PARIS — Often cited as the best healthcare system in the world, France is struggling with a critical shortage in medical imaging that has brought down its reputation in medical research and, according to the chairman of the French Radiology Society, threatens responsible clinical practice.

Frustrated with government policy and a new hospital reform law that further erodes the role of radiology in hospital centers, Jean-Pierre Pruvo, MD, the society's chairman, has gone public with his case and said he will be meeting with the French President to demand urgent action.

"We urgently need 250 MRIs, one for each emergency center where we are behind in a serious way," he told Medical Device Daily in an exclusive interview during the congress, Journées Françaises de Radiologie, held here this week.

"The continued policy of the government authorities is inexplicable," he said. "This has gone on for years without any response."

"The CHUs (Centre Hospitalier Universitaire) in France are struggling," said Pruvo. "We are sending out an alarm with our Plan Imagerie, asking for the same priority that the Ministry of Health has given in the past with programs such as the Plan Cancer."

Plan Imagerie details 10 points aimed at addressing the crisis in medical imaging in France.

In 2009 France fell further behind its European neighbors in the number of MRIs available per one million inhabitants, ranking second to last, just ahead of Turkey. The installed base was 495 MRIs in France in January, 2009

The average waiting time for an MRI scan for 67% of the population is now at 34.5 days, according to the 2009 report from the association Imagerie Santé Avenir (ISA, Health Imaging Future).

"In 2011 we come to the end of the current plan for funding medical equipment, and in the new planning cycle for new regional authorities created by the new healthcare reform law there is no policy to increase authorizations for MRIs," he said.

"This does not make any sense," he said, adding, "We are walking on our heads, as we say, in France."

The association ISA concluded in its report that the authorization for 150 MRI purchases in the current plan should have been doubled, adding 60 MRIs each year over five years to address the current crisis.

In the interview with MDD, Pruvo said, "My approach is to argue clinical need and not to compare France with other European countries."

"I will tell the President, and the Minister of Health, that we have 2,500 incidents of strokes per million population in France and yet none of these patients receive an MRI exam on arrival at the hospital," he said.

"This is a scandal!" said Pruvo.

"We have hundreds of thousands of women in France at risk for breast cancer, who have a known history of cancer in their family, yet we do not have the means to provide a breast examination by MRI, which is clinically proven to be superior for detection than conventional mammography. This is not medically responsible," he said.

"I have 20 concrete clinical cases like this to present," Pruvo told MDD, adding, "The bottom line, the most emblematic response, is to authorize 250 MRIs of 1.5 tesla for emergency departments across France."

The enormous upfront cost of catching up with France's medical need for MRIs is more than offset by savings elsewhere in the healthcare system, he explained.

"Plan Imagerie calls for a serious study of the costs and benefits of medical imaging for France," said Pruvo.

"We suggest there will be reductions in the length of stay at the hospital, that enacting good practices will lead to the prevention of disease, that reducing the waiting lists for examinations, and the consequences of these delays for examinations, will all save spending in the healthcare system.

"We can not afford to continue spending on unnecessary exams and the inefficiencies in healthcare that they create," he said.

"This is not to criticize colleagues," he said. "They do not have the equipment and are working with the tools they have."

"Instead we are critical of the government policies," that create this situation, he said.

Plan Imagerie calls for a revision of the system for authorizing equipment, specifically for MRIs and CT scanners.

Another of the 10 points call for reinventing the modalities of reimbursement for both radiologists in public and private practice permitting the two sectors to collaborate.

"We are asking for a good medical imaging platform for each CHU with a correct balance of the modalities required and a sharing of these resources across the different medical specialties," said Pruvo

Beyond patient care, in the area of research, the number of papers published by French physicians has diminished each year, he said, "and this is directly related to their access to MRI."

"Medical imaging, and most often MRI, is at the heart of many clinical studies, and we are less and less sought out for participation in these studies," he added.

"The CHUs are the centers for medical education and research in France, where young doctors conduct clinical evaluations and improve patient care," he said, "and they do not have the equipment they need. The equipment we do have is aging and it is not being replaced, not to mention the need for enhanced capabilities."

Finally, he said, Plan Imagerie covers the needs for radiology archiving and networks.

"We have a very strong points addressing teleradiology," he said, "connecting radiologists for expert consultations, but also to connect us so that we can stay closer to the patient care processes."