Canadian College of Physicists in Medicine (CCPM)
Le Collège Canadien des Physiciens en Médicine (CCPM)

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Michael BRONSKILL
Sunnybrook & Women's Institute/University of Toronto

Imaging Physics Meets Public Perception: Is Private MRI Bad?

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The clinical applications of NMR in the form of magnetic resonance imaging (MRI) have now matured over twenty years. Their impact and significance have already been recognized with two Nobel Prizes in Medicine. Originally implemented to provide detailed anatomical images of soft tissues, clinical MRI is now developing capabilities for obtaining much more sophisticated information about the human body by measuring physiological functions and by providing guidance and monitoring of interventions and therapies. These capabilities will be illustrated briefly with some examples of MR angiography, functional MRI of the brain, and monitoring of temperature during experimental thermal therapy.

Despite these remarkable capabilities, MRI remains a curiously restricted resource in the Canadian health care system. The history and logic behind this fairly rigid control of MRI systems will be examined, using the situation in Ontario as the prime example. At a time when public expectations of high technology medical imaging are fueled by instant Internet knowledge, does this pattern of restriction make sense? Is there economic evidence that MRI is too expensive for mainstream Canadian medical practice? In particular, the media representation of “private” MRI as a potential violation of the universality of Canadian health care became a political issue in the recent Ontario provincial election. This concept will be explored in an attempt to determine whether private MRI really is bad.