The radiologist’s conundrum: benefits and costs of increasing CT capacity and utilization

Excerpt

Computed tomographic (CT) demand in the United States (US) shows little sign of abating. Radiology stakeholders continue to witness the delivery of an ever-increasing number of clinical indications for CT, driven mainly by better and faster machines combined with innovative scanning protocols and post-processing techniques. Indeed, CT utilization in the US has more than doubled in the last decade and is still growing at more than 5% annually, with some estimating that 60 million CT examinations are now performed annually in the US [1]. Advocates for this phenomenal growth claim that they are only addressing consumer demand, satisfying referring physician demands and delivering superior patient care. Opponents, on the other hand, particularly the third party payers, point to an unsustainable burden on their cost structure. Some also suggest there is an inherent conflict of interest within hospital organizations, opining that it is in their interest to scan as many patients as possible, in the hope of maximizing profit. Indeed, outpatient radiology services now offer US hospitals one of the most favorable rates of financial return and have become critical to many organization’s survival [2, 3]. Radiologists, too, are sometimes accused of becoming too greedy, particularly if they own or co-own the equipment, and their salaries are now some of the highest in the country. Finally, some point to the massive radiation burden to the US population, who worry there will be an epidemic of radiation-induced cancers in the near future [1]. …