[Intl_DxMedPhys] How far should we go with advice

[Bob Kobistek]

Hi list.

I got a call from a lady who was looking for a hospital to do her calcium score scan. Her local hospital closed. She was asking what would be her effective dose from the scan and explained that she had reached her "lifetime limit" so essentially, she was shopping for the lowest dose. I asked her to explain the lifetime limit. She said that she had received "an enormous amount of ct rads due to errors at the hospital." Subsequently a radiologist refused to do a Ba swallow because of it. He told her to not have any more CT scans and only get ultrasound or MRI in the future.

I started typing a response telling her to get a second opinion about the "lifetime limit," explaining how stochastic effects work, how the decision to go forward with a scan should be based on risk vs benefits of the current scan, not the past scans, and so on. Then I deleted that part out of fear of liability. I'm not a physician, and that lady isn't even a patient at the hospital where I consult. But on the other hand, I feel that I'm doing her a disservice to not say something about the fool of a radiologist who told her to stop betting CT scans.

I'm thinking pointing her to some lay-language reading material might be a good step.

Thoughts?



Robert J. Kobistek, MS, FACR, DABR, MRSE(MRSC(tm))
Medical Physicist
RJK Medical Physics, Inc.
440-463-7879

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