Trend: Huge growth in use of CT scans troubles observers

I think that the Los Angeles Times story “CT scans can be better medicine for doctors than for patients” portrays an inaccurate picture of how physicians use computed tomography to care for their patients.

To begin with, the piece overstates the growth and utilization of CT. For example, the story uses GAO statistics to demonstrate an increase in CT scans, but the GAO's recent report on medical imaging did not account for the most recent data available. Had the GAO used the more current 2007 Medicare claims instead, its report would have actually shown a decrease in the growth of medical imaging services in recent years.

Next, the story presents biased information as fact. Insurance companies are wholly motivated to pay less for health care services, which includes limiting medical imaging scans. In fact, insurers have created a cottage industry, called Radiology Benefit Managers, with the sole purpose of refusing coverage for scans. By citing subjective and unverified insurance company-generated analysis of how many scans are "inappropriate," readers are presented with a skewed view about how and why physicians order scans.

Clearly, CT has grown as it's become integral to modern day medicine. From best practices to patient advocate guidelines, CT is a powerful tool for improving patient outcomes. But, the larger issue is ensuring patients have access to the right scan at the right time. In computed tomography this is even more important because of the radiation CT employs to generate what are often life-saving images.

That's why it is vital for payers -- both private and Medicare -- to ensure that healthcare decision making remains between the physician and patient. The recent Medicare bill is an important step in the right direction because it embraces both accreditation and appropriateness criteria, and it is approaches such as these that will ensure that each scan ordered is appropriate, effective and safe for patients.

Lastly, the article also claims that CT angiograms (CTA) are "less accurate" than traditional angiograms, but research has indicated otherwise. A recent study published in the Journal of the American College of Cardiology, for instance, found that CTA was 99 percent as effective in ruling out heart disease as the more expensive and invasive coronary angiography traditionally used by physicians. This CTA study is just one of many peer-reviewed data points demonstrating how medical imaging, and CT specifically, improves health outcomes and reduces overall costs.

Maureen Zilly
Medical Imaging & Technology Alliance