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

The media’s role in educating patients about MRI overuse

Kevin Pho, MD
KevinMD
November 3, 2011
Share
Tweet
Share

Thankfully, there have been more news stories recently illustrating the overuse of tests.

Specifically with cancer screening, the PSA test and mammograms have come under increasing scrutiny.

I think this type of media attention is long overdue, as the public needs to be aware of the potential downsides of diagnostic tests.

Now comes the MRI.

A recent piece in the New York Times points to a small study by famed sports orthopedist James Andrews, who found when he scanned the shoulders of 31 healthy baseball pitchers,

the pitchers were not injured and had no pain. But the M.R.I.’s found abnormal shoulder cartilage in 90 percent of them and abnormal rotator cuff tendons in 87 percent.

This is an important finding. MRIs are frequently framed as the “most detailed” and “definitive” test available. But, in fact, the test is so sensitive that normal joints cam present with abnormal findings:

… if a healthy, uninjured person goes out for a run, a scan afterward will show fluid in the knee bone. It is inconsequential. But in an injured person, fluid can be a sign of a bone that is stressed or even has a crack and is trying to heal.

“An M.R.I. is unlike any other imaging tool we use,” Dr. Sangeorzan said. “It is a very sensitive tool, but it is not very specific. That’s the problem.” And scans almost always find something abnormal, although most abnormalities are of no consequence.

I applaud these orthopedists, as well as the Times, for bringing this issue to light.

Fixing the problem requires two major changes. The first is reforming how doctors are paid. There are some doctors, but not all, who own MRI machines and profit from them. And with the scans being so sensitive, it can show abnormalities that may lead to surgery, further increasing revenue.

A shift away from fee for service medicine would be effective curbing MRI overuse. And I emphasize that this doesn’t apply to every physician. If I, for instance, order an MRI, I don’t receive any financial gain.

The second change is adjusting patient expectations. Again there are some, but not all, patients who expect a scan and equate an MRI with “being thorough.” In fact, when orthopedic fellows cited in the Times story suggest that patients may not need a scan, patients “look at them like, ‘You don’t know what you’re doing.'”

Doctors can help educate patients away from the mythical benefits of overtesting. But the most effective teacher is the media, which wields significantly more influence. That’s why a story like this in the Times should be applauded, and promoted.

ADVERTISEMENT

Kevin Pho is an internal medicine physician and on the Board of Contributors at USA Today.  He is founder and editor of KevinMD.com, also on Facebook, Twitter, Google+, and LinkedIn.

Prev

Why your website is important to recruit physicians

November 3, 2011 Kevin 1
…
Next

Why you should cancel your doctor's appointment

November 3, 2011 Kevin 12
…

Tagged as: Mainstream media, Patients, Radiology

Post navigation

< Previous Post
Why your website is important to recruit physicians
Next Post >
Why you should cancel your doctor's appointment

ADVERTISEMENT

More by Kevin Pho, MD

  • Surgeon General’s warning: the dark side of social media on children’s mental health

    Kevin Pho, MD
  • Unmasking wage disparity in health care: the truth behind the Elmhurst Hospital physician strike

    Kevin Pho, MD
  • Is FDA-approved Veozah a game-changer in menopause hot flash treatment?

    Kevin Pho, MD

More in KevinMD

  • The Spandex dilemma: Does size still matter?

    Janet L. Cray
  • Surgeon General’s warning: the dark side of social media on children’s mental health

    Kevin Pho, MD
  • Unmasking wage disparity in health care: the truth behind the Elmhurst Hospital physician strike

    Kevin Pho, MD
  • Is FDA-approved Veozah a game-changer in menopause hot flash treatment?

    Kevin Pho, MD
  • Remembering Heather Armstrong: the tragic loss of the “Queen of Mommy Bloggers” sparks a global conversation on mental health

    Kevin Pho, MD
  • Celebrating 2 million downloads of The Podcast by KevinMD!

