Canada's universal health care program has a problem that imaging centers in the United States would love to have... too many patients for the number of available MRIs and CTs. Creaking and groaning under the weight of months of backlogged patients for diagnostic imaging, an audible `crack' could almost be heard in December of 2005 as the state Medicare system saw the first - and arguably illegal - private MRI opened in Winnipeg to self-pay patients.

If the Canadian government turns a blind-eye to self-pay imaging facilities, a tacit acknowledgment of public need having far outstripped the government's supply, then Canada may become the great frontier for imaging equipment. What vendor couldn't assemble an attractive pro forma for MRI or CT for a market that has 12 weeks of backlogged patients?

So while imaging providers in the United States engage in cut-throat competition, Canada is bloated with patients awaiting windows of scan time. True demand is probably even higher than the backlog suggests as some patients and physicians are not scheduling clinically indicated diagnostic imaging because of the profound waiting periods and inconvenience.


Throughput improvements from enhanced operations or more efficient suite designs could make a dent in the patient backlog, though this strategy, by itself, can't erase the enormous backlogs. Shortened scan times from 3.0 T MRIs or 64 slice CTs may provide incremental throughput improvements as well, but a quantum leap and not incremental improvement is what is really called for.

While the appropriate prescription for Canadian imaging may be an additional 1,000 each of MRIs and CTs, changes of that magnitude will require either an unprecedented shift in priorities for the government to install the needed equipment, or significant changes in the legislation that restricts private providers from scanning Canadian patients.

For the moment the great northern diagnostic imaging gold rush is on hold, at least until the Canadian courts and legislators decide how to balance their state-sponsored healthcare system against the health and treatment requirements of individual Canadians. But should the door open, the U.S. pharma-tourists to Canada will likely be joined by imaging equipment manufacturers and re-sellers.

To our Canadian readers: If you have any information on the regulation of imaging procedures in Canada, please let us know. We are looking to follow up on this story. Please submit your comments in the link below.

Tobias Gilk, a registered DOTmed user, is an architect at Junk Architects, PC specializing in MR safety evaluations and design services in support of complex medical equipment installations.

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