This morning I went for my annual mammogram. It’s not something I generally look forward to. In fact, I mildly dread it.
In my personal experience, mammograms have ranged from quite uncomfortable to downright painful. And then there’s the general unpleasantness of standing topless in a cold room. The first time I had this screening imaging study done, the plate pressed so hard into my sternum that I was almost in …
When you get frustrated with my interpreting a chest x-ray as “atelectasis at the right lung base, pneumonia can’t be excluded,” trust me, I don’t enjoy it. But when you ask me to rule out pneumonia you leave me no choice but to tell you that pneumonia can’t be ruled out.
To rule out a disease a test must have a sensitivity of 100%, meaning there should be no false negatives. …
I hear it over and over again.
From a nurse, “She can’t have providine prep, she has a shellfish allergy.”
From the patient, “I can’t have the contrast because I’m allergic to iodine and shellfish.”
The list of allergies placed in the chart by a doctor, “Radiocontrast. Iodine. Shellfish.”
It’s not the fault of the patients who are typically repeating the medical misinformation they have been given. However, the medical professionals who perpetuate the …
I have been actively engaged in the clinical practice of radiation oncology for the last 40 years, and over the last 10 years have been asked to participate as a radiation oncology expert witness in a variety of medical malpractice cases. Radiation therapy, together with surgery and chemotherapy, is one of the major cancer treatment methods. It is estimated that 50-60% of all cancer patients seen in the USA receive treatment with …
My kids were at the dentist this weekend for their routine cleaning and check ups (yes, Saturday hours!) when the hygienist mentioned x-rays. I smiled and mentioned I’d rather discuss the need with the dentist after his exam. This isn’t a dental x-ray thing, this is what I do for every test that involves ionizing radiation.
My son, Oliver, has had more radiation than most people will have. Ever. In fact, …
Radiologists care about their patients, even though most diagnostic radiologists don’t meet and greet their patients the same way direct-care clinicians do.
Some people have the erroneous perspective that radiologists and pathologists don’t care about the welfare of their patients. It is possible for us to understand that view if we look at radiologists and pathologists as isolated workers who work …
The use of ultrasound has had a large impact on health care in resource poor countries. This article details some of the research that has been done overseas to look at the impact on bedside ultrasound by caregivers to deliver more appropriate care for injured and ill patients in Africa, Asia and Mexico.
Using an ultrasound to determine how dehydrated a child …
The United States is higher in its use of computed tomography (CT) scans than any other industrialized country. There were about 3 million scans done in the U.S. in 1980. By 2007 that number had risen to 70 million. A number of articles published in medical journals over the past few years have reported that excess radiation delivered by these scans will …
It always has broken my heart to see a person bankrupted by the costs of their healthcare. I remember my outrage when I first learned the only people who pay full price for their medical procedures are the ones paying cash. Insurance companies use their market muscle and patient volumes to negotiate discounts for their patients that have always been unavailable to the uninsured, individual healthcare consumer.
If you have been …
I’ve received several inquiries from women living in various regions of the country, asking how they should choose where to go for their mammogram, and if it really matters. I cannot emphasize this enough: It matters! Here are a few tips to help your search:
The most basic requirement is whether a facility is accredited under the MQSA (Mammography Quality Standards Act). The accrediting body for most states is the ACR …
A tug-of-war is going on in medicine right now between the past and the future. The present is confused and very unsure of itself.
Though I could be writing about health care in the U.S and the looming Supreme Court battle over the new health care law, I’m actually raising a much more intimate issue: Whether your doctor touches (examines) you or not.
Many pundits have weighed in on whether the …
In a widely circulated CNN article, many radiologists have been found to cheat on their board exams: “Doctors around the country taking an exam to become board certified in radiology have cheated by memorizing test questions, creating sophisticated banks of what are known as ‘recalls,’ … The recall exams are meticulously compiled by radiology residents, who write down the questions …
Radiology is the cornerstone of any hospital. An efficient, high-quality, well-run radiology department increases patient satisfaction as a result of its ability to improve patient care. Over time, a well-run radiology department adds significant patient volumes to the hospital, which, of course, favorably enhances the hospital’s bottom line. Regardless of whether the hospital is not-for-profit or for-profit, a smooth-sailing radiology department vastly increases the profitability of the hospital. The …
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Federal law generally prohibits physicians from referring their own patients to a diagnostic facility in which they have an ownership issue – a practice called “self-referral” – unless the facility is located in their own practice.
This exemption exists to allow patients with access to a laboratory test, x-ray, or other imaging test at the same time and place as when patients are seeing their physician for an office visit. Less …
Radiology has transformed into a core subject of medicine, since imaging procedures are getting more and more crucial to clinical decisions. Whether these developments, be it over-diagnosing or unnecessary radiation on the one hand or a more detailed and enhanced way of diagnostics on the other, are …
With healthcare reform dominating the news recently, MRI and other imaging tests have become the (misguided) targets of many critics.
Although MRI makes up only one-half of one percent of total healthcare expenditures, it is easy to demonize since the average healthcare consumer can understand imaging much easier than the diagnosis related groups (DRGs), hospital facility fees or insurance contracts that have a much greater impact on the cost of health …
by Michael Kirsch, MD
Does anyone out there know why President Obama underwent a virtual ‘colonscopy’ (VC) instead of a conventional colonoscopy earlier this year?
In my gastroenterology practice, we do not offer colon cancer screening to 48-year-old individuals, unless special risk factors are present. Of course, maintaining the president’s health is in the national interest, so I understand why professional screening guidelines might not apply to him. For …
I am often asked how we get the prices for the radiology imaging tests, such as MRI’s and mammograms, or ultrasounds. Most people assume that my day job as a doc gives me some sort of special access to this info. But that’s just not the case. Anyone can find out testing prices.
However, over the last year, those of us working at LesliesList.org have gotten more experienced and better at …
During residency, there was always a case of misdiagnosed chest pain to discuss in conference. Incorrectly sending a patient home and missing the diagnosis of cardiac chest pain was an infrequent, but repetitively observed, phenomenon.
So as to tread carefully with words, it is sufficient to say that even now, chest pain triage remains a vexing problem.
Chest pain diagnosis is like appendicitis; there are always small numbers of unusual cases in …
It’s commonly thought that health care in the United States is heavily dependent on diagnostic testing.
But how do we compare with the rest of the world? Perhaps these graphs, courtesy of the New York Times can provide a stark illustration.
Here’s the data regarding CT scans, showing the number of tests per 1,000 people. Guess which country’s on top:
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