Radiation Tests Are Questioned

"Every dollar of health care expenditure represents income to a provider - that's why cutting costs is so hard. Do you blame them? I don't."

Many doctors say they order the tests because they think that's what is best for an individual patient. Also, fears of malpractice lawsuits may lead physicians to order extra tests in some circumstances.

"It's not that we should stop imaging," said Dr. Rebecca Smith-Bindman, a professor of radiology and epidemiology at the University of California-San Francisco and co-author of a report on medical imaging in the journal Health Affairs last year. "But the sense is that all imaging is good. Some is good. Some is harmful. We need to get appropriate imaging."

Many medical experts said they worried about whether imaging is used too much for managing chronic illness. Once the disease is diagnosed, in most cases, new imaging isn't needed, Smith-Bindman said. Guidelines for when tests should be used need to be developed and followed and kept current with evolving science.

Meanwhile, she said, Medicare continues to pay for nearly all scans. Only recently did it refuse to pay for screening colonscopies using CT, she said. "They've just been willing to pay for anything," she said.