CT scan misuse and Obama’s physical
Posted by medconsumers on April 14, 2010
It could become a regular feature on this Web site….we’d call it, “Inappropriate medical care of the rich and powerful.” In February, it was “Angioplasty overuse and Bill Clinton.” And the latest example could be titled, “Too many CT scans for our healthy young president.” Barack Obama had his first presidential physical recently and at least one academic physician has already written a critique of two tests he received. There was the CT scan of his coronary arteries, a test with no proven value in reducing the risk of heart attack in a symptomless person. “Indeed the most powerful way for President Obama to reduce his cardiac risk is to stop smoking—a step that will reduce by 72% his chance of a cardiac event in the next ten years,” wrote cardiologist Rita F. Redberg, MD, editor of Archives of Internal Medicine.
The president also underwent a virtual colonoscopy, which has no proven benefit as a screening test for anyone without symptoms. It wasn’t just the excessive cost of these inappropriate tests that alarmed Dr. Redberg. Each CT scans exposed the president unnecessarily to a large radiation dose from each procedure that increased his risk of developing cancer later in life. The more immediate harm is the detection and unnecessary treatment of small cancers that would never become life-threatening.
In an earlier editorial for her journal, Dr. Redberg warned about the ever-increasing number of CT scans done on Americans yearly (one-third of them unnecessary) and how the radiation exposure from these scans is far higher than previously thought. But that’s not all that bothers Dr. Redberg about the presidential physical. President Obama has—unwittingly, no doubt—set a bad example for health care reform. He fed that typically American misperception that more testing equals better care.
How can we hope to protect ourselves from unnecessary CT scans when a sitting president just gets on the proverbial conveyor belt going from one questionable test to another? Dr. Redberg gave one example of a situation where a patient might object to a CT scan: “More and more patients go from the emergency department to the CT scanner even before they are seen by a physician or brought to their hospital room.”
For more information about limiting radiation exposure and when to “just say no” to CT scans, read this 2010 article from the Associated Press and our 2009 article “CT Scans—lots of radiation, little research.” For more about the risks of finding cancers that do not progress, read this review of a book entitled, “Should I be tested for cancer” by H. Gilbert Welch, MD.
Maryann Napoli, Center for Medical Consumers(c)