Unnecessary CT scans ordering must stop, warns Medicare

The widespread and unnecessary ordering of high-radiation CT scans which can trigger cancer has alarmed the Medicare watchdog, after a high increase in the number of health workers and doctors referred to the agency for investigation.

Professional Services Review (PSR) has scrutinized the records of a doctor who had ordered a CT scan for a patient who complained of back pain starting just the night before, even though no signs of serious health problems were presented.

Another doctor has been found to have the habit of ordering abdominal CT scans of young women, exposing a radiation of 800 times more than emitted by a simple X-ray, onto their reproductive organs, without even warning them of the risks.

According to the PSR's latest report released today, there have been 136 of such referrals in 2008-09, compared with 50 the previous year. The PST made 28 findings of inappropriate practice against doctors last year, as compared to just seven in 2007-08, that resulted in orders or agreements that doctors repay $1.7 million in Medicare benefits.

Director of PSR, Tony Webber said he was "disappointed" in the increase in referrals that reveals a host of other issues like inaccurate charging, cavalier ordering of antibiotics, addictive drugs and other treatments, and poor record-keeping.

The report also reproduced an excerpt of a medical record of one unidentified patient, whose doctor had written nothing more informative that the patient's blood pressure and the summary "feel sick" as the whole history, for over five separate consultations. Listed in top concern is the inappropriate ordering of CT scans.

The investigations found one doctor who was required to repay a total of $50,000 of the $512,188 claimed by Medicare, for regularly ordering CT scans on any patient presenting with back pain.

Richard Mendelson, Perth consultant informs that a single abdominal CT scan emitted so much radiation it was estimated it would cause a cancer in one in every 1000 patients. Dr Webber says that CT scans should not be ordered for patients with back pain unless there are other "red flags" like a recent trauma, fever or unexplained weight loss.

"Patients sometimes bear a bit of responsibility. They will sometimes request a CT, thinking it's the best thing since sliced bread. Patients need to be educated that these things have a place but not without due consideration," says Dr Webber.