No Soup for You!!

Famous words to Elaine from the soup-nazi on Seinfeld. The same advice may apply to early MRIs.

When do you get an MRI? Is sooner better? Isn’t it good to know the situation as soon as possible? Well, apparently not.

Attendees at the most recent “Crisis in Opioid Management” conference sponsored by AADEP – the American Academy of Disability and Evaluating Physicians – heard from Dr. Russell Travis, Lexington, Kentucky neurosurgeon that studies show just the opposite is true.

Most guidelines indicate that, without certain red flags, MRIs should be used only after 4-6 weeks of conservative treatment. But workers who receive MRIs or opioids within 7 days of injury have an increased rate of disability and all workers receiving MRIs have longer periods of disability regardless of whether there was radiculopathy. Yet time and again workers and treating physicians push for early MRIs.

Sometimes we know too much. We hurry to aggressively treat a condition that would naturally resolve if we would only leave it alone. This leads to a “cascade of care” – over prescribing and over treating. We spend thousands for tests that won’t improve our level of care and often lead to even more problems.

Good UR, which includes review of diagnostic testing, can help you with this. So if your treating physician says “No soup for you”, he is probably practicing good medicine; no premature MRIs either.

Call us.  We can do better.