What’s wrong with this picture?
It’s time to get serious about the overconsumption of healthcare services
Are we the picture of health? Or does the image spell bad news? It’s a determination doctors can now make faster than ever.
We’re talking, of course, about medical imaging and the advancements the field has brought to the practice of medicine over the years. It’s truly a healthcare success story, given the myriad improvements in diagnoses and treatment thanks to revolutionary technologies.
At the same time, however, imaging represents a chronic malady in the healthcare delivery system and in our society in general: We consume too much of a good thing.
Just last week, Chicago again hosted the annual gathering of the Radiological Society of North America, one of the largest membership groups representing the medical imaging sector. The sprawling conference and technology expo drew nearly 60,000 attendees and some 700 vendors. The event always touts the latest advances and research in radiology.
This year’s meeting included a panel discussion that addressed safety issues in medical imaging, as well as the costly and potentially harmful problem of overutilization.
“Imaging procedures conducted for the wrong reasons contribute to unnecessary costs and radiation exposure to patients,” said William Hendee, a professor of radiology at the Medical College of Wisconsin, Milwaukee, and one of the session’s panelists, in a news release.
Serious overexposure to radiation as a result of imaging tests—typically because of human error—made headlines this year and prompted a rush to implement a variety of remediation measures. These were alarming incidents, procedures potentially resulting in more harm than good, which is antithetical to any definition of quality medical care. Even the best technology can quickly lose its luster if there isn’t a reasonable guarantee of patient safety.
Last week also brought a report in the journal Radiology on the use of CT scans in the nation’s emergency departments—findings that again raise questions about the overuse of imaging services.
Researchers using data from a Centers for Disease Control and Prevention national survey found a 500% increase in the number of ED visits that included the use of CT from 1995 to 2007—surging from 2.7 million to 16.2 million during that period. At the same time, the use of tests requiring higher doses of radiation rose at a faster rate than procedures requiring lower radiation levels.
While the report’s authors acknowledged that the study did not directly address the issue of medical appropriateness, “the increasing use of CT in the EDs throughout the United States raises the question of whether CT use rates are moving toward appropriate rates or have moved beyond them.”
While there’s no disputing the fact that advances in technology, along with innovations in pharma and other medical breakthroughs, can be credited with improving health and saving lives, what about the big picture? Recent studies continue to show that we’re still a country that spends much more per capita than other nations, yet we still end up several rungs lower when it comes to quality, safety, access and overall outcomes. It appears that state-of-the-art diagnostic tools can take us only so far.
As we’ve previously discussed at length on this page, the nation needs to make a much stronger commitment when it comes to getting the healthcare cost spiral under control. If we look at the long-term trends, it’s more like we’ve been fighting a healthcare cost cyclone. We continue to use too many healthcare services for all the wrong reasons.
It’s certainly not too early for providers and consumers to make a New Year’s resolution promising to take our healthcare dieting much more seriously.