5 ms·

> MRIs are actually widely available in most cities at reasonable cost Typical wait time for an MRI in Canada is 2 months.

thaw13579 3mo ago
Yes, that is a economic & public health policy problem that really needs to be solved. We can look to Japan as example of what's possible, they have invested in nearly twice the number of scanners per capita of Canada, and they can get same-day MRIs for $50, roughly speaking.
- deleted 3mo ago
  [deleted]
- lostlogin 3mo ago
  > they can get same-day MRIs for $50 I’d like to see a breakdown on how they do that. Staffing alone is a multiple of that.
  - thaw13579 3mo ago
    From what I know, seems like a mix of medical price fixing by the gov't, adoption of lower cost hardware, and universal healthcare. There's apparently less bureaucracy, perhaps because there is no need for negotiation at every step of the process?
    - lostlogin 3mo ago
      There are big costs. The hardware, the facility (RF cage and chillers), power, water, staff, RIS/PACS etc etc. I can’t see how you can do it for $50. Does the ‘universal healthcare’ bit mean that the government is paying most the bill and it’s $50 out of pocket?
      - thaw13579 3mo ago
        Yes, $50 was a rough out-of-pocket estimate, the amortized cost per scan for operation alone is probably on the order of hundreds of dollars per scan, assuming high utilization. One funny thing about MRIs is the magnet is always on, so there could be some clever ways to reduce costs running them after hours.
        fc417fc802 3mo ago
        > there could be some clever ways to reduce costs running them after hours. It seems like a dedicated round the clock facility housing at least dozens of MRI machines ought to offer significant economies of scale. I wonder if I'm wrong about that or if there's some other reason we don't see this approach taken by governments.
        lostlogin 3mo ago
        The staffing costs then skyrocket. 1.5x or double time. However, the main obstacle is a lack of staff. Good staff are hard to find and worth what they cost. And they usually don't want to work out of hours. The economies of scale are interesting. Eg PACS/RIS cost very little more when you increase scans done, and rent is a fixed cost. The best thing that happens are you increase scanners at a the management of no-shows. Patients fail to turn up regularly (a 'did not arrive', DNA). With more imaging going on, you just grab the next available patient, the gap ends up later on, then you make a new booking. The record at my site is 6 DNAs and no slots missed. I run a small MRI service.
        fc417fc802 3mo ago
        > 1.5x or double time. Is the premium really that large for the night shift at (for example) a hospital? But even if you can't do 24/7 presumably there are physicians and technicians who would be willing to do either early morning or late evening without demanding much of a premium. A massive daytime only facility should at least enjoy reduced capex and maintenance burdens if they have enough machines in one place. Less duplicated infrastructure and everything closer at hand. Although if as you say even a small service can paper over 6 DNAs without missing a slot then maybe there isn't all that much to be gained here.
  - vixen99 3mo ago
    Romania: for a head MRI on demand - not more than a few days and less than 400 Euros.
    - lostlogin 3mo ago
      That’s more believable than $50, and isn’t out of whack with what’s achievable where I am (New Zealand).
  - deleted 3mo ago
    [deleted]
haldujai 3mo ago
Depends for what reason. I trained in Canada. Studies are triaged priority 1 through 4 in most provinces. Nowhere in Canada is a high priority MRI waiting 2 months.

thaw13579 3mo ago

Yes, that is a economic & public health policy problem that really needs to be solved. We can look to Japan as example of what's possible, they have invested in nearly twice the number of scanners per capita of Canada, and they can get same-day MRIs for $50, roughly speaking.

deleted 3mo ago
[deleted]
lostlogin 3mo ago
> they can get same-day MRIs for $50 I’d like to see a breakdown on how they do that. Staffing alone is a multiple of that.
- thaw13579 3mo ago
  From what I know, seems like a mix of medical price fixing by the gov't, adoption of lower cost hardware, and universal healthcare. There's apparently less bureaucracy, perhaps because there is no need for negotiation at every step of the process?
  - lostlogin 3mo ago
    There are big costs. The hardware, the facility (RF cage and chillers), power, water, staff, RIS/PACS etc etc. I can’t see how you can do it for $50. Does the ‘universal healthcare’ bit mean that the government is paying most the bill and it’s $50 out of pocket?
    - thaw13579 3mo ago
      Yes, $50 was a rough out-of-pocket estimate, the amortized cost per scan for operation alone is probably on the order of hundreds of dollars per scan, assuming high utilization. One funny thing about MRIs is the magnet is always on, so there could be some clever ways to reduce costs running them after hours.
      - fc417fc802 3mo ago
        > there could be some clever ways to reduce costs running them after hours. It seems like a dedicated round the clock facility housing at least dozens of MRI machines ought to offer significant economies of scale. I wonder if I'm wrong about that or if there's some other reason we don't see this approach taken by governments.
        lostlogin 3mo ago
        The staffing costs then skyrocket. 1.5x or double time. However, the main obstacle is a lack of staff. Good staff are hard to find and worth what they cost. And they usually don't want to work out of hours. The economies of scale are interesting. Eg PACS/RIS cost very little more when you increase scans done, and rent is a fixed cost. The best thing that happens are you increase scanners at a the management of no-shows. Patients fail to turn up regularly (a 'did not arrive', DNA). With more imaging going on, you just grab the next available patient, the gap ends up later on, then you make a new booking. The record at my site is 6 DNAs and no slots missed. I run a small MRI service.
        fc417fc802 3mo ago
        > 1.5x or double time. Is the premium really that large for the night shift at (for example) a hospital? But even if you can't do 24/7 presumably there are physicians and technicians who would be willing to do either early morning or late evening without demanding much of a premium. A massive daytime only facility should at least enjoy reduced capex and maintenance burdens if they have enough machines in one place. Less duplicated infrastructure and everything closer at hand. Although if as you say even a small service can paper over 6 DNAs without missing a slot then maybe there isn't all that much to be gained here.
- vixen99 3mo ago
  Romania: for a head MRI on demand - not more than a few days and less than 400 Euros.
  - lostlogin 3mo ago
    That’s more believable than $50, and isn’t out of whack with what’s achievable where I am (New Zealand).
- deleted 3mo ago
  [deleted]

haldujai 3mo ago

Depends for what reason. I trained in Canada. Studies are triaged priority 1 through 4 in most provinces. Nowhere in Canada is a high priority MRI waiting 2 months.