Saurabh Jha, a radiologist at the Hospital of the University of Pennsylvania, in an article in New England (From imaging gatekeeper to service provider: a Transatlantic journey) explains that when he undertook MRI in the UK, residents feared the radiologists, not in vain, since one of them known as “Dr. No”. Migrated to the United States, quickly realized that there, the radiologists who were operating and issuing invoices as service providers, were rather “Dr. Yes”. The involvement of the radiologist in clinical reasoning was gone.
There is a widespread perception that the large investments of modern screening equipment are increasing their disproportionate use and the position of the radiologists, many of them involved in investments, is far from the function of gatekeepers, so praised by Dr. Jha. To this effect, it is revealing in a letter published in JAMA Internal Medicine (Overuse of Magnetic Resonance Imaging) about a consensus methodology (Rand Corporation University of California Los Angeles UCLA) to determine the degree of indication of MRI for low back pain and headache cases. The results say that 77% of the experts consulted, for example, believe that the MRI indication for back pain of less than 6 weeks duration is inappropriate or not well founded.
