Brain imaging is a huge business. The benefits of this research field are vast, the costs are high and most important of all: everybody wants in.
Wasteful behavior of X-rays
This (dutch) article (May 2013) sums up the problem: we’re getting scanned too much. The main problem is the high number of CT scans. Because of this Belgium ranks very high in ionizing radiation (2 millisievert/capita), which isn’t a very healthy situation.
Worse still a lot of these examinations weren’t necessary in the first place. 25 % of these examinations were done in questionable circumstances. Instead they should have been replaced by MRI scans or scrapped altogether.
The Belgian Health Care Knowledge Centre already reported this problem in a paper released in 2009. It warned policy makers that regulation and financing of CT and NMR can’t be allowed to lead to an increase in CT scans for other than medical reasons.
Quote: Belgian Health Care Knowledge Centre
De reglementering en financiering van NMR en CT mogen niet van die aard zijn dat het uitvoeren van CT wordt gestimuleerd in plaats van NMR voor andere dan medische redenen, zoals op dit moment soms het geval lijkt.
MRI shortage
The main problem is that there is a shortage in MRI scanners, according to Martijn Grietens (head of radiology Ziekenhuis Oost-Limburg). This isn’t helped by the significant cost to buy one. An MRI scanner is three times as expensive as a CT scanner: 1,2 million Euro. This leads to long waiting lists ranging from 22 weeks up to 5 months.
A second problem is that the number of MRI units in Belgium is restricted by the government. A hospital has to meet the accreditation criteria In order to obtain approval, after which it gets funds to operate the MRI unit. The MRI scanner and its usage are then reimbursed by the National Institute for Health and Disability Insurance (NIHDI) (source) . Without these funds the cost for buying and running a MRI scanner is too high for a hospital to carry.
Every patient needs a total body scan
But it doesn’t stop there. Patients have become more and more demanding. We no longer wait for the doctor to tell us that we need to have a scan done, we ask/demand it. This has opened up a whole new market.
A number of companies have started selling health care. They don’t act on medical judgement, but let the “customer” decide which checkups and scans they need. Now everyone, who’s willing to pay the price, can get a his whole body examined on simply request.
One of the companies that specializes in selling health care is prescan. On their website they use all the same marketing tricks that you can also find in the best teleshopping programs. They even handy bundles for those amongst us who just can’t decide.
The checkup can include MRI scans of various body parts, lab work, external and internal examination, ECG, … Even a hotel, food and transportation can be included depending on which package you choose.
For me this is taking it a bit too far. Health care is an area that, in my opinion, shouldn’t be commercialized. On a related note, people should also understand that searching the internet doesn’t compare to a real medical training and years of expertise.
And yet the long waiting lines in hospitals could well be causing a lot of patients turning towards these kind of organisations.
Is imaging increasing health or profit? I think the answer lies somewhere in between.
Brain imaging has come a long way since its earliest techniques. Already in 1918 a technique called ventriculography was invented. This technique consisted of injecting filtered air into the ventricles, the hollow cavities inside the brain, and included a high risk for the patient. Seeing that it did provide a lot of useful surgical information, new techniques were started to be developed.