April 16, 2025 • 11 mins
Dr. Jim Keany, Chief Medical Officer at Dignity Health St. Mary Medical Center in Long Beach, joins The Bill Handel Show for 'Medical News'! Dr. Keany talks with Bill about full body MRI’s and whether they are doing more harm than good.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
It's time for a medical news doctor Jim Keeney every Wednesday.
(00:04):
Jim is chief medical Officer for Dignity Saint Mary Medical Center,
Long Beach.
Speaker 2 (00:08):
Jim is also an er doctor and so is news
is fit to print? Jim, Good morning, Good morning Bill.
Speaker 1 (00:16):
Okay, Now, this story and I've been following this story
for many many years. Full body mr I's and I
don't know if I told you this story about Marjorie
and having a full body MRI. I was once involved
with the company that did these and we both ended
(00:37):
up with the full body scan and they found with
her carsonoids, these little lesions that would have absolutely turned
into lung cancer. And with lung cancer you don't know
the symptoms until it's almost too late. And it was
if you talk to her, even though she's lost part
(00:59):
of a love and you ask her, she'll goo that
was a joke about her inability to breathe. That didn't work,
but we tried anyway. Yeah, the argument is, or the
question is are they more harmful than good? And you
and I have talked about this before, so I want
(01:20):
you to comment on full body on MRIs.
Speaker 3 (01:23):
Sure. I mean I also have access and probably could
get one for a very reasonable price, and I've never
done it because you got to understand screening tests right there.
So first of all, you can get people like Marjorie,
and she kind of won the lottery, right it was
one of those people that rarely found something significant that
(01:45):
was correct and was actually there and you were able
to change something, I assume based on what she found.
But for an overwhelming majority of people either either going
to not find anything, or they're going to find something
that's not real. It's not there, you know, like you
find a little clumps of tissue that looks like a tumor,
(02:06):
but it's not cancerous, it's not a problem, and now
you're going to get biopsies and do all this other
stuff for no reason at all. You're going to go
through the emotional anxiety. So you know, people say, well,
that's ridiculous. Wouldn't you rather know than not?
Speaker 1 (02:20):
Yea, wouldn't you rather know? Because what's the worst case scenario?
You find out, you do a biopsy, pain pain in
the ass as well as painful, and then you're paying
whatever medical costs. But then you go at least it
went the right way as opposed to not having done it.
Speaker 2 (02:37):
And it would have been a real problem. Yeah.
Speaker 3 (02:41):
So I mean there's probably some people that would take
that approach, and you know, if you have the time,
money and effort, go to town. But I don't want my
health insurance premiums to go up because a bunch of
people want to feel better about themselves after getting this MRI.
Because Number One, the MRI is this is a big view. Right,
it's not focused view of your lungs or your liver
(03:02):
or your kidney. It's a it's kind of an overview
of the body. So it's not the detailed MRI that
you get when you get an MRI of your lungs
or an MRI just looking at your kidneys. It's completely
different than that. So it can Number one, so think
about a screening test is like a ven diagram or
some overlapping circles. Right, you got two overlapping circles. You
got a part on the left. It's by itself that
(03:23):
would be false negative. So it's it was negative, but
we missed it. There's something there. Then you got the
far right. It's false positive. You know it was positive,
but it's not real and you're wasting your time. And
then the overlap is the true findings, right, the true positives,
true negatives, and you'd hope that the circles perfectly overlap,
(03:45):
so everything is either true positive or true negative. But
that's not the case in any test. There's no such
a test that's like that. And this test is particularly
low on it's what we call sensitivity. It's it has
a high false and it has a relatively high false
negative rate as well, so you may be reassured. And
(04:07):
if it's just you know, and the advantage is it's
only rate, it's only magnetic radiation, so probably nothing bad
will happen from you just by getting this thing. It's
the it's the problems that happen afterwards that when you
get by biopsy. By the way, that's taking a chunk
of your tissue out of your body. So it's a
procedure that definitely has has bad effects. I mean, when
(04:28):
you do one in the liver, the liver is so
filled with vasculature that your chances of hitting an artery
are kind of high. And then now you have bleeding
and you have a blood transfusion, and you have all
you have to have open surgery to try and stop
the bleeding. I mean bad things can happen.
Speaker 1 (04:44):
All right, let's take a break. You've just convinced you
have convinced me even more to do it. Thank you
for that, Jim. We got news yesterday. Actually we now
are FK Junior, who is my favorite Human Health and
Human Services secretary, because man, we do a good job
with these cabinet positions, don't we.
Speaker 3 (05:07):
Well, what he's done for your show is incredible.
Speaker 1 (05:09):
Yeah, he's really helped. Just a quick aside. I was
just in the elite. You were there and I had
gotten married, and as we went around. I don't know
if you talk to people, but in reference to what's
going on in this country, it wasn't good bad. It
was we don't understand. We just don't get it. What
the hell is going on? And one of the we
(05:32):
don't get it is RFK Junior and his comments yesterday
about autism, starting with it used to be one in
I don't know how many thousands of kids were diagnosed,
and now it's come down to one in thirty one children,
and he has called this an epidemic.
Speaker 2 (05:50):
Your comments, please, Yeah.
Speaker 3 (05:52):
I mean I don't understand how someone has parlayed a
complete lack of understanding of certain things into some type
of special understanding that no one else. You know that
as if you know his understanding is above and beyond
everyone else. I mean, it is true, huge jump in
diagnosis over time. Right, So in two thousand it was
one in one hundred and fifty and like you said
(06:13):
before the break, now it's about one in thirty. It's
a fivefold increase. That's not necessarily because there's more cases.
There's clearly better awareness, right, I mean we used to
just call people like this quirky. Now we realize they're neurodiverse.
