A recent article in Reuters, “Overexposed: Imaging tests boost U.S. radiation dose“, pointed out that Americans are being exposed to increasingly high levels of radiation as a result of diagnostic testing. The author seemed to mostly point fingers at physicians for overusing scans.

Seriously? I wonder how much influence for these diagnostic tests is coming from the patient side. Also, what role does the trend of decreased reimbursements to doctors play? This has to be a much more complicated process than just “profiteering” by doctors.

The entire health care system (patients, providers, insurance companies, device/drug manufacturers) is plagued by cost shifting. Each player tries to recapture profit by pushing cost onto somebody else. Could the trend towards increased diagnostic testing, which is highly profitable, be another way for providers to shift costs back onto insurance companies? What about the influence of the litigative culture doctors work in?

Regardless, this trend of increased diagnostic testing and imaging (without health benefits) is troublesome. Overall health care costs continually increase while patient health outcomes remain stagnant. Doctors are trapped in a system that reinforces cost shifting as a mechanism for maintaining income. The incentives need to change – the system needs rewarded providers for giving VALUE (better outcomes for lower cost).