Posted on 06/28/2008 8:09:11 PM PDT by neverdem
A group of cardiologists recently had a proposition for Dr. Andrew Rosenblatt, who runs a busy heart clinic in San Francisco: Would he join them in buying a CT scanner, a $1 million machine that produces detailed images of the heart?
The scanner would give Dr. Rosenblatt a new way to look inside patients’ arteries, enable his clinic to market itself as having the latest medical technology and provide extra revenue.
Although tempted, Dr. Rosenblatt was reluctant. CT scans, which are typically billed at $500 to $1,500, have never been proved in large medical studies to be better than older or cheaper tests. And they expose patients to large doses of radiation, equivalent to at least several hundred X-rays, creating a small but real cancer risk.
Dr. Rosenblatt worried that he and other doctors in his clinic would feel pressure to give scans to people who might not need them in order to pay for the equipment, which uses a series of X-rays to produce a composite picture of a beating heart.
“If you have ownership of the machine,” he later recalled, “you’re going to want to utilize the machine.” He said no to the offer.
And yet, more than 1,000 other cardiologists and hospitals have installed CT scanners like the one Dr. Rosenblatt turned down. Many are promoting heart scans to patients with radio, Internet and newspaper ads. Time magazine and Oprah Winfrey have also extolled the scans, which were given to more than 150,000 people in this country last year at a cost exceeding $100 million. Their use is expected to soar through the next decade. But there is scant evidence that the scans benefit most patients.
Increasing use of the scans, formally known as CT angiograms, is part of a much larger trend in American medicine. A..
(Excerpt) Read more at nytimes.com ...
and there is also the risk of reaction to the dye that is used to do the scans.
The New York Times is excerpt/link only. We will have to remove your response in #1.
If the doc decides not to order the CT, and there is a bad outcome, what then? Who gets blamed? Who’ll listen to reason?
Self ping
I can’t have MRIs due to metal lodged in my body so CT scans are my next best bet. Thankfully this technology is available.
Why the angst that an owner of a commercial machine may want to realize a profit from it?
That risk becomes really sizeable if you have kidney problems.
Because it is pushing up the cost of insurance and Medicare without any proven benefit yet. Have you read the story?
I had a heart CT a couple of years ago. Paid for it out of pocket. How did that private exchange help drive up costs for any government largesse program?
The problem isn’t private enterprise with an expensive precision diagnostic machine. It’s the government making people think they have a right to use said machine at not personal cost that’s the problem.
I say let them buy the machine and make all the money they can with it.
I read the article. ( And boy have I read a lot in this area lately )It is scary how the Medicare people were pushed into paying for this without clear cut requirements for doing the test. This has gone too far.
there are definite risks to this test and the thought of repetitive tests year after year can produce such a downside in medical care. And once the train has left the station on approval doctors see this as an extra profit center. ( ok, not all doctors ). this will drive up the cost of tax funded medical care.
there are specific situations where this test is invaluable, such as the ER.
I just had a thallium stress test done, and it covers quite a lot of information. then with the CT and there is some plaque...now what? We can’t determine what the significance of the findings are ( unless the blockage is so high that a stress test would have picked it up.),,,now do you do uneeded invasive proceedures?
there are very sure fire “bullets” in medicine..even aspirin has vagueness.
I agree that people should not think they have the right to have government pay for everything, but contest the wide use ( the oeprative word , wide ) of this test without medical necessity.See my post # 10.
Waiting to hear from Glenn.
Because hospital administrators will pressure doctors to unnecessarily use the new CAT scan to recover its cost, exposing patients to potentially dangerous amounts of radiation. Have you read the story?
My wife reacts to the “contrast.”
Link to graphic with examples of patients and various tests
(Oversize)Graphic Spending Far More on Health Care
Proposed Decision Memo for Computed Tomographic Angiography (CAG-00385N)
The Response From Several Medical Societies (January 2008) (PDF)
Decision Memo for Computed Tomographic Angiography (CAG-00385N)
http://www.nytimes.com/2008/06/29/business/29scan.html?_r=1&hp&oref=slogin
The last link is to the regular webpage if you want to see the video and pics.
Mandatory In-Car Breathalyzers Coming?
FReepmail me if you want on or off my health and science ping list.
I guess it didn't. Of course, your experience is without meaning for the 98% of the population who either will submit an insurance claim or not get the procedure at all.
I posted the story and a whole lot of stuff in comment# 1, which I had to repost. I think your looking for someone else.
I am printing most of these for my mom. Thanks.
The problem comes if I am the cardiologist and I also own the CT Scanner. That gives me a monetary incentive to order a CT on everybody that walks through the door whether they need one or not.
However, if XYZ Imaging owns the CT and I have no financial stake in it, XYZ Imaging makes the profit and my income is not increased by ordering unnecessary CT's.
Such ventures were a big conflict of interest problem about 15 years ago until the Feds started cracking down on them.
Canadians are coming across the border in droves to use our health care system.
Some high deductible and Health Savings Account plans have been performing pooring on rate increases lately. I was wondering why, but there are hints that those who sign up for these plans may be using up their savings, and deductibles, on procedures like this.
After that MSNBC guy though, I find it hard to blame folks
for wanting the best care.
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