Radiology and imaging

386 articles · Since 2005

Articles, page 12

Should Medicare cover PET scans for the diagnosis of dementia?

March 27, 2013Mar 27, 20133

Do they need a PET scan to confirm the presence or absence of amyloid plaque? More importantly, would doing such PET scans make meaningful impacts on patients’ health? Those are the questions that a Medicare expert panel recently considered, and…

Do they need a PET scan to confirm the presence or absence of amyloid plaque?

More importantly, would doing such PET scans make meaningful impacts on patients’ health?

Those are the questions that a Medicare expert panel recently considered, and their impression, after carefully reviewing lots of high-quality research, is that we don’t yet have evidence supporting the benefit of using the PET scans. Unsurprisingly, some experts disagree, including a working group …

Physician voices

Just sign here: That isn’t real informed consent

Peter Ubel, MD

March 26, 2013Mar 26, 201343

Before patients can become savvy consumers of healthcare, they need information about their healthcare choices. Too often, such information is nearly impossible to get, especially when it requires doctors to give patients useful statistics about things like treatment side effects.…

Since publishing Critical Decisions this fall, I have received a number of emails from readers who have recognized their own medical histories in the pages of my book. I received …

Physician voices

Questions to ask before your CT scan

Toni Brayer, MD

March 18, 2013Mar 18, 2013

The United States is higher in its use of computed tomography (CT) scans than any other industrialized country. There were about 3 million scans done in the U.S. in 1980. By 2007 that number had risen to 70 million. A number of articles published in medical journals over the past few years have reported that excess radiation delivered by these scans will …

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Questions to ask before your CT scan

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Conditions and diseases

Incidentalomas: The real cost of ordering tests

Edward Pullen, MD

March 2, 2013Mar 2, 20132

I recently read a very good article in the New York Times about a patient found to have the classic incidentaloma, a small mass in the adrenal gland. This is estimated to be seen in 4% of abdominal CT scans,…

I recently read a very good article in the New York Times about a patient found to have the classic incidentaloma, a small mass in the adrenal gland. This is estimated to be seen in 4% of abdominal CT scans, and is rarely serious but typically leads to recommendations for additional testing and follow up CT scans to assure that it is not either a metastatic cancer …

Physician voices

Medicine requires doctors to constantly manage probabilities

Robert Fenster, MD

February 14, 2013Feb 14, 201322

“I’d really feel better if we got the MRI,” Ms. James said. “I understand you think it’s a migraine, but I want to know, just in case. Wouldn’t you?” Ms. James and I sat in her darkened hospital room—the light…

“I’d really feel better if we got the MRI,” Ms. James said. “I understand you think it’s a migraine, but I want to know, just in case. Wouldn’t you?”

Ms. James and I sat in her darkened hospital room—the light bothered her eyes and exacerbated her headache. She was a dialysis nurse with many years of experience in the healthcare field, and I …

Physician voices

I didn’t become a doctor to bankrupt my patients

Jordan Grumet, MD

February 8, 2013Feb 8, 201316

I have come to terms with making difficult decisions. I accept the possibility of committing a mistake that will cost a life. But I never signed on to bankrupting my patients. Never! I had been up all night tossing and…

I have come to terms with making difficult decisions. I accept the possibility of committing a mistake that will cost a life. But I never signed on to bankrupting my patients. Never!

I had been up all night tossing and turning. The stat CT scan was deemed unnecessary by the insurance company. My patient called crying saying he couldn’t afford the thousands of dollars in charges. Never …

Physician voices

To CT scan or not: What is the ultimate goal of patients?

Erin Plute

February 1, 2013Feb 1, 201313

The patient – blue-eyed, red-haired, and healthy but worried looking – guided the doctor’s hand to just below the angle of her jaw, where a small lump was barely palpable. She had first noticed the swollen lymph node after a cold and thought nothing of it at the time. But five months later, it was still there. She knew it was nothing, …

Physician voices

The increasing stress that radiologists face

Matthew D. Rifkin, MD

January 5, 2013Jan 5, 20134

In the past, the radiology profession was seen as a very financially successful specialty, but as every businessperson knows, success often has peaks and valleys. Radiology residencies are some of the most competitive to obtain, which is due to the…

In the early 1990’s, when financial pressures first appeared on the …

Physician voices

Don’t be afraid to ask your radiologist for help

Paul Dorio, MD

December 14, 2012Dec 14, 20124

It used to be that radiologists mainly helped out your doctor so that they could figure out what was ailing you. Such is no longer the case. Nowadays, with the easy access to almost any doctor of any specialty, you…

It used to be that radiologists mainly helped out your doctor so that they could figure out what was ailing you. Such is no longer the case.

Nowadays, with the easy access to almost any doctor of any specialty, you can visit your radiologist, obtain a needed study (or procedure, in the case of an interventional radiologist), and never even see your …

Conditions and diseases

The benefit of CT scans for the diagnosis of appendicitis

Skeptical Scalpel, MD

November 29, 2012Nov 29, 2012

Amid the mounting concern about radiation exposure and future increases in cancer rates comes a report from Washington State describing the benefits of imaging, particularly CT scanning, for the diagnosis of appendicitis. The authors collected data from some 55 hospitals…

The authors collected data from some 55 hospitals of all types and sizes over a six-year period for more than 19,300 patients older than age 15; 91% of patients underwent one or more imaging studies. There were …

Conditions and diseases

What to expect during your first mammogram

Therese B. Bevers, MD

October 14, 2012Oct 14, 2012

Getting your first mammogram can be stressful. After all, it’s your first one, so you don’t know exactly what to expect. Rest assured: even women getting their second or third mammogram may have concerns. But by learning how to prepare…

Getting your first mammogram can be stressful. After all, it’s your first one, so you don’t know exactly what to expect.

