Comments on: The quality of CT and MRI scans vary, and how old machines can affect the treatment course http://www.kevinmd.com/blog/2009/03/quality-of-ct-and-mri-scans-vary-and.html medical blog Sun, 22 Nov 2009 07:50:13 -0500 http://wordpress.org/?v=2.8.4 hourly 1 By: Anonymous http://www.kevinmd.com/blog/2009/03/quality-of-ct-and-mri-scans-vary-and.html/comment-page-1#comment-90159 Anonymous Mon, 09 Mar 2009 01:19:00 +0000 http://clients.emmense.com/kevinmd/2009/03/the-quality-of-ct-and-mri-scans-vary-and-how-old-machines-can-affect-the-treatment-course.html#comment-90159 Somewhat related: Patient gets unneeded scan (like for a new isolated sixth nerve palsy in an older hypertensive), then refers. Rarely would you be wrong to wait 6weeks without a scan. <br/>OR, a scan is ordered, but the area in question is not adequately imaged because the ordering Dr or the technologist or radiologist did not know better or think of it. Very common in my practice. Somewhat related: Patient gets unneeded scan (like for a new isolated sixth nerve palsy in an older hypertensive), then refers. Rarely would you be wrong to wait 6weeks without a scan.
OR, a scan is ordered, but the area in question is not adequately imaged because the ordering Dr or the technologist or radiologist did not know better or think of it. Very common in my practice.

]]> By: Anonymous http://www.kevinmd.com/blog/2009/03/quality-of-ct-and-mri-scans-vary-and.html/comment-page-1#comment-90146 Anonymous Sun, 08 Mar 2009 03:49:00 +0000 http://clients.emmense.com/kevinmd/2009/03/the-quality-of-ct-and-mri-scans-vary-and-how-old-machines-can-affect-the-treatment-course.html#comment-90146 This only touches on the problem with scans. My pediatric hospital is a level 1 trauma center, so we get transfers from outside facilities all day. But a quarter of the time patients come without the actual scan, just a report. Unless it's a slow day (rarely), we have to repeat the scan because it takes hours (sometimes days) to get the scan sent from outside. Insurance will not cover a second scan so shortly, so we swallow the cost. And sometimes the quality of the scan is crap, so we have to repeat the scan then too. Or the disk just doesn't open on our computers (maybe they saved it in Mac OS5). There should be a mechanism that if the outside facility does not provide adequate imaging, we get paid for the scan we have to do and they should take the shaft. We don't like to irradiate kids twice, but too many facilities (and it's usually the same ones) force the situation because we have nothing useful to work with. This only touches on the problem with scans. My pediatric hospital is a level 1 trauma center, so we get transfers from outside facilities all day. But a quarter of the time patients come without the actual scan, just a report. Unless it’s a slow day (rarely), we have to repeat the scan because it takes hours (sometimes days) to get the scan sent from outside. Insurance will not cover a second scan so shortly, so we swallow the cost. And sometimes the quality of the scan is crap, so we have to repeat the scan then too. Or the disk just doesn’t open on our computers (maybe they saved it in Mac OS5). There should be a mechanism that if the outside facility does not provide adequate imaging, we get paid for the scan we have to do and they should take the shaft. We don’t like to irradiate kids twice, but too many facilities (and it’s usually the same ones) force the situation because we have nothing useful to work with.

]]> By: Doc99 http://www.kevinmd.com/blog/2009/03/quality-of-ct-and-mri-scans-vary-and.html/comment-page-1#comment-90126 Doc99 Sat, 07 Mar 2009 12:44:00 +0000 http://clients.emmense.com/kevinmd/2009/03/the-quality-of-ct-and-mri-scans-vary-and-how-old-machines-can-affect-the-treatment-course.html#comment-90126 Once again, the Devil's in the details. While aging equipment is a problem, marked declines in reimbursement plus tightening of the credit market force centers with a Hobson's choice - close or delay new purchases and soldier on. Without funding sources, demands for new equipment are unrealistic.<br/><br/>As far as unnecessary testing, there's no argument this occurs. However, the problem will continue until the powers that be are ready to face the reality of defensive medicine and enact meaningful reform to rein in the voracious trial bar. Once again, the Devil’s in the details. While aging equipment is a problem, marked declines in reimbursement plus tightening of the credit market force centers with a Hobson’s choice – close or delay new purchases and soldier on. Without funding sources, demands for new equipment are unrealistic.

As far as unnecessary testing, there’s no argument this occurs. However, the problem will continue until the powers that be are ready to face the reality of defensive medicine and enact meaningful reform to rein in the voracious trial bar.

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