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Is it the economy? Fear of radiation? Loss of health insurance by potential patients? All of the above?

Whatever the cause or causes, this has not been a good year for the high-tech imaging business. The Diagnostic Imaging news service reports that CT and MR imaging volumes are flat or declining across the United States.

The article quotes Tom Cabot, vice president of Arlington Medical Resources, a medical-data company, as saying that CT and MRI volumes plateaued nationwide in the second half of 2009 and began to decline this year. The hospital market is even with last year, possibly helped by an increase in coronary CTA, which is usually available only in hospital settings, he said. Volumes in the nonhospital market, largely imaging centers, are declining, he said.

RadNet, a network of 175 outpatient imaging centers in seven states, reported that its volumes were down between 5 percent and 10 percent from the same period last year.

At Wake Forest University Baptist Medical Center in North Carolina, nearly every area of radiology grew by 5 percent to 7 percent a year over the past decade. This year, CT volumes are down 7 percent compared with last year, MRI volumes are down 5 percent, and ultrasound is down 1 percent.

“This is quite typical of what is happening at many private and public institutions in the Southeast, as best I can tell,” said Allen Elster, MD, radiology chair at Wake Forest. “Some of the largest private groups in North Carolina are down in both CT and MRI by 10 percent or more this year.”

In a recent poll of U.S. hospital administrators, 12 percent said their CT volumes had decreased by 10 percent or more in the past six months, and another 32 percent said volumes had have decreased by up to 10 percent. Deserving at least part of the blame, said 40 percent, were concerns about radiation.

Dr. Elster focused more on economic concerns:

Although radiation worries could be driving CT down, it’s my guess that it is the economy as a whole, and different patterns of patients going to the doctor and putting off elective and expensive tests.

Don’t look for a quick recovery, said Steven Renard, president and CEO of Diagnostic Radiology and Oncology Services, a development, management, and consulting firm with particular expertise in imaging centers.

“I think we’re going to be among the last to fall out of this economic recession by virtue of the fact people don’t want to take time off work to go find out what’s wrong with them and risk losing their jobs.”

So maybe more flexible hours might help? Or promotion of MRI as a radiation-safe imaging method? It might not be a bad idea to give some thought to unconventional strategies for dealing with these unconventional times. It’s looking doubtful that a general economic recovery will be coming to the rescue anytime soon.

Related seminar: The Business of Radiology


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