To scan or not to scan? That is the question

In modern approaches to medicine, we, as clinicians, focus on patient-centered care to provide holistic medical attention revolving around the patients’ concerns and interests. In the UK, this has been made more apparent with a shift from solely NHS-based treatment to a mixed private-social care model. This has raised the question as to whether patients should be allowed to request whole-body Magnetic Resonance Imaging (MRI) scans as a screening method, and whether it is ethical to allow this to happen. This has been made all the more relevant by a recent X post by entrepreneur and former Senior Advisor to the President of the United States, Elon Musk: “Widespread MRI usage done at least annually with AI reviewing the data would greatly improve wellbeing and mortality” [1]. This raises the question: to scan or not to scan? Allowing patients to self-refer to an imaging center to obtain a whole-body MRI scan to screen for conditions puts patients’ healthcare in their own hands. If a patient is concerned about a diagnosis, they can get a scan; if the patient is worried about delays to their treatment, they can request a scan. Ultimately, this can reduce patients’ anxiety and healthcare worries, providing almost-instant diagnosis or feedback to either rule in or rule out pathology. Furthermore, in many cases, this would undoubtedly reduce wait times and delays, avoiding unnecessary appointments and “cutting out the middle-man”. For example, if a patient has a knee injury, instead of going to the General Practitioner (GP), getting a referral to an orthopedic surgeon, getting a scan, and then going back to the orthopedic surgeon to decide upon treatment, the patient with a knee injury can simply request a scan and take it to the surgeon. In screening contexts, this is already being started in the UK, with a self-referral service for patients wanting MRI screening for prostate cancer. Previously, there would have been several questions surrounding the time taken to undertake the scan and interpret the scans. Today’s models can perform MRI quicker, with early artificial intelligence (AI) tools such as Convolutional Neural Network (CNN) models to aid in efficient recognition and reporting [2, 3].