From Daily Dose with William Campbell Douglass II, M.D. We're Zapped By More Tests Than Any Other Nation
We're so radioactive that our bodies should be declared hazardous waste and
sealed in lead-lined vaults - or maybe just shot out into space. Americans get
more radiation-powered medical tests than anyone else on earth - half of all
advanced procedures performed on the entire planet, according to a recent
Associated Press report.
In one outrageous instance, a New Hampshire teen was run through the CT ringer
14 times to check for kidney stones, giving him the kind of radiation you'll
only find in survivors of Hiroshima and Chernobyl, and I only wish that was an
exaggeration. I don't know what fool this kid had for a doctor, but I've never
needed a CT scan to deal with a case of the stones.
Another young woman had 31 abdominal scans - each one packing the radioactive
punch of roughly 500 traditional X-rays, according to a doctor in the article.
Horrified, the doctor began searching the records in the two hospitals where he
works and found at least 50 people who were given massive amounts of radiation
over a three-year period. Think that can't happen to you? Think again - because
chances are, it already has.
One study found that heart attack patients get the equivalent of 850 chest
X-rays in the first few days of their hospital stay and that most of them were
repeats of tests they'd already had. It's so bad that CT scans are now
responsible for 1 percent of all new cancer cases, with 29,000 cancers expected
from the tests carried out in 2007 alone. And that's just the beginning,
because our overall radiation exposure has shot up SIX TIMES in three decades.
There's one simple reason for this, and it has nothing to do with your health.
Advanced tests are expensive tests and each zap is worth hundreds, even
thousands, of dollars. I've heard of some people who've been billed $6,000 for
a CT scan in search of those kidney stones I mentioned earlier - a zap that can
usually be completed during a commercial break. Like I've said before, it's
some of the easiest money in the entire field of medicine. Bottom line: There
is no safe level of radiation. Approach any test with extreme skepticism,
because most docs aren't interested in looking inside your body- just your
More Medical Care May Prove Unhealthy
As reported by Lauran Neergaard, AP Medical Writer Back Pain No. 1 Most Overtreated Medical Issue (6/10)
More medical care won't necessarily make you healthier - it may make you sicker.
It's an idea that technology-loving Americans find hard to believe. Anywhere
from one-fifth to nearly one-third of the tests and treatments we get are
estimated to be unnecessary, and avoidable care is costly in more ways than the
bill: It may lead to dangerous side effects.
It can start during birth, as some of the nation's increasing C-sections are
triggered by controversial fetal monitors that signal a baby is in trouble when
really everything's fine. It extends to often futile intensive care at the end
of the life.
• Americans get the most medical radiation in the world, much of it from repeated
CT scans. Too many scans increase the risk of cancer.
• Thousands who get stents for blocked heart arteries should have tried
• Doctors prescribe antibiotics tens of millions of times for viruses such as
colds that the drugs can't help.
• As major health groups warn of the limitations of prostate cancer screening,
even in middle age, one-third of men over 75 get routine PSA tests despite
guidelines that say most are too old to benefit. Millions of women at low risk
of cervical cancer get more frequent Pap smears than recommended; millions more
have been screened even after losing the cervix to a hysterectomy.
• Back pain stands out as the No. 1 overtreated condition, from repeated MRI
scans that can't pinpoint the trouble to spine surgery on people who could have
gotten better without it. About one in five who gets that first back operation
will wind up having another in the next decade.
Overtreatment means someone could have fared as well or better with a lesser
test or therapy, or maybe even none at all. Avoiding it is less about knowing
when to say no, than knowing when to say, "Wait, doc, I need more information!"
The Associated Press combed hundreds of pages of studies and quizzed dozens of
specialists to examine the nation's most overused practices. Medical groups are
starting to get the message. Efforts are under way to help doctors ratchet back
avoidable care and help patients take an unbiased look at the pros and cons of
different options before choosing one. "This is not, I repeat not, rationing,"
said Dr. Steven Weinberger of the American College of Physicians, which this
summer begins publishing recommendations on overused tests, starting with low
It's trying to strike a balance, to provide appropriate care rather than the
most care. Rare are patients who recognize they've crossed that line. "Yet let
me tell you, with additional tests and procedures comes significant harm," said
Dr. Bernard Rosof, who heads projects by the nonprofit National Quality Forum
and an American Medical Association panel to identify and decrease overuse.
