The Joint Commission is sending a powerful notice about the radiation risks of diagnostic imaging. Its August 24, 2011, Sentinel Event Alert clearly states that diagnostic radiation can save lives. That is not in dispute. What is at issue is the amount of radiation patients receive over time and the risk for long-term damage.

Over the last 20 years, Americans’ exposure to ionizing radiation has nearly doubled. As the Joint Commission states, “…any physician can order tests involving exposure to radiation at any frequency, with no knowledge of when the last of when the patient was irradiated or how much radiation the patient received.”  The World Health Organization’s International Agency for Research on Cancer, the Agency for Toxic Substances and Disease Registry of the Centers for Disease Control and Prevention and the National institute of Environmental Health Sciences all classify x-rays as a carcinogen.

As an Emergency Physician, I recognize the value of x-rays and CT scans and use them when they are medically appropriate. In its Sentinel Event Alert, one of the Joint Commission’s recommended actions is use other imaging modalities when appropriate: “In order to reduce the expose of the patient to ionizing radiation, use other imaging techniques, such as ultrasound or MRI, whenever these tests will produce the required diagnostic information at a similar quality level.”

I support Joint Commission’s call for judicious use of ionizing radiation from medical imaging and to order an equivalent and safer test for the clinical scenario. If these principles are followed, collectively we can have a large impact on patient safety by reducing radiation from medical imaging.