Tuesday, March 3, 2009
Invaders From Mars at Your Local Imaging Center
INVADERS FROM MARS: PART I
Both The New York Times and The Wall Street Journal ran articles recently regarding the cost of Diagnostic Imaging (DI); especially MRI (Magnetic Resonance Imaging) CT (Computerized Tomography) and PET (Positron Emission Tomography), which are big-ticket tests for the government and insurers.
Both periodicals raise legitimate concerns regarding the lack of quality assurance in the system; Namely, how good is the machine being used (the scanner); and how good are the the interpretations?
You --the consumer-- don't really have a handle on these questions because your health care brains are controlled by the little guy at the the top of the page. He, in case you don't recognize him, is the leader of Mars (1953 and 1986) and he has taken over the brains of the world so that decisions are made from a single place (his jar) which makes everything easier for everyone.
If you think your health care brains are not controlled by an alien fish head then see if you can answer these BASIC questions about tests many of you have probably had. Let's go....TRUE OR FALSE. OK?
1. A mammogram is a good test
CHEAT SHEET: good = accurate; or sensitive; or specific;
or, correct often enough to get into a good college if it were a high school student
2. A CT scan to evaluate the lungs irradiates the breasts
CHEAT SHEET: irradiates = to expose to ionizing radiation -- a known cancer causing process
3. A Radiologist is a doctor who delivers radiation to cancer patients to try to cure or ameliorate the cancer
CHEAT SHEET: You're on your own. I'll tell you this much: a radiologist has nothing to do with RADIOS on company time
4. The doctor that you consult in his private office (the internist or gastroenterologist or pulmonologist) can look at your CT / MRI / PET-CT / US (ultrasound) and comfortably discuss with you the findings
CHEAT SHEET: Ha Ha
5. The doctor who officially reads (interprets) CT/MRI/PET/US is required to have a medical license, or permit, or some type of official permission/authorization to interpret these exams and has been specifically trained to do so.
CHEAT SHEET: I mean, come on, just use your common sense
If you got any of these answers wrong, or you don't completely understand why I asked these questions the way I did, or what I'm illustrating, then your health care mind is controlled by the guy in the jar who put a needle in your neck when you weren't looking.
Who's In Charge? Not You
The Wall Street Journal and The New York Times are running these articles because Mr. Obama is setting his sites on Diagnostic Imaging. In case you don't know (ha ha) George Bush and Tom Frist already blew away out-patient imaging centers (that are now folding up like origami art) by slipping a 50% reduction of payment into the 2006 Deficit Reduction Act (you didn't read it on line before it was signed into law?) and Obama et al are about to continue the assault.
Eventually you will be getting all your tests done in hospitals as you wait next to the lady writhing in pain from pancreatic cancer and the funny looking guy with a mask on who is coughing up some strange stuff.
And you'll have to wait a month for this privilege.
Want to know more? Read on, because in coming posts I'm going to discuss the answers to this quiz (I'll even teach you what you need to know); why Quality Assurance in Diagnostic Imaging is important for YOU to understand, and why you need to learn these things and start making your own decisions when it comes to these extremely important tests.
If you choose otherwise, or choose to ignore these issues otherwise that's OK because the green guy in formaldehyde intends to direct you and your children and your children's children to the least expensive, lowest-tech imaging facility while the interpretation of the images is done by his cronies, who I believe are gathering en masse in India and China.