Trend: Huge growth in use of CT scans troubles observers

September 9, 2008 — 8:45am ET | By Anne Zieger

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IMB Medical Information Division

At one point, CT scans were used now and then, when doctors had few alternatives. Today, however, CT scans have become a standard method for diagnosing ordinary problems like kidney stones, frequent headaches or appendicitis. Given this pattern, the volume of CT scans ordered has grown dramatically, hitting 68.7 million scans in 2007. That's three times more than the number ordered in 1995, according to IMB Medical Information Division. Meanwhile, the number of CT scans in the U.S. has climbed to 24,000, almost three times the number available in most industrialized countries, since the first was purchased here in 1993.

Why has the growth in CT use been so steep? Well, for one thing, their price has fallen. Though 70 percent of CT scanners are still found in hospitals, more private practices and independent imaging centers have managed to buy their own machines. They're urged along by companies like Siemens, a CT scan maker, which tells potential buyers that two scans per day can generate enough revenue to cover the machine's cost and operation over a five year period. More attractively, 10 scans executed daily can generate more than $400,000 in annual profits.

With the volume of CT scans growing so high, they've gotten a lot more attention from industry watchers. One party worried about the pattern is federal regulators, who say they're concerned about the potential for a conflict of interest between cardiologists, orthopedic surgeons and other specialists who provide their own scans and radiologists, who rely on referrals. To address this issue, CMS has slashed Medicare payments for CTs and other scans, though it hasn't made any major moves yet to block doctors from self-referring scanning business. Meanwhile, clinicians say that they worry that the scans can expose patients to excessive radiation, while exposing patients to tests that might have been avoided or replaced by technologies that don't pose this risk.

To learn more about this issue:
- read this Kaiser Daily Health Policy Report item

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