Question

Hi, kindly respond to the below question for me:

Regarding Gawande's "Score":

What controls, if any, should be placed on the diffusion of innovation (e.g. MRIs, CTs, drugs, obstetrical or surgical procedures) and other knowledge in health care? Why or why not?

Answer 1

MRI

There is no need of control on MRI Because radiation is not used, there is no risk of exposure to radiation during an MRI procedure.

However, due to the use of the strong magnet, MRI cannot be performed on patients with:

• Implanted pacemakers
• Intracranial aneurysm clips
• Cochlear implants
• Certain prosthetic devices
• Implanted drug infusion pumps
• Neurostimulators
• Bone-growth stimulators
• Certain intrauterine contraceptive devices; or
• Any other type of iron-based metal implants

CT

At the low doses of radiation a CT scan uses, your risk of developing cancer from it is so small that it can't be reliably measured. Because of the possibility of an increased risk, however, the American College of Radiology advises that no imaging exam be done unless there is a clear medical benefit.

So, use of CT lies on the demand of the hour.

Drugs

Every drug has it's own advantage and side effects. Most of the commonly used drugs have very little to none side effects and we need not worry about them. But some drugs like Anti-Biotics, Anti-Tubercular drugs, etc. are causes of concerns as their rampant use might lead to development of resistant pathogens.

Surgical Procedure

Every surgical procedure before it is carried out, all the risks involved are explained to the patient. Not all surgeries go wrong and not all surgies go right. Minor surgeries involves very little risk. High risk surgeries are peeformed only when the patient's life depends on the surgery, without which the patient has high chances of mortality.