From hacker to hospice in seven weeks

I don't know about the financial model.

Google indicates you can pay up to $3M for a MRI machine and $100K/yr energy and required maint costs. Google indicates a median radiologist gets $300K/yr and to make the figures ridiculous I'll dedicate one radiologist full time to the MRI. Google indicates mean lifetime of a MRI machine is a decade. Google indicates a hospital remodel to make a MRI safe room and electrical and cooling and ventilation might exceed the cost of the machine maybe $4M. Google indicates budgeting 3 hours per patient is not totally unreasonable. There is maint downtime and testing and the radiologist probably wants to sleep occasionally, even if there are actual specific scans that only take 15 minutes.

So the total cost over the decade lifetime of a MRI machine

3e6 + 4e6 + 300e3 * 10 + 100e3 * 10

You don't need a calculator to add that up to a cool eleven million bucks for ten years of MRIs. However you divide that out and thats only three grand per day over that decade. Or if you assume a long term average of 3 hours per scan (a bit on the high side) thats $375 total cost per scan.

Google reports the average billing is somewhat under two grand, but my math shows about four hundred bucks. Even assuming only 50% utilization they can still only account for $800 per scan.

I'm thinking that despite the mantra / astroturf that MRI is really expensive to provide, its actually a huge profit center for a hospital. Not as bad as the proverbial $35 aspirin pill, but pretty profitable none the less.

Another way to run the numbers is if the fixed cost of having the machine and radiologist available is about $3K/day, and they get about $2K/scan in revenue, you may have been part of a long MRI train that day, but the average machine actually only scans 3 people every 2 days on long term average.

Sounds like a market that's either ready for disruption, or so well protected by regulation that it can't be disrupted.

I have strong upper chest pains (constant pressure), regardless of position. Went to first doctor, was told "it's just bruised ribs", even though I don't play any sports or do any serious workouts.

Went to a second doctor recently after a few months as it started getting worse. "It's just heartburn", even though I told him I already take a PPI, H2 blocker and calcium. I've had heartburn for 12 years and know this was a very different feeling, but he basically ignored me and proceeded to ask me about how often I went to church and about my sex life. I wish I was joking. So he wrote me a prescription for ranitidine (a weaker H2 blocker, sold as Zantac OTC.)

But thankfully the second time I was given a blood test and found that my vitamin D level was So I looked into this and found that D2 has poor bioavailability and depletes magnesium. So I obtained D3 and magnesium supplements, am taking a saner supplement level (10,000 IU daily), and have been feeling quite a bit better. Not perfect, but supposedly it can take three months to fully recover.

I was very surprised to learn that a lot of people develop random musculoskeletal pains in response to very low vitamin D levels. Neither doctor even considered that possibility.

I was very worried that this might have been something more serious, and it was basically impossible to convince either of two doctors to actually do some real tests just to be safe. When I read stories like this, I can't help but wonder, what if it was the start of cancer (which killed my father)? And by the time the symptoms got bad enough to not write me off right away, it'd be too late to treat it?

I've had similarly terrible experiences with fatigue during the day due to my job's oncall responsibilities. That doctor told me it was depression (I am absolutely not depressed), and tried to get me to start taking Zoloft, which I refused.

These GP doctors just don't listen to their patients nor take their concerns seriously. I'm sure everyone always assumes the worst when something bad starts to happen, and likely it does turn out to be nothing. But one in three people do develop cancer in their lifetimes. How the hell are we supposed to get it diagnosed early when doctors just casually dismiss us out of hand?

So how about a residency system that doesn't depend on medicare government funding? Or accepting foreign residency programs? I wouldn't think canadian, scandianvian, british, german, australlian, etc residencies and doctors should be considered invalid for example. From what I know, even being a Sweden trained doctor makes it hard to transfer into the USA and get a licence.

Residents from what I know are not well paid, what makes it a profit cost center for them that they require government funding for it?

> I still think daily whole body scans are a spectacular waste of human capital for relatively little benefit.

I agree, and I'm not recommending we do that right now. But imagine if we had cheap, fast ways to do the scans. So much money is being pumped into cancer treatment right now, I'm just wondering if better cancer detection might be more beneficial. Our current treatment methods might get us a lot farther because we'd use them when the tumors are smaller, and we'd have a much better sense of how aggressive a tumor is.