Why go to the hospital to see a doctor and have to do a bunch of tests at every turn? Are you cheating?

“Finally, there is no need to do repeated examinations, and I will be exposed to radiation!”

Ms. Liu was hospitalized because she was ill and wanted to go to another hospital for better treatment, so she was transferred. She thought that when she arrived at a new hospital, she would have to repeat a bunch of examinations. She did not expect that many examination reports could be directly used in the same hospital. Even the lung films taken, the doctor said that there was no need to repeat them. The equipment in the hospital is almost the same. , approve the examination of the last hospital.

Ms. Liu was delighted that it not only reduced the cost of examinations, but also reduced exposure to radiation. In fact, there has always been a strong voice for the cancellation of repeated inspections. On March 1 this year, the state’s Administrative Measures for Mutual Recognition of Inspection and Test Results in Medical Institutions was officially implemented to minimize repeated inspections.

1. Good news: these checks can be done without repetition!

In the recently announced “Administrative Measures for the Mutual Recognition of Inspection and Test Results of Medical Institutions”, it is clarified that each medical institution can realize the mutual recognition of test results across hospitals.

The content of the “Measures” shows that the first inspection result refers to the image or data information obtained by examining the human body by means such as ultrasound, X-ray, and magnetic resonance imaging;< /p>

The second refers to the data information obtained from a certain skin tissue, organ tissue, etc. of the human body through biological, microbiology, immunology, chemistry, hematology, cytology and other tests. It is worth noting that diagnostic conclusions issued by doctors are not included.

The “Measures” clearly stipulate that For those who pass the quality evaluation of the inspection and inspection items, the inspection results of medical institutions shall be uniformly marked with HR. That is to say, only the inspection and inspection marked with HR are the inspection and inspection items that are interoperable among various medical services and have undergone quality evaluation. However, mutual recognition also has a regional scope, such as “national HR”, “Beijing-Tianjin-Hebei HR”

Of course, due to the special nature of some diseases, mutual recognition is not allowed in some cases /strong>. For example, in tumor patients, the condition changes at any time, and the test results do not match the patient’s clinical situation, which makes it difficult to meet the needs of clinical diagnosis and treatment; there are also identifications involving judicial, disability, and retirement, which are not within the scope of mutual communication.

Second, why do I always have to do a lot of tests when I go to the hospital?

Friends who have been to the hospital to see a doctor know that the process of registering, seeing a doctor, and paying the bills is a complete process. The most frustrating thing is: queuing for 2 hours, inquiring for 1 minute, checking for half a day, and waiting for the next day for the results of the examination… If you are seriously ill, you can understand it, but minor illnesses and pains will more or less cause anxiety. Why see so many tests for one patient? Are you cheating? In fact, the examination is entirely for the needs of diagnosis and treatment.

1. Accurate diagnosis

Take the most common cold as an example. During flu season, Xiao Zhang has fever, dry mouth, nasal congestion, and takes cold medicine. It didn’t get better either. When you arrive at the hospital, you need to go to the fever clinic to measure your blood pressure, heart rate, breathing and other vital signs. If you find that they are normal, you will also need to take a nasopharyngeal swab. If the result is negative, you will go back to the emergency room to listen to the lungs, draw blood, and take a film. Only after all the results can be judged as a lower respiratory tract infection.

In the eyes of ordinary people, they can only see the “cold” on the surface. Many diseases can show the same symptoms, such as fever and cold, which may be caused by virus. Caused by tumor and possibly throat inflammation. It can be said that colds and fevers are not directional. If you do not check step by step, it is difficult to distinguish the cause.

2. Precise treatment

Auxiliary examination is often done to assess the disease more comprehensively severity. Doctors can make more accurate shunting according to the patient, for example, whether the same pneumonia patient needs outpatient treatment or hospitalization, oral medication or intravenous infusion, all of which require auxiliary examinations for further precise treatment.

3. How many CT examinations are unnecessary?

A medical report written by David Brenner in the New England Journal of Medicine in the United States states that CT examinations currently performed, strong>About 1/3 is medically unnecessary, and some abdominal pain or chronic headaches do not require a CT scan at all.

CT radiation cannot be ignored, however, according to “Reference News”, in Japan, 3.2% of new cancer cases every year are caused by X-ray and CT examinations. Also in the United States, where CT is over-examined, there are 29,000 cases of malignant tumors caused by examination every year.

There is a real risk in the abuse of CT. Generally speaking, one or two CT examinations will not cause much radiation to the body, and it can basically be repaired by the human body. Perform self-recovery. However, if the dose is relatively high, or repeated CT examinations will lead to gene damage, which will lead to the appearance of various harmful substances. Large amounts of radiation may even kill white blood cells in the body, causing cells to become cancerous.

Fourth, how many CTs can a person take in a lifetime?

The recommended radiation dose limit for the public in my country is that in addition to natural exposure, the additional artificial radiation dose should not exceed 1 mSv/year. If the average dose for 5 consecutive years does not exceed 1 mSv, the effective radiation dose received in a single year can be increased to 5 mSv.

Tong Tong, Director of the Radiation Diagnosis Department of Fudan University Cancer Hospital, said that clinically, the radiation dose of each part of the human body undergoing a CT examination is roughly: 0.7 mSv for the head, 0.7 mSv for the abdomen 4.05 mSv, chest 5.29 mSv,Cervical spine 0.76 mSv, lumbar spine 4.16 mSv, pelvis 7.68 mSv. A simple estimate is that the number of CT examinations per person per year should not exceed two times as much as possible.

According to the recommendations of the American Academy of Radiology, the acceptable amount of angiography examinations for adults in their lifetime are: head CT50 times, low-dose chest CT66 times, 5000 chest X-rays, 18 chest CTs, and 12 abdominal CTs.

However, it is worth noting that for high-risk groups and patients, out of the need for a clear diagnosis or to guide treatment, treatment must not be refused because of radiation. The threat to life of disease/cancer is far greater than that of cancer. There is a lot of radiation, and doctors will also assess the risk to minimize harm.

CT examination is for clear diagnosis and precise treatment. Ordinary people do not need to worry too much about radiation damage to the body. However, if it is excessively abused, CT radiation may also become a dangerous cause of cancer.

References:

[1] “Transfer to a hospital, no repeated inspections, and mutual recognition of inspection results in medical institutions from March”. National Party Media Information Public Platform. 2022-02 -23

[2] “Foreign Countries: CT Radiation Can Not Be Neglected Scanning Abuse Can Cause Cancer”. Reference News. 2016-04-18

[3] “Tumor Patients, Shoot CT Don’t Tangle”. Life Times. 2020-04-23