    Kevin Pho, MD
  • Most Popular

  • Past Week

    • How a doctor defied a hurricane to save a life

      Dharam Persaud-Sharma, MD, PhD | Physician
    • Why primary care needs better dermatology training

      Alex Siauw | Conditions
    • Why physician strikes are a form of hospice

      Patrick Hudson, MD | Physician
    • Why medical notes have become billing scripts instead of patient stories

      Sriman Swarup, MD, MBA | Tech
    • Doctors reclaiming their humanity in a broken system [PODCAST]

      The Podcast by KevinMD | Podcast
    • Focusing on well-being versus wellness: What it means for physicians (and their patients)

      Kim Downey, PT & Nikolai Blinow & Tonya Caylor, MD | Physician
  • Past 6 Months

    • Why transgender health care needs urgent reform and inclusive practices

      Angela Rodriguez, MD | Conditions
    • COVID-19 was real: a doctor’s frontline account

      Randall S. Fong, MD | Conditions
    • Why primary care doctors are drowning in debt despite saving lives

      John Wei, MD | Physician
    • New student loan caps could shut low-income students out of medicine

      Tom Phan, MD | Physician
    • Confessions of a lipidologist in recovery: the infection we’ve ignored for 40 years

      Larry Kaskel, MD | Conditions
    • mRNA post vaccination syndrome: Is it real?

      Harry Oken, MD | Conditions
  • Recent Posts

    • Doctors reclaiming their humanity in a broken system [PODCAST]

      The Podcast by KevinMD | Podcast
    • Guilty until proven innocent? My experience with a state medical board.

      Jeffrey Hatef, Jr., MD | Physician
    • How to balance clinical duties with building a startup

      Arlen Meyers, MD, MBA | Physician
    • When life makes you depend on Depends

      Francisco M. Torres, MD | Physician
    • Could ECMO change where we die and how our organs are donated?

      Deepak Gupta, MD | Conditions
    • Every medication error is a system failure, not a personal flaw

      Muhammad Abdullah Khan | Meds

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 2 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

ADVERTISEMENT

  • Most Popular

  • Past Week

    • How a doctor defied a hurricane to save a life

      Dharam Persaud-Sharma, MD, PhD | Physician
    • Why primary care needs better dermatology training

      Alex Siauw | Conditions
    • Why physician strikes are a form of hospice

      Patrick Hudson, MD | Physician
    • Why medical notes have become billing scripts instead of patient stories

      Sriman Swarup, MD, MBA | Tech
    • Doctors reclaiming their humanity in a broken system [PODCAST]

      The Podcast by KevinMD | Podcast
    • Focusing on well-being versus wellness: What it means for physicians (and their patients)

      Kim Downey, PT & Nikolai Blinow & Tonya Caylor, MD | Physician
  • Past 6 Months

    • Why transgender health care needs urgent reform and inclusive practices

      Angela Rodriguez, MD | Conditions
    • COVID-19 was real: a doctor’s frontline account

      Randall S. Fong, MD | Conditions
    • Why primary care doctors are drowning in debt despite saving lives

      John Wei, MD | Physician
    • New student loan caps could shut low-income students out of medicine

      Tom Phan, MD | Physician
    • Confessions of a lipidologist in recovery: the infection we’ve ignored for 40 years

      Larry Kaskel, MD | Conditions
    • mRNA post vaccination syndrome: Is it real?

      Harry Oken, MD | Conditions
  • Recent Posts

    • Doctors reclaiming their humanity in a broken system [PODCAST]

      The Podcast by KevinMD | Podcast
    • Guilty until proven innocent? My experience with a state medical board.

      Jeffrey Hatef, Jr., MD | Physician
    • How to balance clinical duties with building a startup

      Arlen Meyers, MD, MBA | Physician
    • When life makes you depend on Depends

      Francisco M. Torres, MD | Physician
    • Could ECMO change where we die and how our organs are donated?

      Deepak Gupta, MD | Conditions
    • Every medication error is a system failure, not a personal flaw

      Muhammad Abdullah Khan | Meds

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

The media’s role in educating patients about MRI overuse
2 comments

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

Loading Comments...