Well, some doctors and other public health officials.
Over the past few years, the cost of computed tomography (CT) scan equipment has fallen dramatically. The price is so low, in fact, that there are now a number of companies which sell CT scan services directly to consumers.
Gina Kolata writes in The New York Times about the controversy over one such company, CAT Scan 2000. For $200-$570, CAT Scan 2000 will perform a CT scan of your body. As Kolata notes, “It [CAT Scan 2000] proudly calls itself the Wal-Mart of scanning.”
This, in turn, is part of a growing trend of marketing medical diagnostic tests to individuals directly. In fact there are a number of referral services on the Internet that, for a fee, will arrange for all sorts of tests that your doctor is unlikely to order (unless you present evidence of having a related condition).
Doctors and public health officials seem to universally despise this democratization of medicine. How dare a patient presume to go out and get a CT scan just because she can? They tend to criticize these sorts of tests as wasting precious health resources — especially since such tests are likely to turn up small abnormalities that are really not health problems but which will cost a lot of money to investigate (Kolata does a nice job of chronicling one doctor’s expensive foray into tests following abnormalities that showed up on a CT scan). Of course, CAT Scan 2000 and others point to people whose scans found cancers and other diseases that would have otherwise went undiagnosed.
As Ronald Bailey notes in an article on private CT scans for Reason, the medical profession has a long history of wanting to keep patients from having direct access to diagnostic tests. As he notes,
The CT scanning dispute is reminiscent of the debate in the 1990s over whether women should have access to the test for the BRCA breast cancer gene. Medical professionals were nearly unanimous that women should not be able to get a BRCA test on the grounds that, if it turned out they had the gene, there was no clinically validated treatment available.
Despite these pronouncements, many women pressed on, obtained the test, and if they found that they were at risk, chose to have mastectomies. Subsequent research has conclusively shown that mastectomies dramatically reduce a BRCA gene carrier’s risk of getting breast cancer. Many women would have died had they waited until they got the gatekeepers’ okay to proceed.
I think CAT Scan 2000 and companies like it are an excellent idea. One company advertised that they would even burn images of the scan onto a CD-ROM for a fee. I’d love to post a scan of my lungs to my web site.
Sources:
Cheaper Body Scans Spread, Despite Doubts Gina Kolata, The New York Times, May 27, 2002.
Scanning for Health?
“Ignorance is bliss,” say some doctors. Ronald Bailey, Reason, May 29, 2002.