That Americans are over-treated has become a common claim in light of sky-rocketing health-care costs, but diagnostic experts dispute Hadler's argument that our advanced technology is not actually improving health care.
"I know what healthcare was like in the '60s and '70s," says Dr. Herb Kressel, radiologist-in-chief at Beth Israel Deaconess Medical Center in Boston. "There's no doubt in my mind that we're doing a better job ... no doubt that in part [the decrease in mortality] is due to technology. The problem is how we use the resources effectively to prolong life and improve quality of life."
Kopans cites unexplained abdominal pain as an example: In the 1960s, exploratory surgery often would be used to diagnose the problem -- a painful and somewhat risky process that today is done easily and painlessly with CT scans and ultrasound. And he says that technological advances have had similar benefits for breast biopsies; whereas invasive surgery was once needed, now ultrasounds allow the biopsy to be done with needles.
Both Kopans and Kressel agree that overuse of these technologies -- especially diagnostic or screening tests -- is a problem. But they say it is not one that should be solved by using less technology across the board, but rather by using technology selectively, where it is needed, and where it can do the most good.
A substantial part of over-utilization of this technology is "reflecting defensive medicine," Kressel says, where doctors fear that if they don't provide every test, than they will be liable when they miss a diagnosis.
"The trick is we really need research to know how to use these tools in a manner that will be preventive and predictive, to tailor the tests and interventions to what the patient really needs," Kressel says.
And this may be where the two sides meet. Hadler says that when this new technology is used for a specific diagnostic purpose, that is likely to provide insight into healing.
"Now that's a medical advance," Hadler says.