Is Emergency Medicine Overusing Valuable Resources?

Abstract

Over the past three decades, the growth of medical imaging has unquestionably helped patients by allowing physicians to diagnose disease and improve patients’ quality of life. However, overutilization of medical technologies, such as computed tomography (CT), can lead to an increase in the total public risk of cancer deaths due to radiation exposure. Although CT is an important technological advancement in medicine, approximately a third of all CT scans are performed needlessly. Children have a longer lifetime after radiation exposure and a greater radio-sensitivity than adults, hence they are at a higher risk of developing cancer. Extra caution should be taken when imaging children in the ED. Choosing Wisely, Image Gently, and ALARA are organizations that offer valuable tools to educate physicians about avoiding unnecessary medical treatments and reducing radiation exposure in patients. However, most ED physicians are aware of the problem of overimaging; lack of insight was not the reason why physicians were overimaging. The main reason was fear of malpractice. Solutions thought to be helpful for reducing unnecessary ED imaging included malpractice reform, physician feedback on test-ordering metrics, improved education of diagnostic imaging for physicians, educating patients to increase patient involvement, and shared decision making. These solutions could alleviate some of the ED physicians fears of malpractice and reduce the overuse of medical imaging technologies which can not only lessens patients’ radiation exposure but reduce the cost to the healthcare system.