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Patients who pressure doctors for tests they may not need are part of the problem, write Dr. Bruce J. Hillman of the University of Virginia, and Jeff Goldsmith, president of Health Futures Inc., a Charlottesville, Va.-based health information policy and analysis company.
Fear of being sued also leads to too many tests -- a problem that won't be fixed unless there are limits on malpractice awards, they write.
And although Medicare bars doctors from having a financial stake in care they order for their patients, "a loophole" lets them do tests on machines in their offices, Hillman and Goldsmith write. Some doctors have exploited this to send patients to off-site scanning facilities they own.
Congress could give the FDA authority to set doses for CT scans the way it has allowed the agency to do so for mammograms, Smith-Bindman said.
Groups that track quality-of-control measures for the federal government also should include lowering radiation dose as one of their standards, Smith-Bindman said. European countries have done this for more than a decade and doses have fallen there, she said.
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Online:
New England Journal: http://www.nejm.org/
Consumer information: http://www.radiologyinfo.org/ and
http://tinyurl.com/2wv5fg
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