In a recent NEJM article by Lauer the author presents data on the increased usage of imaging. We show the Figure above. The annual growth rates for each are shown below.
If we were to perform a simple calculation on these we see that at $1,000 per MRI, a good Medicare number, that we have $72,000 per year for MRIs per 1,000 people. That is $72 per year per Medicare patient. Is that too much for the 65+ age group? The question is versus what. The other question is what was discovered that can be remedied. The problem with all imaging, and I have been a fan of imaging for almost 40 years now, having done my doctoral work there, is that the better it gets the more you find! There are a lot of things you find that if you never knew they were there you would never hear from. That is the conundrum.
Lauer also raises the most serious issue of ionizing radiation and CAT scans. As we go towards more complicated CAT scans, with multiple cuts and complexities we expose the patient to a truly excessive amount of radiation. Is this worth the risk? That is no longer just an academic question.
Lauer has done a great job in raising this issue. I would like just to extend the concern on what is often an incidental finding and the resulting plethora of tests needed to rule out every other problem.
If we were to perform a simple calculation on these we see that at $1,000 per MRI, a good Medicare number, that we have $72,000 per year for MRIs per 1,000 people. That is $72 per year per Medicare patient. Is that too much for the 65+ age group? The question is versus what. The other question is what was discovered that can be remedied. The problem with all imaging, and I have been a fan of imaging for almost 40 years now, having done my doctoral work there, is that the better it gets the more you find! There are a lot of things you find that if you never knew they were there you would never hear from. That is the conundrum.
Lauer also raises the most serious issue of ionizing radiation and CAT scans. As we go towards more complicated CAT scans, with multiple cuts and complexities we expose the patient to a truly excessive amount of radiation. Is this worth the risk? That is no longer just an academic question.
Lauer has done a great job in raising this issue. I would like just to extend the concern on what is often an incidental finding and the resulting plethora of tests needed to rule out every other problem.
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