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Medical Association Journal
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Private MRI clinics flourishing in Quebec
Twenty-five radiologists from the McGill University Health Centre (MUHC) in Montreal are the latest to launch a private medical imaging centre, joining similar clinics in Alberta, British Columbia and Quebec. "We're doing this because there's an acute shortage of MRIs in Montreal and Canada," says Dr. Larry Stein, chief of radiology at the Royal Victoria Hospital, 1 of 5 hospitals consolidated under the MUHC umbrella. "I have to spend hours every week prioritizing patients to see [who gets] bumped. The bottom line is that in Quebec we probably need double the number of MRIs we have now."
Slated to open next month, the $5-million, state-of-the-art clinic will include a $2-million MRI machine, additional imaging equipment such as a CT scanner, and a picture-archiving communication system that will allow images to be transmitted across the province.
In Montreal, the waiting period for an MRI scan at the city's 8 public facilities now ranges from 2 weeks for high-priority patients to 14 months for patients with non-life-threatening symptoms.
Montreal got its first privately owned MRI machine in 1997; 3 more privately owned machines will be in use soon, including the one purchased by the MUHC doctors. The privatization trend is endorsed by the Quebec Association of Radiologists. "We are in favour of a private system that complements the public one, but we are against a single system like the American one," says President Dr. Gaétan Barrette. "The government no longer has the interest, nor the means, to provide the medical imaging services the population needs."
He added that the provincial and federal governments are hardly in a position to criticize private radiology centres, given that Quebec's workers' compensation board is one of its biggest users.
Dr. John Radomsky, past president of the Canadian Association of Radiologists, says private clinics are simply filling a void left by a system in "deep trouble. The government seems unwilling or unable to provide the services that people need. People can't take it any longer."
Until recently, many patients went to US border towns for MRI scans. The MUHC group estimates the average cost of a scan done at its site will be around $550.
But the private centres have their detractors. Dr. Paul Saba, from the Coalition for Physicians for Social Justice, questions the motivations of the MUHC radiologists. "Are they doing this purely for profit reasons, or are they concerned about the health of the patient? When we become business people first, we have abdicated our moral responsibility as physicians."
A potential conflict of interest also worries MUHC cardiologist Maurice McGregor. "I certainly don't oppose the clinic, but I deplore the existence of the need. The fact is that the public system is severely underfunded at this time. There is a potential conflict of interest when doctors in the public system invest in, and work in, private, competing clinics." — Susan Pinker, Montreal
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