Modern Diagnostic Imaging Tests Health-Care System

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Two random thoughts, gleaned after a recent trip to Florida, about today’s picture-taking technology: First, I’m an idiot when it comes to taking pictures with cell phones, and secondly, I wonder if that airport screener who ran that camera scan is still hee-hawing in that little closed-in room? I was a bit surprised at the time that a voice didn’t suggest I ‘stand up,’ to which I would have had to say, ‘I am standing.’ Truly, though, it was not my lack of height I was concerned about being duly noted.

Now really, you’ve wondered the same during all the debate about airport scans. Exactly what do those folks see and how clearly do they see it? And do not tell me they don’t talk about it over lunch! Oh well, that is a debate for the privacy wonks and others. I just want to learn how to take pictures with my BlackBerry.

While the teens scurrying about my house can do virtually everything with their phones – text 175 words a minute, listen to music with words I can’t understand, play games and catch by photo every silly thing their father does – it took four full days of Disney fun for me to learn how to snap a photo and then actually retrieve it. I am now trying to refine those newfound skills.

All this picture-taking technology, in the airport or via phone, is beyond my comprehension, but it can be a fairly handy ability to have. It can, however, also be fairly costly, which brings me to the point of this article.

First, though, two disclaimers. One, some folks may get mad if they read on and only hear part of the story; and two, in no way am I implying someone shouldn’t do everything possible to address a serious health concern.

So on to the pictures, but not the airport or cell-phone variety. I’m talking instead about advances in medical technology involving modern diagnostic imaging. Those imaging tests (such as CT and PET scans and MRIs) that take pictures of my internal anatomy have revolutionized medicine and tremendously helped doctors detect, diagnose and treat diseases and injuries. That is indisputable and wonderful, especially when it’s your family member whose life is extended because cancer was detected while still at a treatable stage.

Today, more than $2 trillion is spent in the U.S. each year on health care, and diagnostic imaging costs are one of the fastest growing components of that total. Those costs are understood and even appreciated when they produce positive outcomes. Yet the hard part of this story is that studies consistently show us that as much as one-third of imaging procedures may be inappropriate, and one report estimated that about 20 percent of hospital radiology tests are duplicates. Billions of dollars are being spent unnecessarily.

Why? There’s enough blame to go around, and this is where someone will probably get mad and call my little self all kinds of nasty words. Often, it’s our fault as patients, the worried well who demand our physicians check us out because they can and because someone else (an employer or insurer) is paying the bill. It’s the fault of a society that sues itself at every corner, forcing doctors to practice defensive medicine to avoid a lawsuit. A group of orthopedic surgeons recently indicated that defensive imaging – not clinical care – accounted for one-fifth of their total tests. And though we can’t broad-brush the physician community, studies have also shown that doctors with an ownership interest in imaging equipment refer patients for such tests at a greater rate.

All this points out again how complicated and costly the health-care industry is today, and how hard we must work at TRH Health Plans to continue offering health coverage to Tennesseans at affordable rates. The answers are difficult, far more difficult than simply snapping a picture with a cell phone.

Questions to Ask Your Doctor About a Medical Test

  1. Is it truly needed? How will it change my care?
  2. Have you or another doctor done this test on me before?
  3. Does the test involve much radiation and is there an alternative that does not?
  4. How many images are needed?
  5. Do you have a financial stake in the machines that will be used?

— Associated Press

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