If you have been a patient in any health care situation recently, you have experienced a denial of some type of medical care. It could have been a procedure that was not approved, a diagnostic test that someone determined was not necessary, or more likely a medication that was not on your approved list. Health care is changing rapidly and even though you have not been too dissatisfied with your healthcare insurance recently, that is likely to soon change.
Trying to get control over medical costs has become a significant priority as the implementation of the Affordable Care Act is approaching. Drug costs are a significant factor in the cost of healthcare. A common complaint from patients, as well as physicians currently, is there is difficulty in getting approval for any pharmaceutical that is not a generic.
During the last decade, advances in imaging technology have been cited as a primary driver of increasing healthcare costs. Imaging services and their costs have grown at twice the rate of other healthcare technologies. After all, Baby Boomers want all the technology there is and we are approaching the age where we will usurp twice as many healthcare costs as the younger population. We see it on television and we receive it in our mailboxes. Our quest is to stay young and active and we want it the Burger King way (Have it Your Way). We are the demographic and most of us will afford it if we think it makes us any better.
The 5 rights of patients in imaging are to have the Right Study, the Right Order, the Right Way, with the Right Report, and the Right Action. The 5 Rights incorporate the concepts of overuse, misuse, and underuse. Combined with the harmful effects of radiation exposure, overuse and misuse carry some patient risks. Although underuse may seem scarce, it carries significant penalties for the patient. Patient safety in each of these “rights” is of paramount importance. There has been much discussion in print and in the field about the radiation dose rates for pediatrics and for the procedures involving CT scanners. For too many years we turned a blind eye to the dose rates produced by the radiation equipment. The studies are diagnostically magnificent and much easier to obtain than some previous methods to study the head, neck and other body parts. For too long a time, the benefit versus the risk logic was there was no risk, and all was benefit. It is a good thing that the blinders have been removed. Today medical radiation contributes slightly more than half the average total radiation dose to the United States population an increase from 1980 where it contributed less than a quarter of the average dose.
Implementation of the Patient’s 5 Rights of Imaging is not an easy task. It is complicated. It requires collaboration, communication, and cooperation of many facets of the healthcare community. But, it is a cinch we will be hearing a lot more about them in the future.