This radiation over-exposure does more harm than good
BY NISSAR H GILANI
Doctors Association, Kashmir [DAK] few weeks before saidpatients are being charged hefty sums on tests, procedure and medicines in Kashmir valley’s Government run hospitals. While appreciating the concern of’DAK’ president Dr. Nissar ul Hassan’s statement about unfair practices in ourstate run hospitals, is true of even private hospitals mushroomed in Kashmirvalley. Though the fact remains that most of the charges are determined byhospital owners.
All said and done, the question arises, weather patientsreally need all the tests advised by the doctors’ which are commonly usedtoday, such as CT Scans computed tomography], which are the biggest source of radiation of all imaging technologies, used to diagnose every thing from heartdisease and cancer to brain tumors, kidney stones, and even injuries.
Admittedly the ability to peer inside the body is nothing short of miraculous and saved countless lives since x-rays were discovered morethan a century ago.. but medicos have become increasingly concerned about theover use of many types of scans lately not only because of the huge and growingexpense, but even more be cause of the potential risk posed by the exposure toradiation.
People on average, are exposed to about six times moreradiation from medical imaging than theywere decades before it is reported that scans now account for hale of our totalradiation exposure (“Back ground” radiation from soil, air, water and thecosmos account most of the rest).
Many patients are advised multiple scans, and the number isobviously on increase. The risk from a single CT scan, when properly done, isminuscule, but radiation exposures and up over a lifetimes.
While debating statistics about estimates of risk frommedical imaging is on, everyone agrees that un-necessary radiation should beeliminated.
Do Doctors order tests out of habit?
Some doctor’s may Advise tests out of habit, wanting toconfirms their clinical skills, and may not focus on radiation doses or thecancer, risks associated with medical imaging. They may also order scansbecause of failing to diagnose something and being sued for scan’s to be ón thesafer side.’
Advertisements, and other IT promotions also influence thepatients. As testing machines in private hospitals have financing stake doctorsworking there order more scans. Scanning machines powerful resolution sometimesmake incidental find, though they may be clinically in significant, but lead to more testing and possibly overtreatment.
Now what to do
The American college of radiology (ACR) has established and array ofwell-respected medical imaging practice parameters and keep on advising thatimaging tests be done only when a clear benefit outweighs the risks, and aminimal level of radiation be used. Question that be asked before undergoing ascan.
It thetest necessary?
Is therea non-radiation alternative, such as ultrasound or MRI, that is equally good?
Will thetest use the lowest amount of radiation and fewest scan’s for satisfactoryresults?
Will thescan be limited to the suspected indicated area and will nearby areas beproperly shielded?
Medical imaging tests are in valuable in the diagnosis andtreatment of many disorders. Never avoid necessary exams out of radiationconcern. And if a test does not find any thing, that does not mean it wasun-necessary.
The best thing. Before having any imaging scan, discuss theadvantages and disadvantages.
The writer is former Assistant Commission Revenue Department J&K Government.