Dr. Mark Jacobson
A few years ago while I was working in a hospital, I received an order to read a chest X-Ray specifically to locate a catheter in a patient’s abdomen. The X-Ray was performed with a portable machine at the patient’s bedside, however, when I looked at the chest X-Ray I could not see a catheter in this patient. The image looked like a normal chest with nothing exciting to report. Despite my findings, the nurses insisted the patient had a line and I needed to provide its exact location for the surgeon to do his work. I looked again thoroughly and then consulted with another radiologist who also could not see the placement of the catheter. I contemplated how I could solve this issue without subjecting the patient to the radiation exposure of a CT scan. As a hospital patient it was likely he may have already had many scans, as is routine in hospitals.
I recalled stopping in the hallway that morning to examine a brand new DR (digital/filmless) portable X-Ray machine, wondering why it was sitting in the same place as the days before. I was told that it wasn’t being used because it was so new that no one had yet been trained to use it. I insisted we give it a try, and we brought it to the patient’s bedside where the technologists and I were able to figure out how it worked and even take a new chest X-ray. To my amazement, this picture looked as if it belonged to a completely different patient. The resolution was crisp and clear, which enabled me to not only see the placement of the catheter, but the vascular, muscles and organ systems as well. I was able to complete an accurate report from these fine resolution images.
I wish I could count how often people without insurance call my office and ask how much it will cost to have an imaging study, then decide to go to a competitor over a 25 dollar price difference. If you were calling various places for the price of a car for example, wouldn’t you compare the exact same make and model to get the best apples to apples price comparison? In other words, it isn’t wise to assume medical machines are all alike; technology is quickly changing while equipment safety standards and image quality are constantly improving.
Imaging equipment, much like cameras, comes in many makes, models, and prices. The finer the precision of the lenses and the higher the technology and safety, the higher the price. You can’t expect them to achieve the same photograph, because they aren’t the same.
The same goes for imaging equipment in medical facilities. Your diagnosis is only as good as the image quality because the radiologist can only report what they can see. When it comes to your health and a proper diagnosis, why compromise quality? My advice for patients is to Be in the Know and become your own advocate. Look for quality equipment. Look for a facility that adheres to ALARA (As Low As Reasonably Achievable) when referring to radiation exposure. This is the guiding principle of radiation safety, which is a regulatory requirement by the American College of Radiology.
Radiology is much more than owning a machine such as a CT or X-ray. It’s about using it safely by paying close attention to the size of the patient, time of the procedure, distance from the machine and lead shielding, all in an effort to maintain exposures to ionizing radiation as far below the dose limits as practical. An unbelievable number of medical offices contain CT machines which are not ACR accredited and do not adhere to ALARA standards, and have no radiologist physicians. It is crucial that the operators are certified radiological technologists as well and not just certified machine operators. Technologists have specialty training in radiation safety in addition to clinical training under the guidance of a radiologist physician. Additionally, unlike many centers which just follow orders to do a specific exam, a center which adheres to ALARA principles will take the time to determine which imaging study is most appropriate. Sometimes it’s a study that delivers no radiation to the patient such as an MRI or an ultrasound. At MIT we work with your physician to determine appropriate studies.
Finally, it’s not just about having quality equipment, but also a highly-skilled team that knows how to use that equipment to the patient’s advantage. Don’t be afraid to ask your physician or technologist if the X-ray is digital, rather than analog. Digital X-ray offers much lower radiation exposure than the older analog machines and the image quality is sharp and precise. High-quality machines paired with a reading done by a Board Certified radiologist will produce the greatest likelihood of receiving a correct diagnosis, as radiologists are specialty trained physicians with many years of experience.
Medical Imaging & Therapeutics
The Summit Medical Park
769 Co Rd 466, Lady Lake, FL 32159