The MRI Lie: A Matter of Economics

(PRWEB) February 25, 2005

At his recent book signings and lectures in New York, Dr. Ronald P. Grelsamer, author of What Your Doctor May not Tell You About Knee Pain and Surgery, Warner Books, 2002, and What Your Doctor May not Tell You About Hip and Knee Replacement Surgery, Warner Books, 2004, spoke candidly on how unnecessary MRI (magnetic resonance imaging) testing and resultant surgeries are driving up the cost of health care in our country.

“While personalized patient care and physician reimbursements are plummeting, health insurance coverage continues to soar,” states Grelsamer. “The cost of radiology, which is expected to keep growing at an annual rate of 20% or higher, is now outpacing the cost of prescription drugs for the first time. At a projected $100 billion annually, diagnostic imaging is one of the fastest growing concern areas in our health care.”

Current figures back up Grelsamer’s findings. The most recent data from IMV Medical Information Division – an Illinois market-research company, reports that the number of patients undergoing MRIs is up more than 80 percent in the past four years. National Imaging Associates, Inc., a New Jersey radiology management company that serves over 12 million health plan members in 30 states, and manages $2.5 billion in radiology expenditures annually, concedes that about 1/3 of advanced imaging tests are either inappropriate or don’t contribute to a physician’s diagnosis or ultimate health outcomes. Their data strongly suggests that efficient radiology benefit management could cut America’s imaging expenditures by $20 billion to $30 billion annually.

“The Accuracy Of The Knee MRI Is One Of The Greatest Myths Of Our Time."

Grelsamer stresses that while MRI testing is an extraordinary diagnostic tool in certain areas, “its accuracy for knee pain and arthritis is arguably one of the greatest myths of our time.” Adds Grelsamer, “In my experience, the odds of coming across a false-positive MRI range from 10 to 100 percent, depending on the knowledge and integrity of the radiologist. The MRI provides nothing more than thin, flat slices of a complex, colorful three-dimensional structure, so it is subject to interpretation and can miss conditions such as arthritis, partial ACL ligament tears, and kneecap malalignment.”

“In The Hands Of The Wrong Orthopedist, The MRI Becomes A License To Operate."

• Grades I, II And III Cartilage “Tears”

Grelsamer reports “at the dawn of this new millennium, one is at greater risk of being misdiagnosed with a torn cartilage than at any other time in history. Since the MRI shows only thin shadows of complex structures, small abnormalities might be missed. While a Grade III tear may or may not require surgery, a Grade I or II never does! By reporting grade I and II changes as tears, a radiologist allows the unscrupulous orthopedic surgeon to recommend a surgical procedure. Seeing the word ‘tear’ on the MRI report, most patients readily agree to surgery.”

• MRIs Can Overread Common Knee Conditions

“Other knee pain causes such as nagging tendonitis, which is an inflammation of the tendon, and runner’s knee, which is an irritation of the so-called iliotibian band, running along the outside of leg and knee, can be misread on MRIs as torn cartilage. All of these conditions can be treated without surgery.”

• X-Rays, Costing 1/10 Of An MRI, Can Diagnose Arthritis, and "LK-SSS(Limited Knowledge, Suspect Scruples) Doctors"

“A severe arthritic flare-up will eventually quiet down on its own. A competent physician will prescribe old-fashioned x-rays, usually sufficient to diagnose arthritis or knee malalignment, at 1/10 the cost of an MRI. If a patient is over forty years of age, the doctor should make certain the frontal x-rays are taken in a standing position. However, an LK-SS Doctor –- which is how I describe a surgeon with limited knowledge and suspect scruples – uncertain about a diagnosis, and possibly motivated by revenues created by expensive, in-office MRI equipment, might be quick to prescribe an MRI, followed by surgery for a “torn” meniscus. When the patient’s pain persists after the operation, the LK-SS surgeon identifies the problem as arthritis, which should have been detected preoperatively through x-rays and a good physical examination, but was not detectable on an MRI.”

“Treat Patients, Not Tests."

“Unfortunately,” says Grelsamer, “less emphasis is being placed on patient history and physical exams. Taking the time to really listen to a patient is becoming a lost art. Too often patients, not making the connection between the proliferation of technology and rising health care and insurance costs, feel shortchanged if no MRI is prescribed. The reality is that MRIs, which can run between $500 and $1500 a scan, depending on circumstances, inflate our insurance premiums, and the insurance companies’ ability to pay for other tests and treatments.

What is the answer? “Education! says Grelsamer. “The key to improving health care while holding down prices is twofold: encouraging consumers to be more involved in decisions regarding their own care, and reminding doctors to combine cutting-edge technology with old-fashioned, personalized service.    

Dr. Ronald Grelsamer, M.D., is currently the chief of hip and knee reconstruction at Maimonides Medical Center, and a noted staff orthopedic specialist at the NYU Medical Center and Hospital for Joint Diseases Orthopaedic Institute. A highly-regarded knee and hip surgeon, Grelsamer has been listed in Castle Connolly’s “America’s Top Doctors,” and in New York Magazine’s “Best Doctors of New York” for many years.

Traditionally trained and educated, Grelsamer is an avid patient advocate at the forefront of orthopedic research and technology, who integrates the latest treatments and surgery options into his practice. He has been treating people of all ages for over twenty years at his two offices in New York City and Brooklyn, New York. He has also shared his expertise with the public on NBC’s Today Show, ABC’s Eyewitness News, FOX TV, and in publications such as Forbes Magazine and USA Today.

Books Authored by Ronald P. Grelsamer, MD:

What Your Doctor May NOT Tell You About Hip and Knee Replacement Surgery. Ronald P. Grelsamer. Warner Books, 2004

What Your Doctor May NOT Tell You About Knee Pain and Surgery. Ronald P. Grelsamer. Warner Books, 2002

La Rotula - approcio d'equipe. Ronald P. Grelsamer and J. McConnell PT, GDMT.

Translated by A. Albasini. Masson Milano, 2001.

The Patella: A Team Approach. Ronald P. Grelsamer and J. McConnell PT, GDMT. Aspen Press, 1998

The Columbia-Presbyterian Osteoarthritis Handbook. Ronald P. Grelsamer and Suzanne Loebl, New York: Macmillan, 1996

Ronald Grelsamer, MD, Website: http://www.kneehippain.com

For futher information, please contact:

Diana Aceti Public Relations

PO Box 1919

Bridgehampton, NY 11932

Phone/Fax 631-613-6057

DMAceti@aol.com

###