Medical imaging services sold on Groupon save money but may put patients’ safety at risk

The e-commerce website Groupon saved money for patients who bought medical imaging services, but sellers did not always “accurately or adequately” provide information about the risks of imaging, researchers reported.

“Physicians should be aware that they may be approached by patients who want to use these services in lieu of a traditional imaging service or that they may receive actionable results or results they do not understand,” Arash Mostaghimi, MD, MPA, MPH, director of dermatology inpatient services at Brigham and Women's Hospital, told Healio Primary Care. “Clinicians who send their patients to Groupon should make sure to alert patients to the risks and benefits of their treatments, and make sure that the patients do not agree to unnecessary imaging tests that may be encouraged by sellers.”

Earlier this year, Mostaghimi and colleagues performed a cross-sectional analysis of 84 companies that offered Groupon vouchers for 130 different types of medical imaging and scanning services. Of 28,380 vouchers that had been sold by Feb. 6, 2020, most were for CT devices (41.3%), followed by fetal ultrasonography (36.9%), dual-energy X-ray absorptiometry (18.4%) and body or biofeedback scans (1.5%). The average price for each service ranged from $60 for a body or biofeedback scan to $687 for an MRI. The average customer rating was 4.8 out of 5.

According to researchers, 38 of the companies (67.9%) made “unsubstantiated claims,” and only one mentioned possible risks associated with imaging. None of the 57 companies that stated that a consultation was necessary to determine the purchaser’s eligibility for imaging services mentioned that requirement in subsequent advertisements.

The researchers also analyzed 2,044 customer reviews and found that 90 suggested they were subject to upselling. Additionally, 25 customers who reported an incentive for using Groupon said they were self-referred.

Mostaghimi said the benefit-risk analysis commonly employed by physicians and patients when seeking treatment be extended to imaging services marketed on Groupon.

“While there is nothing wrong with direct‐to‐consumer sales of medical imaging, we must ensure that ethical and legal standards for patient education regarding risks and benefits of therapy are maintained,” he said. “Although this study was unable to examine the motivations of the consulting physicians upselling additional scans to patients, additional oversight may be necessary to ensure that financial bias does not impact these physicians’ recommendations to patients.”

Groupon did not immediately respond to a request for comment about the study.