title: Radiology's ethical responsibility for healthcare reform: tempering the overutilization of medical imaging and trimming down a heavyweight.
abstract: In this review we describe the problem of overutilization of high-cost imaging modalities, especially magnetic resonance imaging (MRI) and computed tomography (CT). The overuse of CT is numerically more dramatic and also carries with it the not insignificant risk of harm to patients, namely, induction of radiation-induced malignancies. We report what is known of these risks in various imaging scenarios. The use of Radiology Business Managers is described as a means adopted to control overuse and the limitations of this strategy. The imperative of appropriate utilization is focused on, with emphasis placed on computer-based medical decision support. Impediments to appropriate use, however, exist, with concerns of medicolegal liability high on the list of these issues. Finally, we recommend that radiologists take the lead in the reform process by implementing strategies such as decision support.
authors.affiliation: Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
authors.forename: Diane
authors.initials: D
authors.lastname: Armao
authors.forename: Richard C
authors.initials: RC
authors.lastname: Semelka
authors.forename: Jorge
authors.initials: J
authors.lastname: Elias
mesh_terms: D000068:Accreditation; D003661:Decision Support Techniques; D003952:Diagnostic Imaging / Q000191:economics / Q000706:statistics & numerical data*; D017048:Health Care Costs; D018166:Health Care Reform / Q000941:ethics*; D006300:Health Services Misuse / Q000639:trends*; D006801:Humans; D016365:Liability, Legal; D011829:Radiation Dosage; D011835:Radiation Protection; D011871:Radiology / Q000941:ethics*; D012307:Risk Factors; D014481:United States; D014600:Utilization Review