Rapid Rise and Fall for BodyScanning Clinics

1
Rapid Rise and Fall for Body-Scanning Clinics

• By GINA KOLATA
• New York Times
• Published January 23, 2005

http//www.nytimes.com/2005/01/23/health/23scans.h
tml?hpex1106456400enc80c40c9e3171a4aei5094p
artnerhomepage
2
Demand for Scans

• Dr. Thomas Giannulli, a Seattle internist,
  thought he was getting in at the start of an
  exciting new area of medicine. He was opening a
  company to offer CT scans to the public - no
  doctor's referral necessary. The scans, he said,
  could find diseases like cancer or heart disease
  early, long before there were symptoms. And, for
  the scan centers, there was money to be made.
• The demand for the scans - of the chest, of the
  abdomen, of the whole body - was so great that
  when Dr. Giannulli opened his center in 2001, he
  could hardly keep up. "We were very successful
  we had waiting lists," he said. He was spending
  20,000 a month on advertising and still making
  money.

3
The Procedure

• The HealthView Web site quoted Whoopi Goldberg
  ("The most comprehensive health exam that exists.
  I love them.") and William Shatner ("I'm sending
  everyone I know."). And the site told how the
  concept worked a person could call and make an
  appointment and have a simple 15-minute scan,
  while lying fully clothed on a table.
• The powerful X-ray scanner could look inside the
  entire body, "from the neck to the pelvis," the
  advertisements said. "Almost all diseases
  uncovered at asymptomatic stages can be modified,
  reversed, or cured," HealthView promised. Those
  whose scans found nothing amiss could have peace
  of mind.

4
Collapse of Demand

• Three years later, the center was down to one or
  two patients a day and Dr. Giannulli was forgoing
  a paycheck. Finally, late last year, he gave up
  and closed the center.
• Dr. Giannulli's experience, repeated across the
  country, is one of the most remarkable stories
  yet of a medical technology bubble that burst,
  health care researchers say.
• It began as a sort of medical gold rush, with
  hundreds of scanning centers, with ceaseless
  direct-to-consumer advertising, and with
  thousands of Americans paying out of pocket for
  the scans, which could cost 1,000 or more.
• It ended abruptly with the wholesale shuttering
  of businesses.

5
Criticisms

• Dr. Barnett Kramer, director of the National
  Institutes of Health's office of disease
  prevention, said "For every 100 healthy people
  who undergo a scan, somewhere between 30 and 80
  of them will be told that there is something that
  needs a workup - and it will turn out to be
  nothing."
• The same arguments were made by the American
  College of Radiology and the Food and Drug
  Administration.
• Radiologists at scanning centers protested. It
  may not be proven that scans save lives, but on
  the whole, they said, the benefit of finding
  something like cancer early outweighs the problem
  of finding harmless nodules and having additional
  tests to rule out disease.

6
The Economics

• Information - Professional societies warned
  against getting one of these scans. The tests,
  they said, would mostly find innocuous lumps in
  places like the thyroid or lungs, requiring
  rounds of additional tests to rule out real
  problems, and would miss common cancers, like
  those of the breast.
• Market - When insurers refused to pay, requiring
  customers to dig into their own pockets for the
  tests, scanning centers found themselves cutting
  prices to compete. Within a year, some centers
  said, prices fell to less than 500 from 1,000
  or more.