Hospitals are pushing back on Arizona bills to protect providers from radiation exposure

In 2017, renowned Arizona cardiologist Dr. Edward Diethrich died from brain cancer — he said, because of the groundbreaking imaging that he helped pioneer. He was the founder of the Arizona Heart Institute.

Now, studies show that certain cardiologists like him who specialize in a surgical technique that involves radiation have higher rates of brain tumors. In fact, they’ll often get tumors on the side of their brain facing the machine used for these procedures.

Now, state lawmakers are attempting to do something about it. There are three bills with bipartisan support making their way through the Legislature now that would require hospitals to put in new protections for these doctors.

But, Jerod MacDonald-Evoy reported for The Arizona Mirror that they’re facing opposition from hospitals. He joined The Show to talk more.

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Full conversation

LAUREN GILGER: Tell us more about what's in these bills, like how are they trying to help these doctors?

JEROD MACDONALD-EVOY: So this trio of bills that have been proposed at the state Capitol, one of them would mandate that half of the rooms that do these procedures, which are called cardiovascular interventionalist procedures or most commonly known as the cath lab, that half these rooms would have these new pieces of equipment that are called enhanced radiation protection systems.

Another piece would be if these pieces of equipment are installed, then the people who provide these services do not need to wear certain types of other protective equipment that are also known to cause long-term health issues.

And then the last piece of this trio of bills provides an unknown appropriation to help rural hospitals buy this equipment.

GILGER: Right, because it's not exactly cheap. Tell us more, Jerod, about how these procedures work. Like, they were kind of innovative. We talked about Dr. Edward Diethrich, who came up with the technique.

Why is this a problem? Like, why are these doctors who perform this kind of technique ending up with higher rates of brain cancer?

MACDONALD-EVOY: So from the doctors that spoke about this in committee hearings and at press conferences about this legislation, the main issue that is causing radiation exposure to nurses and providers in the rooms where these procedures take place, is called scatter radiation.

And what that is is when it's not exactly the radiation that comes from the machine itself, the radiation that is at most issue is the radiation comes from a patient. So the radiation comes out of the person who is having the procedure, and it kind of scatters throughout the room, and it goes in all sorts of other places throughout the rooms, and that can end up bypassing other pieces of protective equipment that people may have on.

And so they're trying to find new ways to protect providers, whether that be the doctor that is right next to the machine, that also is giving off a certain amount of radiation that is going to be giving them long term exposure or the other people in the room that may be getting exposed inadvertently.

GILGER: And these new protection systems are very effective, right? Like they'll really cut down on that radiation studies have shown, right.

MACDONALD-EVOY: From some studies, they've shown that yes, they do cut down by a significant amount, up to 99% in some studies. And these studies are comparing them to other traditional means of radiation protection like lead vests and barriers. But this technology is fairly new and there are only, I believe, one or two vendors, and that is one of the areas of concern.

GILGER: Right, and they cost about $150,000 for a hospital to put in, right?

MACDONALD-EVOY: Correct, and that's another area of concern that hospital administrators and others have voiced, that these are not cheap things to install. They're $150,000 each. That's just to install. We are not entirely sure, at least in the discussions I've seen on upkeep or any other things that may come with that, whether that be management of the systems itself. Or any other like additional things that may need to be done in regards to cleaning or removal of you know be things that are exposed to radiation.

GILGER: Yeah, you mentioned the kind of lead vests, right? Like I know if I've gotten an x-ray, they'll put a lead vest over me and that should protect me.

Doctors will wear those when they're doing these procedures traditionally, but there are issues with that as well, it sounds like.

MACDONALD-EVOY: Correct. There's been a few doctors that spoke in committee about the fact that these vests, although they've gotten lighter over the years, they still weigh quite a bit and they'll be wearing these for sometimes up to 12 hours a day.

And this has been causing some providers to have orthopedic issues where they're having to get back surgeries or neck surgeries or in one instance, there was a story of a doctor who actually became paraplegic after a very long procedure where afterwards it caused an issue in his spine.

So that's another concern among the physicians that have been speaking and supporting this bill is that if we can put in these types of new systems in place and have to not wear these types of heavy pieces of protective equipment, then maybe we can prevent some of these other long-term damaging effects.

GILGER: Right. So the hospitals are pushing back against this it sounds like largely because of the cost.

One of these bills, though, like you said, provides some money for rural hospitals to install these systems, but hospitals in general, right, are in pretty financially dire straits right now.

MACDONALD-EVOY: Correct. Hospitals right now are facing some financial stress, large in part due to a lot of the cuts we're seeing coming from the federal end. Hospitals are kind of preparing for how that's going to impact them and their budgets. So hospitals are kind of bunkering down for the long term on how that is going to affect them.

We've seen a lot of closures in recent years. And the Arizona Hospital and Healthcare Association kind of made note of that in some of their opposition to this bill in newsletters and in other areas, saying that this is basically an unfunded mandate of requiring these devices.

And the other thing of note that they've noted is that these devices are fairly new and they could essentially end up becoming, you know, vendor bills, so to speak, with only one or two manufacturers of these devices that they fear, right, making it so only one or two vendors ends up being on top and there it wouldn't be a great competitive bid for this sort of equipment going out if we move forward this quickly.