He added, "It seems inevitable that any good tool will be overused at some point; in fact, that is how we learn where the boundaries of diminishing returns are."
In a comment about the article and editorial, president of the American College of Emergency Physicians Sandra Schneider, MD, said a CT scan is great at diagnostics. It can, for example, identify patients with appendicitis accurately, "saving unnecessary exploratory operations or admitting the patient for observation."
"However, the improved certainty saves money and pain, but has a cost – increased radiation.
"Sometimes we order it to protect ourselves from a possible malpractice suit," for example even when prior screening is 98% accurate, she wrote.
"If we provided reasonable protection for emergency physicians who follow endorsed guidelines (perhaps with compensation for that one in a thousand victim) then we might see some real cost reduction in healthcare."
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Cheryl Clark is senior quality editor and California correspondent for HealthLeaders Media. She is a member of the Association of Health Care Journalists.