A special "investigation" from Consumer Reports provides patients with five tactics to deploy prior to receiving a medical test involving ionizing radiation—including assurance that the study will be read by a radiologist.

In recent years, one of the prevailing trends affecting the practice of radiology has been concern about excessive dose and use of medical imaging tests. The recent report suggests that radiologists, radiologic technologists and referring physicians can expect to field increasingly sophisticated questions from their patients on the issue.

Consumer Reports recommends that patients do the following prior to receiving any "radiation-based imaging test":

1. Ask physicians why the test is necessary.
2. Check credentials. Ask whether the facility is accredited by the American College of Radiology; if its technologists are accredited by the American Registry of Radiologic Technologists; whether the test will be read by a board-certified radiologist or pediatric radiologist; and check online to see if the organization providing the test is engaged with Image Gently or Image Wisely.
3. Get the right dose for your size by asking if the technologist has factored your size into the dose that you or your child will receive.
4. Ask for the lowest effective dose. The article notes that dose for the same procedure can vary widely, even within the same facility.
5. Avoid unnecessary repeat scans by letting the physician know you have recently had imaging tests done; keeping track of the date of those exams; and keeping copies of your studies on CD.

The report also offers the following reasons for the overuse of medical imaging:

• the volume-based payment system is an incentive to order more tests,
• defensive medicine and the fear of malpractice litigation,
• many patients and physicians are uninformed about the risks associated with imaging and
• patient demand for imaging.