Of course, no one would dispute ordering a CT for a trauma patient if the presentation warrants. But the article was talking about the increase in CT usage ove

Of course, no one would dispute ordering a CT for a trauma patient if the presentation warrants. But the article was talking about the increase in CT usage over the past 20 years. That's largely been driven (in the US) by misaligned incentives that reimburse procedures at much higher rates that clinical decision making. Put simply, the person who owns the CT machine makes much more than the doctor who interprets the results. And so we have had a blossoming of imaging centers, and CT machines have moved into outpatient cardiology and even family care practices. One of the major goals of Obamacare is addressing these misaligned incentives and shifting to a model where providers are paid to keep people healthy (outcome driven) rather than on volume (fee for service). Another issue has been the difficulty of sharing/accessing existing imaging data, so tests are just repeated to save time (rather that save cost or adequately balance safety). Our long, painful journey to electronic record standardization should also help with that.