"Bill of Health"-Scrutinizing CT's
Thursday, August 28, 2008SUSIE GHARIB: These days doctors are using new high-tech systems to get a really detailed look at what's going on inside a patient's body. They're the latest in CT scan technology. That's short for computed tomography. But are these new systems powerful tools for preventive medicine or powerful profit centers or both? In tonight's "Bill of Health," Jeff Yastine looks at the promise and the controversy.
JEFF YASTINE, NIGHTLY BUSINESS REPORT CORRESPONDENT: It's a high-tech marvel of modern medicine: a Philips 64-slice CT scanning system. The slice refers to the level of detail that can be seen in the processed images of the body. Patricia Michel came here for a heart scan after being referred by her physician. But she welcomes the chance to see how her heart's doing.
PATRICIA MICHEL, PATIENT: It gives me an idea of what my heart -- what condition it's in, what's going on. I don't have high cholesterol or anything, but you want to know the amount of blockage that has occurred in your heart and so yeah, it does make you feel much more comfortable.
YASTINE: This center, south Florida Medical Imaging Cardiovascular Institute, was started five years ago by Doctor Claudio Smuclovisky and his partners. Smuclovisky is a radiologist who specializes in studying images of the heart. He says the ability to clearly see the plaque in arteries makes scans an ideal tool for preventive medicine, especially for those with a higher risk of heart attack.
DR. CLAUDIO SMUCLOVISKY, SO. FLORIDA MEDICAL IMAGING CARDIOVASCULAR INST.: The key is to have a technology that's non invasive which is the cardiac CT that can actually detect disease, the type of disease that they have and treat it effectively at a much earlier age. And that in downstream costs, the savings would be enormous for the society and taxpayer.
YASTINE: But such opinions aren't without controversy. Medicare recently threatened to halt reimbursements of heart scans, citing a lack of clinical studies on their effectiveness. Medicare backed off that stance after complaints from advocates of heart scans. But critics also are concerned about radiation exposure, although new software and scan techniques are said to significantly lower radiation exposure to patients. Still, critics like Jean Mitchell, an economist at the Georgetown Public Policy Institute say many scans are unnecessary and contribute to higher healthcare costs.
JEAN MITCHELL, ECONOMIST, GEORGETOWN PUBLIC POLICY INST.: These scans if they're not absolutely medically necessary, all this is doing is leading to increased utilization and the increased utilization as I said is one of the major drivers of rising healthcare expenditures.
YASTINE: That hasn't dented the flow of people into facilities like this. Gary Grandovic, director of the West Boca Diagnostic Imaging Center says clients often pay up to $600 out of their own pockets for scans of the colon, called a virtual colonoscopy, as well as images of the heart and lungs.
GARY GRANDOVIC, DIR., WEST BOCA DIAGNOSTIC IMAGING CENTER: The scanner's here. The tech is here. You've got personnel that can run that machine all day long. So if you have a patient that's coming in for an exam, whether that is medically-reimbursed revenue or whether it's self pay revenue, facilities are looking at it as revenue.
YASTINE: Despite the reservations raised by critics, radiologists like Smuclovisky believe heart CT scans will eventually become a standard of care.
SMUCLOVISKY: The accuracy is over 95 percent in determining people that have significant impairment of blood flow to the heart. It's just a time that it takes which is natural for acceptance period in healthcare and that usually takes five to 10 years. But this test will in my opinion, replace diagnostic coronary angiogram where somebody needs to go into the hospital to determine whether they do or not have disease.
YASTINE: And the technology of CT scanning continues to evolve. So- called 64-slice scanners are now the high-tech standard for most imaging centers. But a few U.S. hospitals are now buying 320 slice scanners, offering images that are five times more detailed. Jeff Yastine, NIGHTLY BUSINESS REPORT, Bill of Health.
