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Another thing to fear in healthcare: Getting an Xray

I head to Chicago this weekend for the 4th Annual Lown Institute Conference.

The Lown Institute seeks to catalyze grassroots movements for transforming healthcare systems and improving the health of communities.

For those of you who want to be on the right side of the street of history, Dr. Bernard Lown, a cardiologist, activist, and winner of the Nobel Peace Prize founded the Lown Institute.

The part of Lown that I am involved with is the Right Care Alliance. We are a group of people interested in curbing overdiagnosis and overtreatment. We believe that if there was less medicalization of normal, less waste, more RightCare, then there would be more resources for all, less undertreatment and surely less inequity.

This week, and through the weekend, I will share posts that deal with Right Care.

Here is Right Care Alliance member, Dr. Jill Wruble, a radiologist at the VA Hospital in West Haven, Connecticut. She talks about the problem of Incidentalomas.

Know that getting on the healthcare train is easy. Jumping off is hard.


One reply on “Another thing to fear in healthcare: Getting an Xray”

As a radiologist at the end of his career, the problem of incidentalomas is dwarfed by the extensive high end ct imaging that occurs through the ER. This primarily affects people who get most of their medical care through the ER. So it falls disproportionately on the poor and uninsured and underinsured, affecting young women more than men. It is not unusual to see a twenty something patient with a past CT record that may include over 30 ct scans of the abdomen and pelvis and ct chests for exclusion of PE, none of which have been abnormal. These patients are accumulating tremendous radiation doses over time. We are also seeing indiscriminate imaging by ct of every body part for every minor complaint. Part of the problem is our own success in radiology departments of being too efficient for ER imaging. Why order a D dimer which may take 30 or 45 minutes to come back ( though it seems to me that the critical d dimer to be considered abnormal has been dropping over time that it’s virtually usrless) when you can get a CT chest in 5 to 10 minutes?

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