Direct-to-consumer imaging is opening up opportunities for patients to shop for more affordable exams, but researchers are warning that these offers come with substantial safety and ethical concerns.
Discounted radiology services can result in unnecessary testing, incidental findings, and false positives, among other problems, authors noted Monday in JAMA Internal Medicine. The researchers found that 84 companies offer vouchers for these services through the e-commerce marketplace Groupon, yet only one mentioned the potential risks associated with medical imaging.
And given that consumers bought more than 28,000 imaging coupons as of February, the cost-conscious medical solution could pose problems, the team wrote in its new research letter.
“Although free-market solutions can increase patient flexibility and curtail healthcare costs, consumer independence must be balanced with the potential for harm,” Sheena Desai, BS, a dermatologist with Brigham and Women’s Hospital, and colleagues wrote. “Promotions highlighting unsubstantiated medical claims may lead customers to purchase unnecessary, potentially unsafe examinations,” they explained later.
Desai and colleagues completed a cross-sectional analysis of Groupon vouchers offered in the U.S. on Feb. 6. They found 84 companies promoting discounted exams in 27 states, keying in on the state’s largest city.
Here are some highlights from their research:
- California had the highest number of available coupons at 10, followed by Illinois (9), Nevada (7), and Georgia (6).
- Among the 28,380 vouchers sold by Feb. 6, consumers bought CT the most (41.3% of coupons), with fetal ultrasonography accounting for 36.9% of sales.
- The average price of imaging services varied from $60 for a body or biofeedback scan to $687 for MR imaging. Average retail prices for such exams, the authors noted, was $126 and $2,000, respectively.
- Thirty-eight companies made unsubstantiated medical claims, with only one notifying patients of potential imaging-related risks. One such claim said that a CT scan could help prevent heart disease and predict future heart attacks.
- The average customer rated their experience a 4.8 out of 5. After analyzing 2,044 reviews, 90 (4.4%) suggested someone tried to up-sell them on added imaging during their visit. All patients (25) said they were self-referred for their appointment.
The authors noted the study was limited by their inability to fully determine why patients sought out imaging, confirm sales, and assess the quality of exams. Desai et al. suggested that more research is needed to weigh the health benefits of imaging vouchers against consumers' financial savings.
“Future studies should examine the appropriateness, accuracy, safety, and follow-up of DTC imaging services to determine their true benefit," the authors concluded. "Improved regulation of medical advertising is needed to reduce false claims and improve patient safety, thereby maximizing the benefits of DTC imaging services while minimizing the potential for harm.”
Read the entire research letter here.
Matt joined Chicago’s TriMed team in 2018 covering all areas of health imaging after two years reporting on the hospital field. He holds a bachelor’s in English from UIC, and enjoys a good cup of coffee and an interesting documentary.