Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Our easy access to imaging has led to overutilization

Raag Airan, MD
Policy
October 11, 2011
Share
Tweet
Share

With all the debate about cost control, it’s clear that we doctors will have to police ourselves – or else politicians and insurance companies will exert even more influence over our practices than they already do. The main question is:

Are we willing to let our physician colleagues exert influence on our care decisions?

Taking a case from my field: at a conference this past week I met a radiology resident from the U.K. and compared notes about the differences in our practices. The main point we discussed was that, in the U.K., one of the radiologist’s primary roles is to determine which scans are completed. Partly because of the lower density of scanners in the U.K. (e.g. we have double the number of CT scanners per capita in the U.S.), imaging resources are scarcer across the pond than they are here. In that environment, the U.K. radiologist has evolved to be as much a gatekeeper for access to imaging resources, as an interpreter of the scan results. This of course leads to friction between departments, as clinicians ordering the scans are exasperated by radiologists who block the scans for seemingly inappropriate reasons.

We Americans, in contrast, have problems at the other extreme with scans being ordered with seemingly minimal indication. In contrast to my new friend’s training, I will have little to no responsibility for triaging imaging resources at my training sites. The most I will do is advise on which particular scan to order when an ordering provider happens to call, or when the technician doesn’t know how to cohere the scan ordered with the given clinical indication. In most cases, I will only know an inappropriate scan has been completed when the resultant images show up in my list to be read. Despite being a radiology resident for only a few months, I have already seen several scans that I could only describe as inappropriate – for instance, a chest PA and lateral completed within 20 minutes after the patient had received a high resolution chest CT, with no intervening change in the patient’s clinical status. Perhaps my clinical colleagues had a valid reason for such a duplicative study beyond the given clinical history (“cough”), but my cynical side assumes the worst. Our easy access to imaging has led to an over-reliance on imaging in diagnosis, and overutilization of imaging in medicine.

So, if you are a radiologist, would you accept an increased responsibility to triage and dole out imaging resources?

If you are not a radiologist, would you accept a shift in control of ordering of imaging services to the radiologist?

Either way, do you think such a shift would be good for patient care?

Raag Airan is an internal medicine physician who blogs at Progress Notes. 

Submit a guest post and be heard on social media’s leading physician voice.

Prev

Hospital discharge summaries are a health literacy issue

October 11, 2011 Kevin 4
…
Next

The impact of unnecessary testing and treatment on patients

October 11, 2011 Kevin 4
…

Tagged as: Public Health & Policy, Radiology

Post navigation

< Previous Post
Hospital discharge summaries are a health literacy issue
Next Post >
The impact of unnecessary testing and treatment on patients

ADVERTISEMENT

More in Policy

  • Why health care leaders fail at execution—and how to fix it

    Dave Cummings, RN
  • Healing the doctor-patient relationship by attacking administrative inefficiencies

    Allen Fredrickson
  • The hidden health risks in the One Big Beautiful Bill Act

    Trevor Lyford, MPH
  • The CDC’s restructuring: Where is the voice of health care in the room?

    Tarek Khrisat, MD
  • Choosing between care and country: a dual citizen’s Independence Day reflection

    Kathleen Muldoon, PhD
  • How fragmented records and poor tracking degrade patient outcomes

    Michael R. McGuire
  • Most Popular

  • Past Week

    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
    • How New Mexico became a malpractice lawsuit hotspot

      Patrick Hudson, MD | Physician
    • Why doctors are reclaiming control from burnout culture

      Maureen Gibbons, MD | Physician
    • Why health care leaders fail at execution—and how to fix it

      Dave Cummings, RN | Policy
    • How digital tools are reshaping the doctor-patient relationship

      Vineet Vishwanath | Tech
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
  • Past 6 Months

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
  • Recent Posts

    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Decoding your medical bill: What those charges really mean

      Cheryl Spang | Finance
    • The emotional first responders of aesthetic medicine

      Sarah White, APRN | Conditions
    • Why testosterone matters more than you think in women’s health

      Andrea Caamano, MD | Conditions
    • A mind to guide the machine: Why physicians must help shape artificial intelligence in medicine

      Shanice Spence-Miller, MD | Tech
    • How subjective likability practices undermine Canada’s health workforce recruitment and retention

      Olumuyiwa Bamgbade, MD | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 3 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
    • How New Mexico became a malpractice lawsuit hotspot

      Patrick Hudson, MD | Physician
    • Why doctors are reclaiming control from burnout culture

      Maureen Gibbons, MD | Physician
    • Why health care leaders fail at execution—and how to fix it

      Dave Cummings, RN | Policy
    • How digital tools are reshaping the doctor-patient relationship

      Vineet Vishwanath | Tech
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
  • Past 6 Months

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
  • Recent Posts

    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Decoding your medical bill: What those charges really mean

      Cheryl Spang | Finance
    • The emotional first responders of aesthetic medicine

      Sarah White, APRN | Conditions
    • Why testosterone matters more than you think in women’s health

      Andrea Caamano, MD | Conditions
    • A mind to guide the machine: Why physicians must help shape artificial intelligence in medicine

      Shanice Spence-Miller, MD | Tech
    • How subjective likability practices undermine Canada’s health workforce recruitment and retention

      Olumuyiwa Bamgbade, MD | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Our easy access to imaging has led to overutilization
3 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...