Many times, as I’ve blogged before, the tail wags the dog in medicine in many ways. One way that occurs is the “If all you have is a hammer, everything looks like a nail” doctrine. This morning, I’d like to show just how far some doctors take this, by introducing you to my $50,000 MRI nerve injections review! Yes, you read that right, what would cost a few hundred dollars to get injected under ultrasound guidance, a physician is charging 50K to perform. You thought the defense department was nutty with their $600 toilet seat? Hah!
This story comes from a patient who wanted to get a diagnostic numbing injection of a deep nerve and/or muscle in the buttocks. The patient told me that she had investigated getting this done by a physician who is an expert in these injections, but he uses MRI to find the right spot. At first that sounded kind of cool as you need special non-metal needles to pull this off, until I learned the price. He wanted $25,000 USD per diagnostic injection! This covered his costs and the MRI center (which he owns)! What’s the real market price of such an injection performed by an expert in musculoskeletal ultrasound? A few hundred dollars to maybe a thousand.
This is an example of the “If all you have is a hammer, everything looks like a nail” principle. We see it with surgeons who offer patients incredibly invasive and sometimes life changing procedures to help a problem, when they should be offering more conservative alternatives. As an example, I spoke to a woman with neck pain yesterday who had a little stenosis on her MRI but no neurologic problems who ended up with a C5-C7 fusion! I would bet dimes to doughnuts that this hyper-expensive and hyper-invasive “solution” to her problem that has now caused new disabling problems could have been replaced with a much less expensive and invasive injection based option.
The upshot? If you bought an MRI machine and could convince patients to pay you 50K for two injections that should cost a few hundred dollars if done with a different, but just as accurate technology, isn’t that bad? It certainly wastes tons of money and maybe you should listen to what Confucius once said, “Never use a cannon to kill a fly”.