Use Of Medical Scans In Patients Who Experience Pain Might Prompt Unnecessary Increase In Health Care Costs

Main Category: MRI / PET / Ultrasound
Also Included In: Pain / Anesthetics
Article Date: 10 Dec 2008 - 3:00 PDT

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The New York Times on Tuesday, as part of an occasional series titled "The Evidence Gap," examined how medical scans, which have become "more sensitive and easily available than ever," are "increasingly finding abnormalities that may not be the cause of the problem for which they are blamed."

According to the Times, the "expensive" medical scans have become part of "an irresistible feedback loop," in which "patients who are in pain often demand scans hoping to find out what is wrong, doctors are tempted to offer scans to those patients, and then, once a scan is done, it is common for doctors and patients to assume that any abnormalities found are the reason for the pain." Patients often ask for treatment with medication and surgery when medical scans find abnormalities -- which increases health care costs -- although "in many cases, it is just not known whether what is seen on a scan is the cause of the pain," the Times reports.

David Felson, a professor of medicine and epidemiology at Boston University Medical School, said, "Every time we get a new technology that provides insights into structures we didn't encounter before, we end up saying, 'Oh, my God, look at all those abnormalities.' They might be dangerous," adding, "Some are, some aren't, but it ends up leading to a lot of care that's unnecessary."

The Times profiled Cheryl Weinstein, whose knee pain prompted her to have an MRI scan that found torn cartilage. She had surgery to correct the torn cartilage, but later physicians found that arthritis had caused her pain (Kolata, New York Times, 12/9).

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