Word: scans
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Dates: during 2000-2009
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...just using plain films. Today, however, there's a good chance that after ordering up that plain film, the emergency doctor will send you down the hall for a second test - one that exposes you to many hundreds of times the radiation of a plain film: a CT scan. The radiation from a CT scan, or computed tomography, actually has been shown to cause cancer - quite a bit of it. A recent report, published in November in the New England Journal of Medicine suggests that the radiation from current CT-scan use - estimated at more than 62 million CT scans...
...first commercially available CT scanner in the early 1970s. CT was a huge plus: It could image so many things in the body that were difficult, painful or simply impossible to see otherwise - brain tumors, spine problems, problems in the liver or lung. Nevertheless, in the '90s, CT scans were largely upstaged by the vastly more complex - but radiation-free - MRI scan. Overall, few docs would disagree that the MRI is a better test. Except for being somewhat less sharp when looking at bone, MRI is clearly more sensitive and versatile. But CT scanning has made a huge comeback...
...least one reason for the overuse of CT is certainly financial. Major insurers still pay fairly well for the scans. While it's true that advanced technology has made CT machines better, faster and more affordable over the years, the only thing that's really different now versus five years ago is that more hospitals are going bankrupt - they need to be a lot keener at making money to survive. So, for starters, they're hiring doctors: The hospital pays them a salary while billing for the services they order or perform. (Doctors in private practice, unlike hospital-employed doctors...
...question is, can truly rational decisions be made regarding their use? The statistics are hard to calculate. It would take all the computers at the Mayo clinic to compare the real risk to your life of doing a CT scan in a given situation with that of not doing one. And if the doctor can't compute that risk, there's no real way that a second-guessing patient can. But you can, and should, be more than a little reticent to have a CT scan unless it's absolutely needed...
...absolutely necessary with head trauma and acute abdominal conditions. Minutes can make a difference in these cases - if, say, there's bleeding around your brain and you can't get an MRI - and the speed of a CT scan makes it worth the risk. But in most other situations, it's wise to let the doctor convince you it's worth it, before consenting to the scan. Ask your doctor what decisions he or she plans to make with the information from the scan. What other tests could yield the same information? Would an MRI be better...