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Comment by lostlogin

12 days ago

Yes, and needless biopsy can be a big deal.

It’s a great document, I’m an MR tech and we now have something to lean on when we say no to these scans. We can then scan people with problems rather than people with too much money.

Great document? I just read the entire thing, it contains no evidence or justification for their claims.

> We can then scan people with problems rather than people with too much money.

Right, this is what it's really about. MRIs are a scare resource and providers need to manage cost. Fortunately I can afford to pay out of pocket, but I'm just annoyed that doctors are so irrational about this

To be clear, it's up to a doctor whether or not to do a "needless biopsy". That has nothing to do with a scan.

  • … they do it based on the scan result.

    Avoiding a biopsy that wasn’t needed is a good thing.

    • You're imagining that the doctor is required to act irrationally or against the patient's interest. I understand that they do act this way, but I'm pointing out that they don't have to!

      You walk into a doctor's office and meet for the first time.

      Case 1. You have 3 full body MRIs taken 6 months apart in hand and give them to your doctor. Nobody has opened or looked at the scans yet.

      Case 2. You do not have a scan yet

      You are claiming case 1 will lead to worse outcomes in expectation. I claim that's impossible because the doctor can simply do the following: Without opening the scans, email them to the world's best radiologist. Tell that radiologist "only reply if it is nearly certain the patient has an operable cancer with the information available"

      Now there are 4 possibilities.

      Case 1 without cancer: nothing happens

      Case 2 without cancer: nothing happens

      Case 1 with cancer: you maybe survive

      Case 2 with cancer: you die

      The only reasonable objection to this is "that's expensive"

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