0fr
5 hours ago
I'm a doctor. Here's why I wouldn't get a full-body MRI scan
15 pointsposted 5 hours ago
by bookofjoe6 Comments
bookofjoe
5 hours ago
FireBeyond
4 hours ago
I feel like imaging and physicians really amped up on pushing this over the last decade or two. Most of the big DI companies (GE, Philips, Siemens) had very friendly financing targeted heavily at physicians. They had "matching" services ("Find other providers in your area who'd also like to own a DI facility"). They'd help with consultants to facilitate getting your Certificate of Need (i.e. how not to piss off the other facilities in your area who get to say whether or not they'd reduce their investment in serving the area if you open up).
And the not unsurprising conclusion of all this? Physicians who own a DI facility or stake in one (and realize this doesn't have to be just radiologists, but any physician) refer their patients to imaging at rates far above expectations.
But now, line must go up, so we're doing this "scan your whole body and let's see what we can do to give you a touch-up", and ever-so-helpfully we have a whole network of providers lined up for referrals (that's if we don't just handle things in-house). I will be similarly unsurprised if many of the outcomes from this raft of scanning are procedures that are medically unnecessary.
nomel
3 hours ago
> I will be similarly unsurprised if many of the outcomes from this raft of scanning are procedures that are medically unnecessary.
I have trouble comprehending this perspective. The point of defect detection is detecting defects. The IDEAL outcome is that nothing shows up. That's not a failure of the test! in this case, the next desired outcome is that something caught can be addressed, so your life isn't terminated early.
Is it worth doing? That depends on the circumstances, of course. If you have high risk genetics or exposure, and you have some strange symptoms, many people would gladly fork over money for something that effects the remainder of their lives. If you're just doing it because you're paranoid, maybe once every 10 years is reasonable, especially in upper ages, if you can afford it.
FireBeyond
2 hours ago
My thoughts there are that there are a couple of factors at play - false positives, which might lead to interventions, even exploratory, that are not zero-risk. Even without risk, not zero-cost. And as such you end up with "you had no symptoms or concerns about condition X until you had this not-recommended MRI, and then treatment was ordered about condition X that was actually a false positive". Insurance doesn't view full body MRIs as medically necessary preventative screenings and this is generally accurate (though I'm also not naive enough to believe that a non-insignificant part of their objection might be cost).
nomel
an hour ago
> false positives, which might lead to interventions, even exploratory, that are not zero-risk
Do you have an example in mind for this? Non-zero risk interventions are pretty rare if only one signal is present. If that signal was deemed worthy to result in a non-zero risk intervention, then you're completely ignoring the risk associated with ignoring that signal, which is what justified that non-zero intervention!
> Insurance doesn't view
This suggests a very fundamental misunderstanding of healthcare, treatments, and what insurance companies exist for. They are not about health policy or well being. They are about derisking profit loss. Their recommendations are to reduce cost, and nothing more. Doctors understand this, and will tell you this very plainly, as you fight to get required treatments covered.