Rest assured: even women getting their second or third mammogram may have concerns.

But by learning how to prepare for and what to expect from this important cancer screening exam, you can eliminate some of the guesswork. And, that can make your experience less nerve-wracking.

Here’s what you should know.

Mammograms save lives

Don’t …

Physician voices

Go ahead and let teens read x-rays

Keegan Duchicela, MD

July 30, 2012Jul 30, 201216

Costs are spiraling out of control, access is declining, and our quality of care doesn't match what other developed nations are delivering at half the cost. In the search to reduce costs and bring our ever inflating health care budget…

Costs are spiraling out of control, access is declining, and our quality of care doesn’t match what other developed nations are delivering at half the cost.

In the search to reduce costs and bring our ever inflating health care budget under control, the powers that be (insurers, government, health policy wonks (and maybe a few doctors) have looked to individuals with less formal education to perform medical services that were once …

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Go ahead and let teens read x-rays

Conditions and diseases

Parents need to ask: Is this CT scan necessary?

Catherine Musemeche, MD

June 17, 2012Jun 17, 20127

I know a surgeon who, when consulted about a child with appendicitis, will insist that a CT scan of the abdomen be performed before he will see the patient. It doesn’t matter that the history and physical exam fit the diagnosis perfectly. It doesn’t matter that the child has already undergone an ultrasound of the appendix that shows it is dilated and inflamed. It doesn’t matter that the radiologist has …

Conditions and diseases

Is CT lung cancer screening worth it?

Deep Ramachandran, MD

June 14, 2012Jun 14, 20123

In 2011 The National Cancer Institute published results from their study of low dose CT lung cancer screening of individuals identified as at risk for lung cancer. The investigators enrolled those between 55 to 74 years of age who had at least 30 pack years of smoking under their belt (number of packs per day multiplied by number of years smoked). These people were then randomly assigned to either a …

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Is CT lung cancer screening worth it?

Physician voices

Hide your health insurance status and pay cash instead

Dike Drummond, MD

June 6, 2012Jun 6, 201219

It always has broken my heart to see a person bankrupted by the costs of their healthcare. I remember my outrage when I first learned the only people who pay full price for their medical procedures are the ones paying cash. Insurance companies use their market muscle and patient volumes to negotiate discounts for their patients that have always been unavailable to the uninsured, individual healthcare consumer.

If you have been …

Health policy

We must redesign our health care payment systems to value primary care

Mark Ryan, MD

June 4, 2012Jun 4, 201221

I share this post here to point out the discrepancy in physicians' average salaries based on their specialties. In particular, I would like to highlight that the three lowest-paid specialties are the three primary care specialties: pediatrics, family medicine, and…

I share this post here to point out the discrepancy in physicians’ average salaries based on their specialties. In particular, I would like to highlight that the three lowest-paid specialties are the three primary care specialties: pediatrics, family medicine, and general internal medicine.

This post is not written to argue that physicians must be paid more. I would submit that if …

Physician voices

Help your radiologist out and provide as much history as you can

Tashfeen Ekram, MD

May 17, 2012May 17, 20125

The art of practicing medicine is in realizing that there is an overlap between normal variants and pathology. Being able to tell the difference can be difficult, but this where the art comes in. However, as physicians we must realize that sometimes this can not be differentiated. Radiology is no different. Many clinicians and non-health care professionals believe that radiology is cut and dry. There is no art in radiology …

Conditions and diseases

Where you have your mammogram, and who reads it, matter

Stacey Vitiello, MD

May 15, 2012May 15, 20123

I’ve received several inquiries from women living in various regions of the country, asking how they should choose where to go for their mammogram, and if it really matters. I cannot emphasize this enough: It matters! Here are a few…

The most basic requirement is whether a facility is accredited under the MQSA (Mammography Quality Standards Act). The accrediting body for most states is the ACR …

Physician voices

A doctor has difficulty making sense of medical bills

Manoj Jain, MD, MPH

May 2, 2012May 2, 20125

Rarely do people think about medical costs when there is a medical emergency or an urgent need for a test. Recently, I was in such a situation. A few days after a 22-hour international flight, the calf muscle in my…

Rarely do people think about medical costs when there is a medical emergency or an urgent need for a test. Recently, I was in such a situation.

A few days after a 22-hour international flight, the calf muscle in my right leg began to ache. If it were not for the recent flight, or if I were not a doctor, I would have just let it pass.

But long periods of sedentary …

Conditions and diseases

A radiologist disagrees with the breast cancer screening guidelines

Stacey Vitiello, MD

March 14, 2012Mar 14, 201216

As a veteran of World War II, my grandfather was a GI Bill success story, the first man to go to college from his impoverished neighborhood in Jersey City thanks to government at its finest. A card-carrying member of the state teachers’ union, and a politically active Democrat for most of his life, it came as something of a shock to me when, after a few decades of observing big …

Radiology and imaging

Articles, page 12

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