"It's patient education that's going to be extremely important if we're going
to make this happen, so people begin to understand less is often better," he
Even Doctors' Families Not Immune
A hospital appropriately did six CT scans to check Dr. Steven Birnbaum's
22-year-old daughter for injury after she was hit by a car. But the next day,
Molly had an abdominal scan repeated as a precaution despite having no
symptoms. When a doctor ordered still another, "I blew a gasket," said the New
Hampshire radiologist, who put a stop to more.
Overtreatment extends into the maternity ward as well, where doctors can be too
quick to act on minor problems. There are numerous reasons that one of three
U.S. births now is by cesarean, but Dr. Alex Friedman blames some on an
imprecise monitor strapped to laboring women. Too often, he has sliced open a
mother's abdomen fearing the worst, only to pull out a pink, screaming bundle.
"Everyone knows it's a bad test," said Friedman of the Hospital of the
University of Pennsylvania. "You haven't done the patient a big service by
doing an unnecessary surgery."
Electronic fetal monitors record changes in the baby's heart rate, a possible
sign of too little oxygen. They became a tradition, now used in 85 percent of
births, years before research could prove how well they work. Guidelines issued
last summer, aiming to help doctors better interpret which tests are worrisome,
acknowledge the monitors haven't reduced deaths or cerebral palsy. But they do
increase the chances of a C-section. While they should be used in high-risk
women, the guidelines say the low-risk could fare as well if a nurse regularly
checked the baby's heart rate.
Later this year, the National Institutes of Health will begin a major study to
see if adding a newer technology, a type of fetal EKG already used in Europe,
to the heart-rate monitor would better identify which babies really are
struggling and need rapid delivery. Undertreatment was in the headlines over
the past year as the Obama administration and Congress wrestled with
legislation to get better care to millions who lack it.
The flip side, overtreatment, is a big contributor to runaway health care costs.
Yet it's one that lawmakers, wary of being accused of rationing, largely
avoided in the new health care law. Included were modest steps -- studies to
compare which treatments work best, some Medicare financial incentives to push
higher-quality, lower-cost care. "Physicians get up every day with the good
intentions of wanting to do what's best for their patients," said Dr. David
Goodman of the Dartmouth Institute for Health Policy. "We also live in
environments where there are strong financial incentives to deliver certain
types of care. We get well-paid for doing procedures. We get paid relatively
poorly for spending time with patients and helping them make choices."
Fall Out From Radiation Raises Concern
From Natural News Radiation Scan Problems Only Noticed After Patients' Hair Falls Out (7/10)by David Gutierrez
New concern over lack of regulation in medical radiation has been spurred by a
case in which more than 300 patients received excessive levels of radiation,
but doctors only uncovered the problem when patients' hair began to fall out.
The radiation errors occurred at three hospitals in Los Angeles and one in
Alabama, during heart tests performed with a special form of computed
tomography (CT) scan. Some patients received more than eight times the intended
Since the case became public, there has been a growing call for tighter
regulation of diagnostic and therapeutic radiation techniques. The American
Society for Radiation Oncology, the country's foremost radiation oncology
association, recently called for new safety measures, including a central
database where technicians can report any errors in CT scanners or the linear
accelerators that produce medical radiation. The New York Times has printed
features documenting the severe health problems that can result from the
improper use of medical radiation, especially in women and children.
This concern is made all the more urgent by the ever-growing popularity of
diagnostic radiation. Largely because of a vast increase in the use CT scans
and similar tests, the average U.S. resident's lifetime radiation dose has
increased to seven times above 1980 levels. Even if no errors occur in any of
these tests, harm may still result simply from the overuse of inherently risky
Congress is investigating why oversight into medical radiation remains so weak
in the United States. Many observers have attributed the problem to the lack of
a clear regulatory framework, with the New York Times noting that laws and
rules designed to protect patients from excessive radiation exposure are weak,
unevenly applied, and inconsistent across states and institutions. Although the
FDA technically has jurisdiction over all medical devices, it has rarely made
use of its authority. Consumer groups have criticized the agency for failing to
make manufacturers even perform safety tests before putting radiation scanners
or other medical devices on the market.
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