Wednesday, June 23, 2010

MRIs in France

MRIs in France, or the lack of MRIs in France
A new survey reported in Quotidien du Medecin this week reveals that France has one of the lowest rates of access to MRIs in Europe. The chairman of the French Society of Radiology, Jean-Pierre Pruvo called the situation a “scandal” in an interview in November of 2009. There have been some discussions of how the new regional authorities, the Agences Regionale de Santé (ARS) will change that, but little has been done according to the annual survey by Imagerie Santé Avenir (ISA).

That survey showed France has 8.7 MRI units per million inhabitants (543 machines in January 2010) and waiting times for a scan average 35 days, the same wait as in 2004. In contrast, Germany had 20 per million, Norway 25, Iceland 19.3; and Italy, 18.6 per million. The Unites States has 26 per million, the most of any country.

The lack of MRI scanners is threatening to derail the French National Plan for Cancer which calls for a waiting time for scan of no less than 10 days. The waiting times vary widely by region with the Pays-de-la-Loire having the longest at 58 days. The shortest waits are in Picardie (22.3 days)

The arguments for expanding the supply of MRI units rests on the grounds of cost reductions. Dr. Pruvo cited several examples of more costly surgery and invasive procedures to resolve diagnoses and initiate treatment.

The concern in the US has been with the overuse of MRIs and CT scanners. A recent NEJM article (Michael S. Lauer, NEJM August 27, 2009) estimated that up to 4 million Americans were receiving doses of radiation that were likely to cause cancer.

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