Docs exploit MRIs for quick cash

Auto mechanics are notorious for ripping people off with parts and services they don't need.

You don't expect that kind of behavior from your doctor, but maybe you should -- because too many docs will pad the bill with every test they can think of, whether you need them or not.

And that's especially true when it comes to expensive diagnostic imaging, like MRIs.

Two new studies show how docs are way too quick to order MRIs when patients don't need them -- and one of them shows how that's especially true of docs who own their own MRI machines or have a financial stake in an imaging center.

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More scans, more money
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Of course, docs would never admit they order MRIs for no reason, let alone extra cash. So rather than rely on opinions, researchers looked at outcomes -- specifically, how many lumbar MRIs came back negative versus how many revealed actual problems.

In an honest world, there would be a similar number of hits and misses regardless of who owned the machines. In the world we live in, on the other hand, docs who didn't own the machine had more hits... and docs who did had more misses.

Of 250 MRIs ordered by docs who didn't own the machine, 193 found real problems versus 57 that came back normal. Docs who owned their machines, on the other hand, were almost twice as likely to order images of a patient who had nothing wrong -- with 106 of 250 MRIs from them coming back normal.

That's a sure sign they were ordering tests simply to order the test -- and pocket the cash, which for lumbar images generally cost between $1,500 and $2,000.

But it's not just docs who own the machines who are quick to order the images -- some doctors seem to order them almost out of habit... even if they don't make a difference in outcomes.

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MRIs when you don't need them
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Steroid injections are commonly given to patients who suffer from low back pain, despite the fact that they often do very little for the condition.

But in addition to being ineffective, the injections are often given only after the patient submits to an expensive MRI exam. And, as it turns out, that MRI makes almost no difference in the outcome.

Researchers gave MRIs to 132 patients suffering from a form of back pain called sciatica, the infamous "pinched" nerve at the bottom of the spine. But while they let half of the doctors see those images, they held the other half back to see what would happen.

And here's what happened: Nothing.

Doctors made virtually the same treatment decisions whether they saw the image or not -- and three months later, there was almost no difference in outcomes: 35 percent of the patients whose doctors didn't see the MRIs showed improvements, versus 41 percent of those who did see the image.

And in both cases, that means roughly 60 percent or more experienced little to no improvement. Like I said, it's not a great treatment in the first place.

I won't say no one ever needs an MRI. Obviously, the scans can provide docs with critical information when they need it most.

But if you've been told to get one for a common condition, consider a second opinion before you consider shelling out big bucks for that MRI.

On a mission for your health,
Ed Martin
Editor, House Calls