Here’s a true story written by a neurologist struggling with mis-interpreted results from an MRI scan. His patient came to him after seeing an internist the previous week. The internist had ordered an MRI which came back “normal”. After looking over the MRI image himself, the neurologist determined that the image quality was too poor and never should have been flagged as “normal”. Here’s an excerpt from the story:
So I needed another MRI, done on a decent machine, with sedation, and read by a neuroradiologist. Easier said than done.
I ordered the study. Dave’s insurance denied it, on the grounds that he just had an MRI last week, and so they wouldn’t pay for another.
I appealed it, and personally called their physician reviewer. I told him the patient had something serious going wrong in his neck. I told him the previous films were worthless. I even offered to send him the films to look at himself.
He told me that I’d have to live with them, and it wasn’t his fault that the ordering doctor had chosen that facility. So I was stuck. And Dave was getting worse. What could I do?
As a last effort, the neurologist admitted his patient to the hospita to get his insurance to cover the MRI
Within an hour the neuroradiologist called me. Dave had a huge herniated disk in his neck, crushing his spinal cord. I called a neurosurgeon immediately, and 2 hours later Dave was having the disk, and it’s threat of landing him in a wheelchair, taken out.
Dave did fine.
Yes, getting an MRI is complicated. You can read the rest of the MRI story here. This story could have gone in a million different directions. What if the internist knew the MRI Center was a low quality one? What if the radiologist had re-done the scan? What if the neurologist didn’t have the time to search through Dave’s records? Those are all good questions. Here’s how I see it. Dave wasn’t hospitalized, and it sounds like the story took place over about a week. So there was plenty of time to do online research. What if we had access to:
- a website with ratings for individual MRI Centers. I haven’t seen anything like this, comment below if you have!
- an article about How to Get the Best Quality MRI including the importance of not moving, and the variables machine quality, movement, and radiologist’s interpretation all contribute to the result
Online research by patients isn’t a panacea. If the 2 resources above existed, maybe things would have turned out exactly the same. Or maybe the story would’ve turned out worse if Dave did his own research and got in the way of the neurologist. But I believe that the quality of information about MRI scans readily available on the internet under searches like “mri safety”, “mri cost”, and “mri errors” needs improvement. Every year there are over 30 million MRI scans performed in the United States. Neurologists and Radiologists as a whole have a daunting amount of experience reading images, requesting scans.
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