The Uncritical Use of High-Tech Medical Imaging

Dr. Bruce Hillman and Jeff Goldsmith argue that the root cause of unnecessary use of imaging may be the style and content of clinical education. Minimizing unnecessary imaging will require a change in mindset among physicians. The use of advanced imaging methods such as computed tomography (CT), magnetic resonance imaging (MRI), and positron-emission tomography (PET) has made diagnosis more accurate and less invasive for nearly all organ systems. Unfortunately, as the use of imaging has rapidly increased, imaging costs have grown as well. Indeed, until recently, these costs were the fastest-growing physician-directed expenditures in the Medicare program, far outstripping general medical inflation. 1 , 2 Such dramatic growth has placed imaging in the policy spotlight. There is broad agreement that an unknown but substantial fraction of imaging examinations are unnecessary and do not positively contribute to patient care. . . .