The quality of CT and MRI scans vary, and how old machines can affect the treatment course

Medical imaging is one of the largest drivers of health care spending.

In a recent NY Times piece, Gina Kolata points to the fact 20 to 50 percent of scans ordered are not necessary. Indeed, as health reformers like to point out vis-a-vis the Dartmouth Atlas study, more care isn’t necessarily better.

In fact, it can lead to worse outcomes, as these scans can point to findings that necessitate biopsies, or other invasive procedures, that can expose patients to additional medical risk.

A new problem, however, is coming to light. Apparently, scans performed on machines that are 10 years old are paid the same as those done on newer machines, often with significant differences in the result.

Regulating scans by forcing centers to be accredited isn’t likely to help, as “there is no consensus on objective measures to ensure quality,” and that, “there is still little assurance that scans will be appropriately ordered and interpreted or that a scanner will be up to date.”

So, in addition to the known variance in the delivery of care, we have the added fact that many imaging scans are done on machines that may be out-of-date. I’m not sure what patients can do about it, except to ask if the scans being ordered are being done on new machines.

Better still, patients can question whether the scans are really necessary in the first place, and perhaps, they can buy into the mindset that more tests do not always lead to better care.

We can only hope.