[fisherjeff]

Agreed. MRI machines are not the bottleneck - we have 3 in my area, serving maybe 100k people. Assuming most people are like me and spend about an hour in an MRI machine every 40 years, we should be at something like 25% utilization, which seems comfortable.

[s1artibartfast]

Thats a pretty big assumption. How old are you? My elderly parents are getting MRIs once or more per year.

They are very common in orthopedic medicine.

[fisherjeff]

Okay that’s a very surprising number of MRIs…

I’m in my early 40s and have had 1. Everyone I know well has had 1 or (more typically) none, including my parents and in-laws, so I figured ~2 lifetime MRIs would be in the right ballpark

[fisherjeff]

Well apparently there are ~40m MRIs per year in the US, implying around 9-10 lifetime MRIs, which seems... pretty high? It's also wild that, at 85-90m CTs per year, apparently the average person is getting more than 20 lifetime CT scans.

[s1artibartfast]

And the distribution is likely heavily skewed in one direction. For example, Medicare recommends and covers annual chest CT for smokers and ex-smokers.

[fisherjeff]

Oh for sure it’s skewed, and it doesn’t surprise me that there are people that will get 20+ CTs. Wild that that’s the average though - the skew must be massive.

[tptacek]

Yes. That's probably a bad thing.

[s1artibartfast]

from a system cost perspective, absolutely. For specific beneficiaries, not so much, especially after they have aged out of paying into the system. This is a textbook challenge with the US healthcare economy.

[tptacek]

Not just from a cost perspective: overuse of imaging, particularly in orthopedic medicine, is apparently a major driver of iatrogenesis in American medicine. It actively does harm.

[s1artibartfast]

surely your mean related over treatment or intervention. I am not aware of any adverse health consequences from MRI itself. CT has clear downsides.

That said, there is a pretty big difference between screening and elective medicine.

[tptacek]

I don't think the term "elective medicine" means anything useful in this conversation. But, yes: I'm referring to unnecessary surgeries consequent to MRI; a big problem, especially for stuff like knees and spines.