The MRI Rush

One of my aunts called the other day. “I think I need to see you” she said. “I have this terrible pain low down, where I sit. One doctor has advised me to undergo MRI scan.” “Come to the hospital tomorrow morning, and I will see you” I told her. She was waiting for me the next day. I saw her. Her gynecological condition for which she had come to me was nonprogressive, mild, and not responsible for her pain over the coccyx. I checked her papers. There was a gynecologist, who had advised her MRI of the whole spine. “Why did you go to the gynecologist when I had already seen you?” I asked her. Perhaps she was unhappy with my advice. “Actually I had gone for an eye check up. After getting my eyes checked, I said I had this pain. So the ophthalmologist told me to see her husband, who was a gynecologist consulting in the same clinic. He said I should get an MRI scan done.” I checked his notes again. There was no mention of any gynecological symptoms or signs. He had mentioned she had back pain and advised an MRI scan. “He had advised something beyond his field of expertise” I said. “You should see an orthopedic surgeon and do whatever he says.” “I will see my nephew, Dr. XXXX” she said. He was my distant cousin, and a good orthopedic surgeon. “Yes. That is a good idea” I said. A couple of days later I called her. “He said it is related to my age, and nothing needs be done except taking a couple of tablets, and daily walk” she told me happily. “There is no need for an MRI scan.” When I mentioned this to a colleague and wondered why a gynecologist had advised an MRI scan of the spine, he said “that is because they give 30% cut to the referring physician.” Suddenly it made a lot of sense. My aunt does not know this and many of his future referrals may not know it. Well, that is how it is.