J Am Coll Radiol. 2015 Jun;12(6):601-3. doi: 10.1016/j.jacr.2015.03.014.
Boland GW1, Weilburg J2, Duszak R Jr3.
The Institute of Medicine has estimated that 30% of all dollars spent on United States health care are wasted [1]. Although imaging’s contribution to that waste is difficult to pinpoint, most sources agree that inappropriate imaging is both widespread and commonplace [2]. Every inappropriate imaging examination places unnecessary, unwanted upward pressure on total health care system costs. From a system perspective, those unnecessary costs, both direct and indirect, are incurred in scheduling, protocoling, performing, monitoring, interpreting, and communicating examinations. From a clinical and quality perspective, patients can be harmed. Any imaging examination can be stressful, so an inappropriate one unnecessarily burdens the patient with anxiety, especially when associated with an access delay. The examination itself can be uncomfortable or incur risk (albeit small) from radiation and/or contrast media. Importantly, inappropriate examinations displace necessary ones, delaying diagnoses and subsequent treatments for more needy patients. In an era of higher deductibles and copayments, this translates into ever increasing upfront costs to patients. In short, inappropriate examinations add no value to the system, only costs.