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Re "The high cost of precision," Sept. 7
By overstating the growth of CT scanning, The Times' article paints an inaccurate picture of how physicians use this lifesaving technology.
The Government Accountability Office statistics used to demonstrate an increase in CT scans are misleading. The GAO's report did not use 2007 data, which show that medical imaging's growth has actually decreased.
The article also presents biased information as fact in order to claim CT over-utilization. Insurance companies are motivated to reduce healthcare costs, including imaging, and have created a cottage industry, called radiology benefit managers, with the sole purpose of refusing coverage for scans. By citing subjective insurance-company-generated analysis of how many scans are "inappropriate," readers are presented with a skewed view of how and why physicians order scans.
The larger issue is ensuring that patients have access to the right scan at the right time. That's why it is vital to ensure that healthcare decisions remain between physicians and patients. The recent Medicare bill embraces this through accreditation and appropriateness criteria. These approaches help ensure that each scan is appropriate and effective without denying access.
Maureen Zilly
Arlington, Va.
The writer is the director of government relations for the Medical Imaging and Technology Alliance.
I want to congratulate The Times for educating the public about the risks of CT scanning, particularly in children. As a pediatric surgeon, I have spent the last seven years educating my colleagues, as well as future physicians, about these risks, and pleading with them to use CT scanning more judiciously.
Unfortunately, outside scattered islands of excellence, American medicine is becoming an increasingly corporate affair, where assembly-line care is practiced and clinical acumen and judgment are giving way to routine and chaotic use of technology. In such an environment, patient benefit and professional ethics often take a back seat to financial profits. Our nonsystem of healthcare is desperately sick, and your article describes one of its many symptoms.
We can initiate the recovery of our healthcare system by banning the practice of physician self-referral and enacting policies that restore medicine as a service, not a business.
Sherif Emil, MD
Irvine
Energy priorities must change
Re "The Geo Metro as dream machine," Column One, Sept. 9
So some people are driving 30-year-old cars that get much better gas mileage than today's automobiles. Such vehicles, because of their scarcity, are unavailable to most of us. What to do then?
Many of us are in the position of owning a gas guzzler that, despite eliciting an ouch on every fill-up, is still too young to be scrapped. Should we sell it, buy a hybrid and get a warm feeling for helping save the planet?
It sounds good at first, but what about the person who buys our big car? He or she will continue, presumably, to drive it, and use as much fuel, or perhaps more, than we did.
Far better to find a good mechanic and keep our big car running as long as possible, thereby helping the local economy, and to change driving habits so we accomplish multiple errands on one trip. We will still say ouch, but less frequently.
Re "The high cost of precision," Sept. 7
By overstating the growth of CT scanning, The Times' article paints an inaccurate picture of how physicians use this lifesaving technology.
The Government Accountability Office statistics used to demonstrate an increase in CT scans are misleading. The GAO's report did not use 2007 data, which show that medical imaging's growth has actually decreased.
The article also presents biased information as fact in order to claim CT over-utilization. Insurance companies are motivated to reduce healthcare costs, including imaging, and have created a cottage industry, called radiology benefit managers, with the sole purpose of refusing coverage for scans. By citing subjective insurance-company-generated analysis of how many scans are "inappropriate," readers are presented with a skewed view of how and why physicians order scans.
The larger issue is ensuring that patients have access to the right scan at the right time. That's why it is vital to ensure that healthcare decisions remain between physicians and patients. The recent Medicare bill embraces this through accreditation and appropriateness criteria. These approaches help ensure that each scan is appropriate and effective without denying access.
Maureen Zilly
Arlington, Va.
The writer is the director of government relations for the Medical Imaging and Technology Alliance.
I want to congratulate The Times for educating the public about the risks of CT scanning, particularly in children. As a pediatric surgeon, I have spent the last seven years educating my colleagues, as well as future physicians, about these risks, and pleading with them to use CT scanning more judiciously.
Unfortunately, outside scattered islands of excellence, American medicine is becoming an increasingly corporate affair, where assembly-line care is practiced and clinical acumen and judgment are giving way to routine and chaotic use of technology. In such an environment, patient benefit and professional ethics often take a back seat to financial profits. Our nonsystem of healthcare is desperately sick, and your article describes one of its many symptoms.
We can initiate the recovery of our healthcare system by banning the practice of physician self-referral and enacting policies that restore medicine as a service, not a business.
Sherif Emil, MD
Irvine
Energy priorities must change
Re "The Geo Metro as dream machine," Column One, Sept. 9
So some people are driving 30-year-old cars that get much better gas mileage than today's automobiles. Such vehicles, because of their scarcity, are unavailable to most of us. What to do then?
Many of us are in the position of owning a gas guzzler that, despite eliciting an ouch on every fill-up, is still too young to be scrapped. Should we sell it, buy a hybrid and get a warm feeling for helping save the planet?
It sounds good at first, but what about the person who buys our big car? He or she will continue, presumably, to drive it, and use as much fuel, or perhaps more, than we did.
Far better to find a good mechanic and keep our big car running as long as possible, thereby helping the local economy, and to change driving habits so we accomplish multiple errands on one trip. We will still say ouch, but less frequently.
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