US commercial scanning clinics are closing down

BMJ 2005; 330 doi: (Published 03 February 2005) Cite this as: BMJ 2005;330:272
  1. Scott Gottlieb
  1. New York

    The trend in the United States for people to pay for whole body computed tomography scans has declined, and once thriving large businesses set up for the purpose are now closing down their operations.

    The growth began in the late 1990s with the creation of hundreds of scanning centres, many of which funded large advertising campaigns aimed directly at the consumer. Thousands of Americans were paying out of their own pockets for the scans, which could cost $1000 (£530; €770) or more.

    Whole body scans gained much momentum in 2000, helped in large part by a high profile media campaign by Dr Harvey Eisenberg, the owner of HealthView, a scanning centre in Newport Beach, California.

    Academic medical centres also got into the business, including Beth Israel Deaconess Medical Center at Harvard, which opened its “Be Well Body” scan. The centre is owned by the Beth Israel Radiology Foundation, a non-profit organisation that supports the hospital's radiology department.

    Now many of the businesses created to deliver the scans are being closed. CT Screening International, which scanned 25 000 people at 13 centres across the nation, went out of business. AmeriScan, another national chain, also closed down.

    A New York Times article reports that the closing of these businesses shows the limits of direct to consumer advertising and the power of dissuasion by professional societies, which warned against having the scans (23 January; sect 1: 1). The tests, they said, would mostly find innocuous lumps in places like the thyroid or lungs, requiring rounds of additional tests to rule out real problems, and would miss common cancers, such as those of the breast.

    The scans also concerned public health officials, including the Food and Drug Administration, which warned that the scans could lead to other unnecessary and potentially dangerous diagnostic testing.

    Dr Barnett Kramer, director of the US National Institutes of Health's Office of Disease Prevention, said: “For every 100 healthy people who undergo a scan, somewhere between 30 and 80 of them will be told that there is something that needs a workup—and it will turn out to be nothing.”

    Concern is also growing about the rising cost of diagnostic imaging in the United States—even legitimate scans ordered by doctors for the purpose of diagnosing real and suspected medical problems. This year alone the total cost could reach nearly $100bn for all types of diagnostic imaging.

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