"If the need is justified...patients should seek out a radiologist-run imaging facility or hospital for their examinations."

The prior quote and the following excerpt are borrowed from an editorial by Dr Helene Pavlov, of the Hospital for Special Surgery. The Radiologist-in-Chief and Professor of Radiology in Orthopaedic Surgery points out the pros and cons of restricting high-end imaging studies in order to attempt to decrease overall health care costs.

In today's cost-conscious climate, too acute a focus on costs may yield unintended consequences that will adversely affect patient care. Radiology imaging is not the culprit; Over-utilization of imaging may be. 

Pay particular attention to the author's acknowledgement of the essential collaboration that occurs between a patient's primary physician and the radiologist. Doctors do not work in vacuums. we collaborate with each other daily.

"The answer to the question regarding the limiting of access and utilization of imaging examinations is based on the role the examination has in the treatment. While it is easy to understand that less imaging would curb health care costs, this may be penny wise and pound foolish as the long-term patient outcomes and health care costs may be negatively affected. An appropriately ordered, performed and interpreted imaging examination can be life-altering. An MR, CT or other imaging examination performed early after the onset of symptoms, when imaging findings of a condition or a disease process are subtle, can be extremely important. These imaging examinations are more sensitive and specific than routine X-rays and can detect certain conditions even before there are significant clinical symptoms. The cost of a CT or MR imaging examination under these circumstances is justified as accurate diagnosis early in the disease process helps prevent prolonged unnecessary suffering, and helps avoid more complex and expensive treatment and preventable lost time from work and interruption of life activities.

Imaging examinations are linked to radiologists; however, radiologists do not order imaging examinations. Radiologists are physicians who spend dedicated years of residency and fellowship training following medical school focused on all aspects of imaging. Radiologists are trained on image acquisition. They learn how to optimize the equipment by setting the correct imaging protocols for demonstration of pathology. Radiologists are also trained to protect patients from ionizing radiation and to prevent injury. They spend their entire careers learning how to interpret images and to identify subtle signs of disease, trauma, etc. on images. Most radiologists are also subspecialty trained and conduct research and closely monitor the technologic imaging breakthroughs in their subspecialty. They have the skill set to determine appropriate utilization of imaging.

Because imaging examinations are often performed by a radiologist who the patient does not see, patients frequently ask questions such as: Who is this doctor billing me for this examination? My doctor looked at the study and told me what it showed; did I need this X-ray interpretation by a doctor I never saw? What patients are usually not made aware of by their referring physicians is that they often consult with a radiologist regarding the findings on imaging examinations. These consultations are pivotal to patient care. A suspected diagnosis can be confirmed or excluded and finalized by this clinician -- radiologist collaboration reviewing an appropriately ordered and interpreted imaging examination. Even though the radiologist may not actually see or be seen by the patient, their training and collaboration benefits the patient, the referring physician, the insurances and ultimately, the healthcare system. I like to think that although the radiologist may not see the patient, the radiologist sees inside the patient."