"A single CT scan of the chest is equal to about 350 standard chest X-rays, so two scans are twice that amount. "
Fear-inspiring propaganda to allow the CMS to put much stricter rules in place on reimbursing CAT and PET scans.
I want people to get the scans they need, but 80% double scanning seems too high. If medically necessary - then fine with me. A local hospital had a Cesarian birth rate several times higher than the average because it was performing them on women receiving Medi-cal at excessive levels(whatever the public assistance name is given to the program for impoverished women). When it was exposed, along with other treatment extremes, the hospital came under review and eventually changed hands. But Cesarian’s are still given at the new hospital - but now only when advisable.
In my opinion, the whole vicious circle of blame between tort-claimants, health care administrations, and insurance companies has become greedy.
An extra cat scan pays for the time waiting for the government to pay up and reduces the risks of malpractice.
Think about it...
Somebody’s gotta pay for those expensive machines....might as well be the taxpayer!
Try x-rays are over used too. Tear a rotator cuff, you have to have an x ray which shows nothing but bone. Then a shot in the shoulder, because the pain doesn’t go away, then you are sent for an MRI to determine what the damage really is, when they knew all along it was more than likely a rotator cuff tear, which will not show up on a x-ray. MRI should have been done first and saved the cost of the x-rays.
I am not, and would not ever try to justify bad medicine and overuse of testing. That said, I would like to know the reasons and circumstances in which this occurred, and what reasons the physicians involved gave.
Generally, a non-radiologist orders the test, and a radiologist evaluates the need, indication, and whether or not the test ordered will answer the question being asked. It's illegal for physicians to receive kick-backs for referrals, including referrals for testing or imaging. So, if the radiologist was a greedy and unethical person, the referring physician would still generally have to OK the additional imaging, and would have no reason to do so financially.
What I wonder is whether or not there are other imaging modalities readily available at the institutions that are doing multiple CT scans. If MRI is not readily available, perhaps the impetus to do CT scans with and without I.V. contrast is higher.
The above aside, the rates for multi-CT studies in some of these institutions seems very excessive, and the reasons for this should be made clear to rule out medicare abuse.
I will, however, reserve judgment until more details are available.
Second to make sure changes/procedures/equipment are in place
More smoke from the 0Bammy short hose!
Hospitals still using the pre-/post protocol routinely aren't doing it to get rich. They either still believe the enhancement characteristics are important, don't have ready access to more advanced technologies, or they are just behind the times and have not updated their scanning protocols.
Another point is that while it is generally true that chest CT performed both without and with IV contrast does give twice the radiation dose, it by no means generates twice the money, as seems to be the implication by some. It pays maybe 20% more, but it requires more time, more staff, more hardware wear-and-tear, IV placement, more risk, more professional time and of course the contrast material itself.
Don't confuse this article's lightly informed rant with the rampant overutiliztion of diagnostic testing which stems from the practice of defensive medicine, increasing patient expectations and self referral.