I understand, but if these machines are used less, someone is going to have to pay a heck of a lot more per scan.
This isn’t quite the Broken Windows theory of economics as applied to health care, but it’s quite close.
A related problem is that MRI machines may be too widespread. If there are five hospitals in town, do each of them need an MRI machine, or can some of them share? (And then there are the MRI machines in radiology clinics not associated with an individual hospital, or even in a medical clinic.) So the doctors at each of those hospitals is encouraged to prescribe enough MRI scans to amortize the cost.
Instead, there needs to be some sort of coordination and perhaps a governing body that decides whether such an expensive machine should be purchased. I know that the State of New York created a commission to decide which hospitals should be made redundant.
That is the problem - third-party payors mean that the consumer has no reason to try to contain costs. Needless to say no serious politician has proposed changing this, though McCain at least tried to remove subsidies for third-party payors.
If the problem is that MRI machines are being underused, the best solution is to have fewer MRI machines, not to perform more scans just so your numbers match up to your financial model. In the short run you may be stuck with what you have, but in the long run, providers should only buy another MRI machine if they need to do enough (legitimate) scans to make it worthwhile.
I do understand your point, and I think it’s a factor in overcare/overbilling. Once a provider has paid the large up-front cost for the machine, they have an incentive to use it as much as possible, first to pay for it, and then, once it’s paid for, to make a profit on it.
I think the OP and this story, together, highlight the problem. If the insurance company pays for whatever services providers want to perform, costs get inflated by unnecessary care. If the insurance company says no, you get horror stories about how Little Timmy is suffering because the big bad insurance company won’t pay for his surgery. It’s hard to come up with a system that pays for what’s needed, but not more, in light of everyone’s economic incentives.
You know, a friend of mine has been dealing with tennis elbow for several months now, and has found that it really limits her mobility with that elbow. It seems to have caused her a lot of pain and has kept her from doing some things that she wants to do. I’m not saying the OP’s kid necessarily needed an MRI, but canceling all further treatment because she’s irked that they suggested an MRI seems a bit drastic.
Sheesh, they did an MRI before they did an x-ray?
I’m not canceling all further treatment. Baseball season is now over, he’s still playing tennis/taking lessons, but less frequently, and the pain is gone. If it comes back, we’ll revisit the situation.
Ah, I gotcha. Makes sense.
Why would they do an X-ray for suspected tendon damage? 
Here’s another thing wrong with our system in the US.
When I went to the doctor for tennis elbow, he gave me a cortisone shot… pain gone!
It came back 6 months later. Back to the doctor… cortisone shot. Pain gone.
It came back 6 months later. Back to the doctor… cortisone shot. Pain gone.
Moved to South Korea.
Tennis elbow came back, so I went to the doctor and asked for a cortisone shot. He said, “What for? Do this!” and demonstrated a couple of stretches to do. A week later the pain was gone and didn’t come back for about a decade (couple of months ago)… so I did the stretches he showed me again and the pain is gone.
We’re too hung up on immediate gratification here, IMO.
Every time I’ve had a suspected sprained ankle they’ve done an x-ray. Every time one of my kids has had a suspected sprained ankle they’ve done an x-ray. They did an x-ray on the kid with tennis elbow!
They did an x-ray. The stress fracture didn’t show on it - I’ve since read that that’s relatively common.
ETA - specifically, they did an x-ray to rule out a stress fracture, amusingly enough. The doctor was surprised as hell, because I didn’t fall or have any kind of twisting injury. The physical therapist said it made total sense after he saw how completely fucked up I am from the waist down, biomechanically speaking.
Radiologists generally aren’t hospital employees; they’re in private practice and under contract to the hospital.
Geez, when I was a kid, I screw up a kick playing soccer during gym class. The pain in my knee was so severe, if my eyes had been closed and you’d asked me what happened I would have said “I think my leg got torn off at the knee.”
Ice and rest is all I got from the MD.
Ditto the tennis elbow from screwing up my strokes learning to play squash when I was 12. Rest, then when it healed up and didn’t hurt anymore, someone showed me how to swing my racket properly.
I can’t imagine anyone sending me for an MRI back then. It was always “Rest it, and then we’ll see.”
Well, generally people end up at the orthopedic clinic because they’ve been resting it, icing it, compressing it, and elevating it, and it’s been two weeks and it still hurts.
They’re cooled with liquid helium–very expensive to obtain, transport, and handle.
X-rays can be “wrong” even when they do show a break. In the ER and at the first visit to the orthopedist, my wrist break showed as straight across, immediately before the “knob” at the end of the radius. My orthopedist said normal OTC pain meds (Aleve) should take care of any pain.
Three weeks later, I come in for follow-up x-rays. Cast gets cut off, x-rays done, doctor looks at x-rays then walks into the room: “That’s still bothering you.” That statement was made without getting any report from me - and yes, it throbbed like hell at the end of each day. I was using that hand to write and type, as allowed by him. He showed me the new X-ray - the break actually went up the bone and came out the end of it, such that the broken ends of the bone had been rubbed against by my wrist bones that whole time. It healed properly. 
But two sets of x-rays didn’t show the actual configuration until it was well into the process of healing.
I am reopening this zombie thread to report that I just got the bill for the x-ray that they did right before they recommended the MRI.
That’s right. I JUST got the bill. Today. The only bill I’ve seen for the x-ray. The x-ray performed on 7-21-09.
I and my insurance company paid the charges for the office visit, whatever they were, at the time, I think it was a $25 copay. Since I never got any other bills, I assumed the x-ray was part of the office visit, as I’ve had doctors who do it that way.
But no. They’re just…very very slow. I guess their billing department is overwhelmed. Understaffed, or something.
It took me fifteen minutes to figure out what it was for. I honestly thought at first it was a case of somebody stealing my identity. Then my brain finally processed the date.
I agree with this. Too many people will turn around and sue, if something bad did show up. We’d have a thread on how awful the doctor was for not wanting an MRI. 