So I don’t know about you Guys and Gals here on ATS, But I have been Scanned, Tested, Poked and Roasted so many times it’s made my head spin.
As the article says, these MRI and CT Scanners are Great Devices, but are way over used. My Medical Insurance has gone through the roof. It’s now
more than my housing expense on a Monthly Basis.
So, What Gives? I am a healthy person (I workout five days a week and eat moderately, No Alcohol or Tobacco). But having tried to decipher some of
the billing from my Doctor’s Offices, the charges related for these Scan/Test Type Items are ridiculous. What say you My ATS Friends and Family,
are the charges related to these items out of line or an I?
Mods, I have out this in the general conspiracy forum,. Please move at your discretion if you see fit
Add easy profits from needless tests to defensive medicine and no cost controls or real competition, and we have the perfect formula for waste, fraud,
profiteering, bad medicine and dysfunctional, unaffordable healthcare.
Why is sickcare (a.k.a. "healthcare") absurdly unaffordable in America? There are many structural reasons which I have covered in depth for years,
but one that most of us can relate to from personal experience is needless, hyper-costly scans and tests.
Even those of us who have never had a CT or MRI scan (and I hope I never will) know the drill from friends and family: practically every injury is now
scanned by one device or another at enormous expense--not for treatment, as M.D. Ishabaka explains, but as defensive medicine to ward off future
lawsuits or in response to patient demands.
Ishabaka (M.D.) walks us through the maze of CT and MRI by using his own injuries and treatments as examples of how our system has become unaffordable
"When I first got into the hospital as a medical student in 1977, MRI scanners did not exist, and the Royal Victoria Hospital in Montreal had the
first CT scanner in Canada. A scan took an hour, and the images were blurry as heck, compared to modern scanners which take a few minutes and produce
crystal clear images - but it was MAGNIFICENT. All of a sudden, we could see brain problems that could only be seen by operating, or doing a cerebral
angiogram - a good but somewhat dangerous test (up to 3% of patients who have one suffer a stroke caused by the test).
When used appropriately, CT scans save lots of money and lives. One example is head trauma. Most people who are knocked out just have a concussion,
but a few have bleeding either around or inside the brain that will kill or permanently disable them unless they are operated on ASAP.
In the old days, just when I was starting practice, most hospitals did not have a CT scanner. People who had been seriously knocked out were ALL
admitted to the hospital for "neurological observation" - a nurse would check on them every hour to see how alert they were.
Two problems with that: for most patients it was a total waste of time and money (and hospitalization is way more expensive than a CT scan), and for
some with a bleed - it wasn't detected until too late.
Now, when someone gets knocked out, you do a CT scan, and within 30 minutes know whether it's safe to send them home, or you need to call a
neurosurgeon to operate on them - as an emergency physician working in a trauma center from 1985 - 1990 this was a REALLY GOOD THING.
Then MRI scanners came along. They show some things really well that a CT scanner doesn't and vice versa. For example, an MRI scanner is unparalleled
for showing a brain tumor. A CT is much better for showing bleeding inside the skull. An MRI scan will also show torn cartilage and ligaments in a
joint with almost crystal clarity - a problem for which CT scanning is almost useless.
So - used appropriately, CT and MRI scans are two of the greatest inventions in my medical career.
But they are hellaciously expensive due to the fact that the machines are so expensive, and like computers, become obsolete within about 5 years - you
have to pay of the multi-million dollar cost of the machine and make a reasonable profit within about 5 years.
Let me tell you from personal experience how they get overused: In 2004 I tore a cartilage (posterior third of the media meniscus if you need to know)
in my right knee. I KNEW I tore a cartilage - I had the right kind of injury, the right symptoms, and the right findings on exam. I called up an
orthopedic surgeon friend of mine and asked "Do you want to operate on my knee?" Somewhat dryly he said "Well, I think I should examine you
So I went to see him. He did a regular X-ray - only $60 - pretty reasonable, and my exam showed ALL the classic findings of a torn meniscus. I told
him I was ready for surgery (I couldn't run or do the martial arts classes I was taking at the time) - but he insisted on an MRI - I suspect because
he was nervous about malpractice operating on a doctor in case the surgery was unnecessary - a risk I was willing to take - I would have signed papers
releasing him from all liability.
Guess what - the $1,700 MRI showed a torn cartilage, I had surgery, and my knee is 99% as good as before I tore the cartilage - so basically the
$1,700 (which was about half my total operation cost) was health care money down the toilet.
This is important: in the pre-MRI days, I would have been operated on based on my history, exam findings, and X-ray.
Now, my back and my neck - I have had recurring problems with both. The back issue came from lifting a heavy table the wrong way. It flares up every 8
- 9 years, I rest it, use a heating pad, take some ibuprofen or naproxen and cyclobenzaprine - and it gets all better.
In 1993, I tore something in my neck - I was lifting weights with my neck with a head harness. I was going up in weight and got to 37.5 pounds. As I
extended my neck, I heard and felt a tearing sound. Idiot that I am, instead of dropping the weight, I finished the rep and REALLY heard and felt
something tear. I had God-awful pain - for about a week, if I had to roll over in bed, I had to hold my head with my hands so my neck didn't bear the
weight - but I got better.
Once or twice a year it flares up, I have trouble swiveling my neck to back up my car. A chiropractor friend of mine gives me a free adjustment and
it's all better within 24 hours.
Now - here's the deal - I don't NEED an MRI of my neck or back. I'm SURE I have torn discs and/or ligaments - but I ALWAYS get better with very
inexpensive meds, and a heating pad, plus chiropractic adjustment. BUT - every patient with spinal pain wants an MRI these days. ALL of them.
The fact is - it doesn't matter a hill of beans if an MRI shows torn disc/ligaments UNLESS surgery is being contemplated. The indications for surgery
are VERY CLEAR - they are loss of sensation or strength in a limb, loss of bowel or bladder control in the case of a very low back injury, or what is
called "parasthesias" - burning, tingling, shock-like feelings, etc in a limb.
The most serious of these is weakness - if a person has injured their spine, and are weak in a limb, they almost all need surgery or they will be
permanently paralyzed/disabled. In these instances, and MRI is marvelous - it will show the surgeon perfectly where the problem is, so he/she knows
exactly where to operate and what needs to be done.