7 ms·

This crazy. It's like saying no one should have access to medical tests without a doctor's approval because some people will misinterpret their tests.

SilasX 7y ago
More than “like”, I’d say “equivalent to”.
jrowley 7y ago
Time on an MRI scanner (and to interpret and communicate the result) is a limited resource. I fear unrestricted access would lead to over utilization by some people at the cost of less utilization by others. It could also lead to nontrivial psychological stress for people who can’t get a full understanding of the results. But I do think we need to strive for increased transparency from price lists to EHR interoperability to patient access to their own records.
- gowld 7y ago
  MRI is profitable and not made from scarce materials. Increased demand will increase production. Doctors are only scarce because they are members of a guild that uses monopoly power to restrict competition to prop up prices.
  - jrowley 7y ago
    MRIs depend on liquid helium, a scarce material by definition, but that's besides the point. There is a high bar to becoming a physician because the consequences for error can be so incredibly high. I want there to be more physicians/access to medical care than ever but I don't think compromising on quality is the way to get there.
    - polishdude20 7y ago
      Actually helium being scarce is a myth.
      - jrowley 7y ago
        Are you sure? Seems to be pretty well documented that there is a shortage? https://priceonomics.com/the-increasing-scarcity-of-helium/ https://priceonomics.com/the-increasing-scarcity-of-helium/ http://www.heliumscarcity.com/ http://www.heliumscarcity.com/
        labawi 7y ago
        When it's cheaper to keep refilling an MRI scanner that boils off lots of helium, than buying one that loses only a little bit, then yes, you use a lot of helium. It's not like we haven't discovered higher temperature superconductors that could be used, even if we didn't have helium. EDIT: You can permanently fill 100 of these[1] per year with the boil off of one shitty MRI. Is uses about 1kg of He, so one year of world helium production would be enough to make one MRI machine for every 200 people. We are not constrained by helium. [1] https://images.philips.com/is/content/PhilipsConsumer/Campaigns/HC20140401_DG/Documents/Option%20sheet_BlueSeal_with%20name%20tag.pdf https://images.philips.com/is/content/PhilipsConsumer/Campai...
- labawi 7y ago
  > Time on MRI scanner .. is a limited resource. It's a limited resource similar to houses and carpenters. If it is permitted and there is funding, more can be built/trained.
DanBC 7y ago
How many "well educated adults" can convert 1 in 1000 to 0.1%? It's not just members of the public who don't understand stats, it's some doctors too. https://www.stat.berkeley.edu/~aldous/157/Papers/health_stats.pdf https://www.stat.berkeley.edu/~aldous/157/Papers/health_stat... This quote is from p61 but the whole thing is interesting) > Note again the great difficulty large parts of the public, like the female veterans, have with translating small frequencies into percentages. Only 25% of the population could correctly convert 1 in 1,000 to 0.1%. Even among the highest education groups, at most 30% could solve this translation task. Lipkus, Samsa, andRimer (2001) even found that only 21% of well-educated adults could answer this question correctly. You have prostate cancer. It's definitely cancer, this isn't a misdiagnosis. Do you want the treatment, or do you want to do nothing? This is a real choice faced by many men, in part because of the over-use of PSA testing. https://www.cdc.gov/cancer/prostate/basic_info/benefits-harms.htm https://www.cdc.gov/cancer/prostate/basic_info/benefits-harm...
anthonypasq 7y ago
That seems like a perfectly reasonable reason to me
- nybble41 7y ago
  It's a perfectly patronizing reason. If they're so concerned that test requires may be misinterpreted then the solution is better education. It is not their place to serve as gatekeepers.

SilasX 7y ago

More than “like”, I’d say “equivalent to”.

jrowley 7y ago

Time on an MRI scanner (and to interpret and communicate the result) is a limited resource. I fear unrestricted access would lead to over utilization by some people at the cost of less utilization by others. It could also lead to nontrivial psychological stress for people who can’t get a full understanding of the results. But I do think we need to strive for increased transparency from price lists to EHR interoperability to patient access to their own records.

gowld 7y ago
MRI is profitable and not made from scarce materials. Increased demand will increase production. Doctors are only scarce because they are members of a guild that uses monopoly power to restrict competition to prop up prices.
- jrowley 7y ago
  MRIs depend on liquid helium, a scarce material by definition, but that's besides the point. There is a high bar to becoming a physician because the consequences for error can be so incredibly high. I want there to be more physicians/access to medical care than ever but I don't think compromising on quality is the way to get there.
  - polishdude20 7y ago
    Actually helium being scarce is a myth.
    - jrowley 7y ago
      Are you sure? Seems to be pretty well documented that there is a shortage? https://priceonomics.com/the-increasing-scarcity-of-helium/ https://priceonomics.com/the-increasing-scarcity-of-helium/ http://www.heliumscarcity.com/ http://www.heliumscarcity.com/
      - labawi 7y ago
        When it's cheaper to keep refilling an MRI scanner that boils off lots of helium, than buying one that loses only a little bit, then yes, you use a lot of helium. It's not like we haven't discovered higher temperature superconductors that could be used, even if we didn't have helium. EDIT: You can permanently fill 100 of these[1] per year with the boil off of one shitty MRI. Is uses about 1kg of He, so one year of world helium production would be enough to make one MRI machine for every 200 people. We are not constrained by helium. [1] https://images.philips.com/is/content/PhilipsConsumer/Campaigns/HC20140401_DG/Documents/Option%20sheet_BlueSeal_with%20name%20tag.pdf https://images.philips.com/is/content/PhilipsConsumer/Campai...
labawi 7y ago
> Time on MRI scanner .. is a limited resource. It's a limited resource similar to houses and carpenters. If it is permitted and there is funding, more can be built/trained.

DanBC 7y ago

How many "well educated adults" can convert 1 in 1000 to 0.1%? It's not just members of the public who don't understand stats, it's some doctors too. https://www.stat.berkeley.edu/~aldous/157/Papers/health_stats.pdf https://www.stat.berkeley.edu/~aldous/157/Papers/health_stat... This quote is from p61 but the whole thing is interesting) > Note again the great difficulty large parts of the public, like the female veterans, have with translating small frequencies into percentages. Only 25% of the population could correctly convert 1 in 1,000 to 0.1%. Even among the highest education groups, at most 30% could solve this translation task. Lipkus, Samsa, andRimer (2001) even found that only 21% of well-educated adults could answer this question correctly. You have prostate cancer. It's definitely cancer, this isn't a misdiagnosis. Do you want the treatment, or do you want to do nothing? This is a real choice faced by many men, in part because of the over-use of PSA testing. https://www.cdc.gov/cancer/prostate/basic_info/benefits-harms.htm https://www.cdc.gov/cancer/prostate/basic_info/benefits-harm...

anthonypasq 7y ago

That seems like a perfectly reasonable reason to me

nybble41 7y ago
It's a perfectly patronizing reason. If they're so concerned that test requires may be misinterpreted then the solution is better education. It is not their place to serve as gatekeepers.