revolutionized trauma care and provided physicians with lots of information to aid diagnosis and track treatment progress. Utilization has gone through the roof, which is good news for radiologists and hospitals but bad news for payers. There has been no significant progress in holding the line on imaging costs, the way there has been on drugs, for example.

But there is growing concern over the high dosage of radiation that some patients receive from CT scans, according to the Wall Street Journal. A chest CT exposes the patient to 8-10 millisieverts of ionizing radiation. That’Â’s 100 to 1000 times as much as a chest x-ray, and about half of the exposure received by the average atomic bomb survivor in Hiroshima or Nagasaki. Some patients get dozens or even hundreds of scans. No doubt not all those scans are necessary.

I’ve always been leery about medical radiation exposure. My mother was conservative about letting us have our teeth x-rayed, and she was probably right. If payers want to rein in CT costs, they’d be wise to tap patient safety concerns. However, if they aren’t careful they will just drive up the use of MRI, which costs even more.

November 2, 2006

8 thoughts on “Saying no to CT”

  1. There is a well-known phenomenon in the radiology world in which one scan begets another scan.

    How many times have I referred a patient for a particular imaging modality (based on my own clinical intuition, and recommendations from the medical literature and frequently from radiologists) only to read the last line of the studies impression: “recommend f/u scan in 3 months” or “recommend bone scan/MRI/plain film”. This is a bogus effort to either create more work/revenue for themselves or a demonstration of their pathetic inability to commit themselves. Radiologist are the worst offenders in the realm of “self-referral”.

    It is becoming more apparent that, in addition to wasting valuable health economy resources, they are putting patients at risk!

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