WILLMAR -- First Willmar had one CT scanner. Then there were two. Now there are three.
The opening of the Willmar Center for Diagnostic Imaging last fall raises the question: How many CT scanners are enough?
Willmar CDI is the latest local health care entity, after Rice Memorial Hospital and Affiliated Community Medical Centers, to acquire a CT scanner, plus ultrasound, digital mammography, bone density scanning and interventional radiology.
Critics might see it as costly duplication that increases health care spending.
But the partners behind Willmar CDI say they're providing a needed service that benefits patients and strengthens the local market.
"I think what you have to do is look at it from a community base," said Gary McDowell, administrator of Family Practice Medical Center. "If we can all do good work, the whole community is successful... You want the biggest bang for your buck. What it does is force everybody to be more efficient and more effective, and hopefully what it does is give the consumer the highest quality at the lowest cost."
Patients "really like the idea of having a choice," said Dr. Marty Janning, owner of the Janning ENT Center and one of the partners in Willmar CDI. "We're getting good response back from the patients."
In the struggle to hold down the spiraling cost of health care, medical imaging has emerged as a particular battleground, both for its expensive technology - a high-end CT scanner can cost upwards of $1 million - and for its widespread use.
Over the past two decades the use of CT imaging has ballooned into an estimated 70 million scans annually in the United States, more than any other industrialized nation. Observers have begun to question whether the technology is being overused.
Yet medical imaging is a mainstay in patient care, says Dr. Anthony Amon, a family practice doctor and chief executive at Family Practice Medical Center.
It greatly aids the diagnostic process and has reduced the need for more invasive procedures, he said. "The practice of medicine and the standard of care have changed. That's standard of care now. We need those services."
The partners in Willmar CDI said they researched the numbers carefully before deciding on the medical imaging venture.
Their conclusion: It is "a worthwhile market," said Darci Nagorski, senior account manager at the Center for Diagnostic Imaging in St. Cloud. "If you're going to put in these expensive scanners, you want to have them utilized. We knew the Willmar population was big enough to support another one."
Nor does the addition of Willmar CDI appear to have significantly eroded the number of medical imaging procedures done at ACMC or Rice Hospital.
Bill Fenske, the chief financial officer at Rice, said there has been some decline in volume but it is slight.
Nagorski and Chad Rusch, an account manager with CDI, said Willmar is a health care watershed and specialty referral base for a significant chunk of southwestern Minnesota. Many of the region's medical providers were already sending patients to St. Cloud for radiology procedures, Rusch said.
The presence of Willmar CDI means many of these referrals can now go to Willmar, he said. "We're fulfilling a health care need in this area. Getting a radiologist out to Willmar has been a huge need for a very long time."
"I think more needs to be offered," agreed Dr. Todd Cunningham, a radiologist and medical director for CDI in Willmar, Alexandria and St. Cloud.
Local radiology coverage has shrunk since ties were severed a few years ago between a Willmar radiology group and ACMC and Rice Hospital. ACMC and Rice now rely on visiting radiologists to do ultrasound-guided biopsies and other interventional procedures. The coverage remains limited to one or two days a week, however -- and when Rice experimented last year with adding another day of coverage, the patient volume wasn't high enough to justify continuing it. Indeed, addressing the need for radiologists is one of the priorities in a new strategic plan adopted by Rice in December.
When radiology services aren't readily available, patients end up either waiting or going out of town for the service, Cunningham said.
Now that Willmar CDI has opened, "hopefully this will alleviate some of that," he said. "Certainly if there's a need we're willing to come more often. We've been pretty busy from the start."
Amon said the family practice clinic strives not to order too many imaging tests.
"We're very cognizant of trying not to overutilize. There's not unlimited dollars for health care so we want to use people's money wisely," he said.
Patients were already going out of town for medical imaging, McDowell said. "The duplication doesn't cost truly any more money. Whether you get it done here or somewhere else, you're having it done."