Back pain compounded by wallet pain

In a small but concerning study, researchers report that doctors may not always make MRI recommendations with their patient s best interests in mind. According to the study, presented at the Radiological Society of North America meeting in Chicago, doctors who own an MRI scanner may be more likely to recommend an unnecessary back scan than if they had no financial interest in the procedure.

In an analysis of 500 MRI scans on patients with lower back pain, about one in three showed no signs of abnormalities. Yet of these scans with normal results, 65 percent had been ordered by doctors who owned the MRI machines, whereas only 35 percent of the normal scans were ordered by doctors who did not. Considering that a physician who owns an MRI machine can earn over $1,000 per scan, there is significant concern that he or she may recommend a scan unnecessarily in order to compensate for the enormous cost of purchasing the scanner, or to earn a profit.

Not only does a lower back MRI scan cost a patient up to $2,000, but as Dr. Rita Redberg, editor of the Archives of Internal Medicine, points out, most lower back pain resolves itself without any treatment. So these MRIs can result in unnecessary surgery and its associated risks for a problem that never actually required treatment.

ACSH's Dr. Gilbert Ross points out that the small number of patients in this study does not support much of a generalization to the population. Still, he says, Needless MRIs are to be condemned, regardless of the motivation. That being said, he continues, "it's also much easier to call a procedure 'needless' in retrospect not so easy in the heat of diagnostic and therapeutic confusion.