Amid growing pushback over the number of fetal ultrasounds performed in the U.S., physicians are weighing in on the issue with recommendations as to how and when the procedures should be used.
The most common fetal-ultrasound procedures averaged about 5.2 per delivery in 2014, up 92% from 2004, according to an analysis of data recently compiled for The Wall Street Journal, triggering criticism from some experts in the industry who say the procedures aren't medically justified. In a letter to the WSJ, Hyde Park, NY-based OB/GYN Dr. Jessica Jacob said it's "absolutely true" that too many physicians are ordering the procedures.
According to Jacob, fetal ultrasounds have become "a very significant source of income" for OB/GYNs and there are "few medical procedures with as high a potential for abuse," she said in her letter. But placing new limitations on the procedures will likely interfere with the work of maternal fetal medicine specialists who need to monitor high-risk pregnancies, Jacob added.
"What we need is a more honest approach to determining when an ultrasound is truly necessary, and a denial of payment for needless scans," Jacob said, as quoted by the WSJ. "This judgment should be made by maternal fetal-medicine specialists and not by the usual physicians hired by insurance companies, who have no inkling about when ultrasound is needed and when it isn't."
Limiting where patients can get the scans could also help reduce the number of unnecessary ultrasounds, Sacramento, CA-based medical geneticist Dr. Douglas Hershey said in a separate letter to the newspaper. Hershey, who provides fetal ultrasound exams, pointed to the FDA's regulation against keepsake image shops performing nonmedical scans for expectant parents. Some states including Oregon and Connecticut have already laid down laws forbidding the shops' operation, he said.
Lists of accredited fetal ultrasound practices "are readily available" on websites of the American Institute of Ultrasound in Medicine and the American College of Radiology, Hershey added, and guiding patients toward these centers could help cut down on superfluous procedures. "If insurance companies and obstetrical-care providers limited their referral of patients to these accredited centers, the number of unnecessary scans would diminish," Hershey told the newspaper.
- read the WSJ op-ed (sub. req.)