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Comment & Response
June 11, 2019

Solutions to Reduce Unnecessary Imaging

Author Affiliations
  • 1Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania
JAMA. 2019;321(22):2242-2243. doi:10.1001/jama.2019.4002

To the Editor Dr Oren and colleagues stated that unnecessary diagnostic imaging is a problem and that the detection of harmless incidentalomas can lead to a cascade of follow-up studies that increase patient anxiety and risk and costs to the system.1 However, their proposed solutions are impractical.

The authors suggested that clinicians engage in a shared decision-making process with patients before ordering examinations such as computed tomographic scans. In an ideal world, this would be helpful, but unfortunately, clinicians are under pressure to move patients in and out of the office quickly. There is no time for a leisurely discussion of whether a patient would like to undergo a computed tomographic scan. Moreover, no insurer is likely to pay for such discussions.