It is important to note that medical professionals and insurance companies decide whether or not an MRI is appropriate primarily based on a cost-benefit analysis model. MRI's individually cost on average over a thousand dollars depending on the location, type and use of contrast. MRI's also account for millions of dollars annually in the U.S. health care system. In attempt to reduce the costs and maximize efficiency in the struggling health care system health care providers are forced to assure insurance companies that an MRI is absolutely necessary. MRI's are certainly indicated when there is a more serious...
Physical therapists are highly trained to work with medical doctors and other health care professionals to identify any ‘red’ flags or causes for concern that would warrant further investigation. Specifically at Onondaga Physical Therapy we designate an hour of 1-on-1 patient care to conduct a thorough evaluation testing for weakness, range of motion limitations, special tests for tears/sprains/strains, sensation, reflexes, and much more to rule out various conditions and identify any risk factors. We detect poor movement patterns, impairments, compensations, muscle imbalances, etc. to establish the most effective plan of care for our patients. The visual inspection of anatomical structures alone provided by an MRI does not supply nearly enough information to determine the most effective interventions for our patients in the PT clinic. Although an MRI itself poses very little health risk to people, we cannot ignore the astronomical financial toll they take on our economy. We must consider the cost-benefit analysis and ask the right questions before issuing expensive and sometimes invasive tests. If you are going to trial physical therapy prior to more invasive interventions (i.e. surgery), the likelihood that the MRI results are going to alter the treatment is very small.
In conclusion although it may be frustrating to be denied coverage for your MRI before beginning physical therapy, remember that we are trained to gather much more important information with a social history and functional examination than an MRI in able to provide. Physical therapists are constantly monitoring their patients’ symptoms and medical status for any signs that indicate further imaging or testing, and we relay this information to medical doctors as necessary. If we feel an MRI is in your best interest your health care team will do everything possible to get you the best diagnostic and treatment options available.
Written by Kevin Brown, PT.
Kevin is currently practicing as a Physical Therapist in our Liverpool, NY Location and recently volunteered at the mile 6 water station of the Empire State Marathon. Check out the photos here.