brain scans

Having an imaging test is serious business, especially when it’s an imaging test that uses radiation, like a computerized tomography (CT) scan.

Consumer Reports has earned a reputation for helping patients ask the right questions about their care. So I recently compared QualityPath standards for hospitals and clinics that offer CT and magnetic resonance imaging (MRI) scans to Consumer Reports’ list of five issues that you should consider before getting radiation-based imaging. CTs use radiation; MRIs do not.

QualityPath Takes on Three Issues for You

As the manager of value measurement for the QualityPath program, I know that QualityPath standards mean that QualityPath hospitals and clinics can give the right answers for three of the issues on the Consumer Reports list.

  1. Consumer Reports says: “Check credentials.”
    This is a step that QualityPath handles on your behalf. QualityPath verifies information about the hospital’s or clinic’s accreditation by national organizations. This accreditation includes credentials, education and training of staff and the doctors who review the scan. QualityPath also requires hospitals and clinics to use standards created by Image Wisely for adults and Image Gently for children. These standards are aimed at reducing overuse of medical imaging.
  2. Consumer Reports says: “Get the right dose for your size.” A smaller dose of radiation is required to perform a test on a smaller person, especially children. The Image Gently standards address this issue. They are required by QualityPath, which means a QualityPath hospital or clinic will use the right dose for your size.
  3. Consumer Reports says: “Ask for the lowest effective dose.”
    If you’re using a QualityPath hospital or clinic, they are required to show that they are using methods to reduce the radiation dose. This is part of their accreditation. QualityPath reinforces this standard by requiring hospitals and clinics to submit dose information from every scanner to a national registry. The registry provides information to hospitals and clinics about how low doses can go while still giving good quality images. Consumer Reports notes that avoiding high doses of radiation from scanning could almost halve the number of future radiation-related cancers developed by patients.

Only You Can Address These Issues

QualityPath doesn’t address every issue for you. It’s still your job as the patient to talk to your doctor about two items on the Consumer Reports list.

  1. Consumer Reports says: “Ask why the test is necessary.”
    You should ask this question whenever your doctor says you need a test, but it’s especially important when you’re getting a test that uses radiation, like a CT scan. If you forget to ask during the visit, call the doctor’s office when you get home.
  2. Consumer Reports says: “Avoid unnecessary repeat scans.”
    Sometimes doctors order a new test rather than looking at one you already had. It’s your job as a patient to remind doctors that you recently had the test and would like to avoid another test unless it’s really needed. You can also be an advocate for others in your family. For example, a colleague at The Alliance was an advocate when a relative was hospitalized following an auto accident. Her relative had just returned from a CT scan when hospital staff announced they planned to give her another X-ray. My colleague made them aware of the CT scan. When the staff checked with the doctor, they learned the X-ray wasn’t needed because the doctor would get the same information from the CT scan.

Reducing Radiation Really Matters

Consumer Reports’ recommendations are part of an article on “The surprising dangers of CT scans and X-rays.” The article offers a reminder that you should always take it seriously when a doctor or dentist orders a scan involving radiation, such as an X-ray or CT scan. Every exposure to radiation increases your lifetime risk of cancer.

So the next time your doctor recommends an imaging test, use the Consumer Reports list to make sure you’re getting the right care. And remember that using a QualityPath hospital or clinic will get you started on the right path by checking three items on the list for you.

  • Find a QualityPath hospital or clinic for CTs or MRIs. Anyone can use a QualityPath doctor, hospital or clinic, but only people who get health coverage from an employer who participates in the QualityPath program will get reduced out-of-pocket costs (sometimes nothing!).
  • Consumer Reports has another list of five questions to help you when your doctor recommends any test, treatment or procedure. Employer-members can get a free supply to give to employees by contacting Tierney Anderson at The Alliance, tanderson@the-alliance.org, 800.223.4139 x6642.
  • The Alliance promotes the Choosing Wisely campaign to help patients make better choices about tests and treatments. Choosing Wisely is an initiative of the American Board of Internal Medicine (ABIM) Foundation in partnership with Consumer Reports.
Amy Moyer

Amy Moyer

Manager of Value Measurement at The Alliance
Amy Moyer joined The Alliance in 2011 as manager of value measurement. In her role, she manages and executes cost and quality measurement and reporting strategies for The Alliance and its members. She's played a critical role in developing The Alliance's QualityPath® initiative. She also participates in state and federal measurement initiatives.

Prior to joining The Alliance, Amy served as the quality program administrator at Physicians Plus Insurance Corporation. She took on the role of project manager for the National Committee for Quality Assurance (NCQA) accreditation efforts as well as the development and reporting of key health plan quality metrics. Her resume also includes work at UW Health (University of Wisconsin Hospital and Clinics) where she served as a clinical content facilitator.

Amy attended University of Wisconsin-Platteville where she received her Master of Science in project management and Lawrence University where she received her Bachelor of Arts degree in music, neuroscience and biomedical ethics.
Amy Moyer

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