Imaging and Health Care Costs

Indeed, his twelve-year old opinion has now been validated by a host of studies saying that the growth of high tech medical imaging, which was just beginning when he died, has contributed to high health care costs not only because it is expensive itself, but because it leads to significant instances of over treatment that are difficult to back away from although costly and even dangerous. That's why the Prevention Task Force made it's recommendations about mammograms for women 40-50, and why the recommendations were so loudly decried.

In my own case, my husband gave me a mammogram and a spine X-ray when I was just past 50 (I had been in a car accident), and when I got dressed, he asked me to come into his office, where he had my films on a light wall (yes, these were the days of films). He sounded so worried that I thought he had found breast cancer. But no, he looked away my chest to my spine, and said "you have the worst degenerative disc disease I have seen in a long time!"

I said, "but nothing hurts," to which he replied,"it will." And then I asked what to do when it began to hurt, and he told me that if I could stand the pain it would fuse by itself.

It's a good thing I asked, because a couple of years later,  he died of cancer, probably precipitated by too much exposure to radiation during his career, when the machines were less carefully calibrated. And one morning I couldn't stand up straight when I got out of bed, my back hurt so bad.

After a week I went to a neurosurgeon, a very famous one. I was in such pain that I was laying on the floor of his office. He came in to give me the results of the MRI he had made me have. "You will need a spinal fusion," he told me, "or you will be in a wheelchair or lose bowel and bladder control." I was scared to death.  Gerry was dead, and this guy was one of the top neuros in the nation. But I remembered what Gerry said. "Don't let anybody operate on your back. Back surgeries don't work." Too bad I had weakened and said "yes" to the MRI.

I left the office in a panic, but fortunately found my way through a trainer to a yoga studio. And I lived happily ever after for the next fifteen years. No surgery, no drugs, no back pain, no wheelchair, no incontinence. Along the way, my friends have had botched back surgeries, back surgeries from which they got nearly fatal infections, and surgeries that worked for a few years and then led to more surgeries.

I'm not saying no one should have an MRI, or no one should have surgery. But doctors now rely on high tech imaging where they used to rely on many other things: last week I went to a doctor whose apprentice couldn't even listen through a stethoscope to my heart and lungs.  When that guy gets into practice, he will cover his inexperience by sending me for X-rays and cardiograms I may not need, but that will cost Medicare and make his job easier till he learns to listen.