Jennwood Chen1, Sarah Majercik2, Joseph Bledsoe2, Karen Connor2, Brad Morris2, Scott Gardner2, Casey Scully2, Emily Wilson2, Justin Dickerson2, Tom White2, Douglas Dillon2. 1. Department of Surgery, Intermountain Medical Center, 5121 South Cottonwood Street, Murray, UT 84157, USA; Department of Surgery, University of Utah and Affiliated Hospitals, 50 North Medical Drive, Salt Lake City, UT 84112, USA. Electronic address: Jennwood.chen@hsc.utah.edu. 2. Department of Surgery, Intermountain Medical Center, 5121 South Cottonwood Street, Murray, UT 84157, USA.
Abstract
BACKGROUND: Defensive medicine is estimated to cost the United States $210 billion annually. Trauma surgeons are at risk of practicing defensive medicine in the form of reflexively ordering computed tomography (CT) scans. The aim of this study is to quantify the monetary impact and radiation exposure related to the radiographic workup of trauma patients. METHODS: We conducted a prospective, observational study involving 295 trauma patients at Level I trauma center. Physicians were surveyed regarding specific CT scans ordered, likelihood of significant injuries found on scans, and which scans would have been ordered in a hypothetical, litigation-free environment. RESULTS: Four hundred sixteen of 1,097 CT scans (38%) were ordered out of defensive purposes. Nine CT scans (2.2%) that would not have been ordered resulted in a change in management. Defensively ordered CT scans resulted in nearly $120,000 in excess charges and 8.8 mSv of unnecessary radiation per patient. CONCLUSION: Defensively ordered CT scan in the workup of trauma patients is a prevalent and costly practice that exposes patients to potentially unnecessary and harmful radiation.
BACKGROUND: Defensive medicine is estimated to cost the United States $210 billion annually. Trauma surgeons are at risk of practicing defensive medicine in the form of reflexively ordering computed tomography (CT) scans. The aim of this study is to quantify the monetary impact and radiation exposure related to the radiographic workup of traumapatients. METHODS: We conducted a prospective, observational study involving 295 traumapatients at Level I trauma center. Physicians were surveyed regarding specific CT scans ordered, likelihood of significant injuries found on scans, and which scans would have been ordered in a hypothetical, litigation-free environment. RESULTS: Four hundred sixteen of 1,097 CT scans (38%) were ordered out of defensive purposes. Nine CT scans (2.2%) that would not have been ordered resulted in a change in management. Defensively ordered CT scans resulted in nearly $120,000 in excess charges and 8.8 mSv of unnecessary radiation per patient. CONCLUSION: Defensively ordered CT scan in the workup of traumapatients is a prevalent and costly practice that exposes patients to potentially unnecessary and harmful radiation.
Authors: Ali Pourvaziri; Amirkasra Mojtahed; Peter F Hahn; Michael S Gee; Avinash Kambadakone; Dushyant V Sahani Journal: Eur Radiol Date: 2022-09-08 Impact factor: 7.034
Authors: Monica Tung; Ritu Sharma; Jeremiah S Hinson; Stephanie Nothelle; Jean Pannikottu; Jodi B Segal Journal: Am J Emerg Med Date: 2017-10-25 Impact factor: 2.469