There is no mystery why healthcare costs in America are soaring and insurance premiums are through the roof. Over-utilization of advanced imaging services such as: MRI, CT and ultrasounds is becoming apparent. Does the U.S. really have more incidences of chronic diseases and pathology, or is it just that more of sickness is identified with the use of advanced imaging? There are so many times in practice where a patient received an MRI or a CT scan that showed some questionable structures not related to their original problem. This leads the doctor down the path that this new thing has to be investigated to cover the doctor’s behind to avoid any type of malpractice accusation. One test leads to another test leads to another test… all to find out that it was nothing in the first place. There are probably many times where lives are saved with incidental findings on advanced imaging studies, but more times than not, they lead the doctor and patient on a “wild goose chase.” All of a sudden that lower back pain that you originally went in for has a cost of thousands of dollars AND you still have back pain AND you still have not received any treatment! This is a problem, a big problem with the U.S. healthcare system and things have to change. We have completely lost touch with personal health care and treating the patient’s whole person rather than abolishing symptoms with drugs.
· We are BIG spenders in the U.S.
· U.S. physicians are trained to do everything that might be possible to come to a diagnosis, rather than identify the minimum actions that are reasonable likely to produce the desired result.
· Fear of malpractice lawsuits creates defensive medicine. Malpractice suits only accounts for a fraction of healthcare costs and defensive medicine accounts for 20% of healthcare costs
· In the mid 1990’s, there was a study that compared the effectiveness of various forms of treatment for back pain. The study concluded that surgery (very expensive and very risky) was equally effective as manual medicine (physical therapy and chiropractic care – which is far less expensive and far less risky).
· Imaging accounts for 6-8% of total U.S. healthcare costs and many radiologists believe that 30% of imaging is inappropriate.
· There was a study performed in 1994 that MRI evaluations of the lower back were performed on 98 ASYMPTOMATIC individuals and 2/3 of the imaging came back with “abnormalities.” Can you say false positives?
· The U.S. has 26 MRI machines for every million people. At $2-3 million per machine, you do the math…
This is what I tell every single one of my patients:
“Unless there are significant RED FLAGS brought up on the initial visit or the subsequent 1-6 visits, there is no need for advanced imaging. I will always try 4-6 weeks of conservative care before thinking about ordering advanced imaging. Give your body the time it needs for healing and I will help you along the way to get relief without the use of drugs or surgery. ”
If you have someone in mind that has been dealing with a health-related issue and doesn’t know where to turn, please pass my information along as I will be more than happy to meet with them to discuss their health issues
