There are interesting cases, where doctors prescribe stuff they get no valuable information from.
I had this in US. Shoulder pain, that was diagnosed via an XRay... But the doctor decided he wanted an MRI. That's no unusual, but unnecessary in my case. Got charged extra $500 for the pleasure. Thankfully I was on an HDHP, so the HSA savings got hit.
>I had this in US. Shoulder pain, that was diagnosed via an XRay... But the doctor decided he wanted an MRI.
Xray is mainly for bone problems. MRI shows well soft tissue. In medicine, if something you suspect even it has a low probability and the diagnostics are not invasive, it is better to check than to miss and regret later. Why are you so sure that MRI was not necessary in your case?
I saw my other doctor, slightly more decorated orthopaedic surgeon, that literally told me that I was blasted with XRay for no reason or my MRI wasn't necessary.
I have an irritating bone spur in the shoulder, that's the only problem.
The doctor ordered both Xray and MRI at the same time, while there was literally no need for one of them.
You are reasoning backwards. Had the cause been something besides a bone spur, such as a tumor or vascular problem, the X-ray might have missed it. Some things like soft tissue calcification don't show up as well on MRI as on a plain X-ray film which is a really low radiation dose these days anyways. Go read up on the terms sensitivity and specificity.
That’s not an unreasonable charge for an MRI and I’d argue that you got off quite lightly. You can’t diagnose many of the potential problems shoulders have from an x-ray but a good clinical examination will catch many of them, with an MRI for confirmation. Labral tears would be an example of this.
For a second I read your comment as liberal tears, and had to do a double-take. :)
Speaking to the 500$ charge, are you saying that is a typical cost around the world for a MRI? Is there something about the machine's cost that justifies this or are you just saying that a 500$ charge is typical in the american system?
That’s impressive. The purchase price and running cost are high. Then there are expensive labour costs (doctor, probably 2x techs and admin/reception staff. Often a nurse is around for more complex procedure too). Peripheral equipment isn’t cheap, with defib, contract injectors, RIS/PACS, reporting stations etc.
Scans are slow relative to CT and x-ray so I have no idea how they make that work. Did you pay the whole bill?
I am an MR tech.
I’m not sure you are correct in that - MRI scanners are expensive to run as they are rarely as low priced as you are suggesting. See link below which is a little old but gives a spread of prices. Note that the prices cited i this thread is less than half the US average.
Another factor that is relatively rarely discussed is the quality. You can do a fast scan or a good scan. That’s inherent in how MRI works.
A good gynaecological, cardiac or liver scan takes about 45mins, and there isn’t much you can do to improve on that as you are limited by metabolic activity (eg liver or heart contast wash-in and wash-out). If corners are cut here diagnosic quality will be reduced.
I regularly see scans that are of such poor quality that they are initially mistaken for the survey scans/scouts that we use to localise the patient in the bore. They are generally from places that you would intuitively avoid for healthcare, but not always.
That negative MRI result can be just as informative as a positive one. Maybe your XRay gave the doc only 80% confidence in the diagnosis, and the MRI was to rule out a larger issue. Like an engineer, doctors work deductively to rule out potential diagnoses, so all that is left is the correct one. Inductive logic brings in subconscious bias and assumptions.
I had this in US. Shoulder pain, that was diagnosed via an XRay... But the doctor decided he wanted an MRI. That's no unusual, but unnecessary in my case. Got charged extra $500 for the pleasure. Thankfully I was on an HDHP, so the HSA savings got hit.