Wednesday, July 09, 2008

CT Scans

This NYT article suggests that CT scans for heart patients are over-used, because the machines cost $1 million each, so one a practice commits to buying one, they have to use it a lot to amortize that high cost.

Without addressing whether CT scans for heart disease are effective, I do have an observation. Similar to airports, this is very expensive equipment, and it should be utilized on a 24x7 schedule. What this would mean is fewer machines purchased, shared between more or larger practices, and some inducement needed to compensate patients for taking the "graveyard shift". Still, it seems do-able. If not fully 24x7, the something close, like maybe 18x7. Having it un-utilized all day Saturday and Sunday certainly seems unjustifiable.

Of course, in implementing this kind of factory-like, high-utilization model, we have to be wary of law of unintended consequences. The one I can see coming, a mile away, is that insurers will set their reasonable & customary based on the midnight rate, and pretty soon, everybody will be trying to book the off-peak hours, and the appointments during peak hours will go begging!

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