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Cullen Ruff, MD
Radiology Business

Saying, “I want it anyway,” the ICU physician insisted that his patient with breast cancer should get an MRI exam to look for lung metastases. My years of experience as a radiologist did not dissuade him; such a test would be a poor way to evaluate his patient’s lungs, even under ideal circumstances (which hers were not). She was on a ventilator, incoherent, and unable to hold her breath, rendering the study a useless waste of time and money. More important, her lungs, just days earlier, had been clear on a chest CT exam—the gold standard for detecting lung nodules. We already knew that she had no lung metastases.

Health care reform ideas are everywhere these days. As a radiologist, I'm all for controlling costs—but I challenge the assumption that national electronic medical records (EMRs) will magically make providers more informed and automatically decrease unnecessary tests.