Wednesday, March 4, 2009

When All You Have is a Hammer...

Everything is a Nail

Everyone is starting to pile on. Now every announcement of some health issue or new academic study has, as its point, THE HEALTH CARE CRISIS.

Everything contributes to this "Health Care Crisis" (i.e. the cost and insurance crisis) in the hands of undereducated reporters.

Reuters today took a perfectly legitimate issue -- the importance of understanding the use of radiation in imaging -- and turned it into a manifestation of the health care crisis; specifically, a mechanism for greedy doctors to enrich themselves at the expense of their patent's health. *Sigh*
CHICAGO (Reuters) - Americans are exposed to seven times more radiation from diagnostic scans than in 1980, a report found on Tuesday as experts said doctors are overusing the tests for profit and raising health risks for patients.
The findings, issued by National Council on Radiation Protection and Measurement, add to already mounting evidence that doctors are ordering too many diagnostic tests, driving up the cost of health care in the United Statesand potentially harming patients. (italics mine)
Just so that you know, there is no doubt that radiation used in imaging is a force that needs to be understood, acknowledged and discussed publicly. However, doctors are not purposely exposing patients to radiation inorder to boost their coffers.

Truth is, the primary reason physicians order CT scans is because they are so good! You get such a good look at what is going on! A CT scan gives one an image that depicts the inside of the body. This is much preferable to listening with a stethoscope (to try and hear) or feeling with your hands (to evaluate). It's the difference between interviewing a witness at the scene of an accident and having a photo of the accident in progress.

Oh yea, another place where CT is MOST over-ordered is in the Emergency Room. Why is that? Two reasons. First, a CT hands the answer to a busy ER physician:
  • Is there pancreatitis? No.
  • Is there bleeding? No.
  • Is there appendicitis? No.

Go home --OR -- Yes--go to surgery.

Second, in the ER the Docs are paralyzed for fear of missing something and then getting a registered letter with a court date from Hawkins, Burnett and Crude. The solution? Whole body CT scan.

Do physicians over-order CT scans? Yes. Do they do this for profit-- not many. Is this a factor in the horrible health care crisis as Reuters hammers home? God no.

Everyone needs to become more educated about radiation and diagnostic imaging. It's a real problem and an issue that needs education and discussion. But to use this topic as an issue to bludgeon the system is dishonest.

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