Too Many Scans Do More Harm Than Good

Madison Haberl began her career as a radiologic technologist in Des Moines, IA, after graduating in 2017. With seven years of experience in orthopedics, she transitioned into leadership, a shift that deepened her understanding of healthcare management. In July 2024, Haberl became Director of Imaging Services at St. Anthony Regional Hospital, a Critical Access Hospital in Carroll, Iowa, overseeing Nuclear Medicine, CT, MRI, Ultrasound, Mammography and General Radiology. Her hands-on experience in imaging has provided a strong clinical foundation, while her leadership role has offered new insights into managing teams and navigating the evolving healthcare landscape. Passionate about advancing patient care, Haberl continues growing as a radiology and imaging services leader.

Through this article, haberl emphasizes the urgent need for responsible medical imaging practices to prevent overuse and ensure ethical, patient-centered care.

With this broadened perspective, I have realized that while medical imaging has undeniably advanced patient care, there are increasing concerns about its safety and responsible use. As a leader in this field, I now see it as my responsibility to ensure the highest quality of patient care and advocate for safer, more ethical imaging practices. Through this lens, I aim to explore the crucial role of medical imaging in modern healthcare and the pressing need for responsible practices that prioritize patient safety and well-being.

In today’s healthcare system, medical imaging procedures like CT scans, MRIs and X-rays have become routine tools in diagnosing and monitoring diseases. These technologies have undoubtedly revolutionized medical care, allowing for early detection, accurate diagnoses and precise treatment plans. However, this rapid adoption has led to a concerning trend, like the overuse of medical imaging. What was once a critical diagnostic tool has increasingly become a go-to procedure, even when not necessarily warranted. This overuse driving up healthcare costs disproportionately affects patients in underfunded healthcare systems, where lower-income individuals may be subjected to excessive testing due to a lack of comprehensive diagnosis or physician discretion. The American Medical Association reports that low-income communities are especially vulnerable to these practices, where patients may experience longer wait times and increased exposure to potentially harmful, overused diagnostic procedures.

The rise in the use of medical imaging is undeniable. According to the American College of Radiology (ACR), the number of CT scans in the U.S. has more than doubled over the past two decades. In 2017 alone, approximately 80 million CT scans were performed in the U.S. Similarly, MRI procedures have increased dramatically, with the number of MRIs conducted annually growing by more than 500 percent over the past 30 years (American Medical Association, 2019).

These numbers suggest an overwhelming reliance on imaging in modern healthcare, even when it may not always be necessary. For example, a study published in JAMA Internal Medicine found that about 25 percent of all imaging tests ordered could be considered unnecessary, driven by factors such as physician habits, patient expectations and financial incentives (Kool et al., 2017).

While medical imaging has brought immense value, the overuse of these procedures comes with various risks. The most immediate concern is radiation exposure, especially with CT scans and X-rays. According to the Radiological Society of North America, one in three CT scans may involve unnecessary radiation exposure that could potentially increase the risk of cancer. A study published in The Lancet estimated that excessive use of CT scans could lead to up to 29,000 future cancer cases in the U.S. every year (Berrington de González et al., 2009).

The financial burden of overusing imaging is staggering. According to the National Academy of Medicine, unnecessary tests account for nearly $210 billion in unnecessary healthcare spending annually in the U.S. alone. This includes not only imaging but other overused medical tests as well.

The overuse of imaging raises important ethical concerns. While ensuring patients receive the best possible care is vital, excessive imaging tests can sometimes do more harm than good. Research published in BMJ Quality & Safety found that approximately 12 percent of imaging tests result in “false positives,” leading to unnecessary treatments and psychological distress (Fazel et al., 2015). For example, a patient might be subjected to invasive follow-up procedures based on a scan that inaccurately suggests the presence of disease.

Addressing The Overuse Of Medical Imaging With Multi-Pronged Approach

Healthcare providers must adopt a more cautious approach to ordering imaging tests. Clinicians should be encouraged to prioritize patient history and clinical examination over automatic reliance on technology. According to a 2019 American Board of Internal Medicine Foundation survey, 60 percent of physicians reported feeling pressure from patients to order unnecessary imaging tests. Fostering better communication and shared decision-making between doctors and patients is essential to address this issue.

Healthcare systems need to introduce stricter guidelines and protocols for imaging, promoting the use of imaging only when there is a clear clinical benefit. A study in the Journal of the American College of Radiology found that 10-20 percent of imaging procedures could be avoided if doctors followed more evidence-based protocols. Additionally, insurance companies could incentivize healthcare providers to avoid unnecessary imaging by reimbursing for fewer but more appropriate tests.

A concerted effort is needed to educate healthcare providers and patients about the potential risks of overuse. A National Institutes of Health report suggests that up to 30 percent of patients may not be fully aware of the risks associated with specific imaging procedures, such as radiation exposure. By promoting patient education, healthcare professionals can empower patients to ask more informed questions about the necessity of imaging and help reduce overuse.

Medical imaging has transformed the way we diagnose and treat illness, but with great power comes great responsibility. Overusing these technologies is a problem that cannot be ignored, as it risks patient health, contributes to healthcare inefficiencies and drives up costs. According to the World Health Organization, the cost of unnecessary imaging procedures could be reduced by 20-30 percent through better practices and guidelines. By fostering a culture of more thoughtful, evidence-based medical practice and promoting patient-centered care, we can ensure that imaging continues to serve its essential purpose without becoming an overused tool that does more harm than good.