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Understanding the CAT Scan Cascade

Posted Apr 13 2009 12:00am


If we are ever to prevail against the CAT scan cascade, we must understand why these tests are ordered. Here are 7 explanations of why doctors scan their patients. Talk to your own doctor and see if I’ve missed a few. While some physicians have financial conflicts of interest, most order scans for other reasons. This is not a ‘choose the best answer’ multiple choice test. Physicians often have more than one reason to scan you.


The physician orders a scan to follow trivial lesions identified by accident on prior scans.

A patient or the family want a medical test believing that a diagnosis has been missed.

The physician orders a CAT scan hastily, without sufficient thought if it makes medical sense.

The physician has a financial interest in ordering CAT scans.

The physician correctly believes that the scan is medically necessary.

The physician orders a CAT scan defensively for his own legal protection.

The physician orders a scan to bypass a difficult discussion of a patient’s chronic complaints.



I don’t pretend to be a medical saint. I have certainly ordered CAT scans for many of the wrong reasons listed above. Clearly, there should be only 1 reason that a doctor orders a CAT scan on a patient. It’s right there on the list. Can you spot it?

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