CDI Miami | Friday August 12, 2016

Do You Really Need That MRI?

Low back pain, headaches, heart palpitations; they could be minor, everyday health woes, or red flags that something serious is going on. Is it time to get an MRI?
With so many advances in medical technology at our fingertips in recent decades, doctors and patients have scurried to have images taken to rule out worst case scenarios.
The Choosing Wisely campaign was launched by the American Board of Internal Medicine Foundation about three years ago, said Dr. Richard Baron, president and CEO of the foundation. The goal behind it, he said, is to help physicians and patients make more informed decisions about medical interventions, based on medical evidence. In other words, only get that MRI or EKG, or pop that pill, if research has actually proven it’s likely to help in a case like yours.
“The idea is there are things we know get done a lot, but the evidence suggests we probably shouldn’t be doing them as much as we are doing them,” Baron told CBS News.
When the campaign first launched, there was some resistance, “It was counterintuitive to some professional societies and they said that some of their members may not like this because it is how they make their living,” Baron said. But it ended up causing quite a buzz, he added.
In a system where health care providers are being paid on a fee-for-service basis, more medical tests are going to be done than are needed, said Baron. “Some have just gotten into the habit of doing it and they think more is always better. And many patients think this, too,” Baron said.

 

The following are overused tests that should prompt serious discussion between doctors and patients. They include:

  • MRIs for headaches and low back pain
  • CMR, an imaging test for chest pain and cardiac screening
  • Whole body scans to screen for cancer
  • Some repeat colonoscopies
  • Certain mammograms, such as before elective breast surgery or after breast reconstruction
  • CT scan and MRI screening tests for brain aneurysms
  • Blood tests for miscarriage risk and urinary tract infections in older people

For neurology, Callaghan said, “MRIs for headaches and low back pain are overused. It’s one of the most-duplicated tests.”