There's something different there, their brain operates on a different
operating system that we have more access to screening and
(06:35):
services now. I mean there was a think about that
fell under psychiatric care before, and psychiatric care still hasn't
come up to what we need it to be to
really serve the public as well as it should. And
so now it's actually it's not just a psychiatric disorder.
This is this is a medical disorder with a neurodiverse brain.
(06:55):
It's different. And then we've broadened the definition of Asperger's
and they call it Asperger's spectrum disease or autism spectrum disease,
and that was broadened in twenty thirteen, so you know,
we because of all these things, we're getting more diagnoses.
But I mean, actually you should have you know, what's
(07:17):
her name, Mary Temple Grandin, that you should have her
on the show. She is incredible. She's an autistic woman
who is well spoken, and she really explains how neurodiversity
is just a different brain and I think it's much
more common than we think. And there's probably a lot
of people running around who are high functioning who are
(07:37):
operating on this different operating system. And so I think
the diagnosis of autism spectrum disease is going to increase
even further, but we may find out it's not. Let
me tell you, when you're autistic, dealing with a neuro
typical person can be challenging because they don't get it,
and vice versa. Right when you're neurotypical, dealing with someone
(07:59):
on the autism spectrum may be challenging, but it just
because they're different with each other doesn't mean that one
is right and one is wrong. I'm really not convinced
that that yet, that the autistic ones are the broken ones,
because they're the ones like Mary Temple Grandin that are
inventing new and amazing stuff. She actually says, if there
were no neurodiverse cavemen, we'd probably still be sitting around
(08:21):
using stone utensils and not using fire to cook her food.
Speaker 2 (08:24):
If I interview her, would she would she look at
me in the eye.
Speaker 3 (08:28):
I don't know.
Speaker 2 (08:29):
No, I don't know either.
Speaker 3 (08:30):
Speaking in large audiences, and so I think she doesn't
have to look Actually, she mentioned that one of her talks,
I don't have to look you in the eye. It's great, hey,
you know, just I.
Speaker 2 (08:39):
Have shared this story with you. My dad.
Speaker 1 (08:41):
It turns out, in retrospect, was severely bipolar, and that
didn't exist as a diagnosis. No one knew from bipolarity,
and certainly no one there was no medication to deal
with it. And here was someone who had We had
the information and what have been part of this world
(09:03):
of psychiatric disorders. So, you know, if we go back,
as you pointed out, if we go back twenty thirty
forty years ago, the number of people who were autistic,
are artistic? Are autistic had to be astronomical relative to today,
well relative to.
Speaker 3 (09:20):
What we thought to relative to what we thought, and
it may not be as big of an increase as
we think we're just doing a better job of identifying
it and helping, you know, especially the more severe autism
where they're having difficulty functioning in society or functioning in school,
learning problems, speech problems, where they can't actually talk. That
you know, we're getting better at helping those people. You know,
(09:42):
we know now that if you intervene early with a
child who's having communication difficulty, you can really change the outcome.
Speaker 1 (09:49):
So bottom line is that RFK Junior is a fruitcake?
Is that fair to say?
Speaker 3 (09:54):
Well, I mean, he's just barking up the wrong tree.
It's you know, it's not an epidemic. An epidemic is
when something is an outbreak, right, it's suddenly happening. It
may appear from the outside as an epidemic, and I'm
not sure epidemic implies that it's a bad thing. You know. Again,
I think humans were possibly made to have some level
(10:15):
of autism spectrum disorder. And it's the people who are
the more severe they're having trouble functioning in society, they
need help. But the other ones like Mary Temple Grand
and I don't think she needs any help.
Speaker 2 (10:26):
Okay, Jim, we'll talk again. Next Wednesday.
Speaker 1 (10:28):
Thank you as usual, you have a good day and
it's always killed somebody for me.
Speaker 2 (10:33):
Okay, oh my god, Okay, we're done. That doesn't matter
you Like, seriously, he's in the R. How bipolar was
your dad? Yeah, well not as bipolar as I am.
He Jim is in the R.
Speaker 1 (10:46):
What do you think we talk about when we hang out,
how many people have died in the er and what
he does but not do to.
Speaker 2 (10:52):
Him He's actually trying to save lives.
Speaker 1 (10:54):
Yeah, but sometimes it doesn't work. And were I talk
about those a lot. Alright, we're done, guys,
It's time for a medical news doctor Jim Keeney every Wednesday.
(00:04):
Jim is chief medical Officer for Dignity Saint Mary Medical Center,
Long Beach.
Speaker 2 (00:08):
Jim is also an er doctor and so is news
is fit to print? Jim, Good morning, Good morning Bill.
Speaker 1 (00:16):
Okay, Now, this story and I've been following this story
for many many years. Full body mr I's and I
don't know if I told you this story about Marjorie
and having a full body MRI. I was once involved
with the company that did these and we both ended
(00:37):
up with the full body scan and they found with
her carsonoids, these little lesions that would have absolutely turned
into lung cancer. And with lung cancer you don't know
the symptoms until it's almost too late. And it was
if you talk to her, even though she's lost part
(00:59):
of a love and you ask her, she'll goo that
was a joke about her inability to breathe. That didn't work,
but we tried anyway. Yeah, the argument is, or the
question is are they more harmful than good? And you
and I have talked about this before, so I want
(01:20):
you to comment on full body on MRIs.
Speaker 3 (01:23):
Sure. I mean I also have access and probably could
get one for a very reasonable price, and I've never
done it because you got to understand screening tests right there.
So first of all, you can get people like Marjorie,
and she kind of won the lottery, right it was
one of those people that rarely found something significant that
(01:45):
was correct and was actually there and you were able
to change something, I assume based on what she found.
But for an overwhelming majority of people either either going
to not find anything, or they're going to find something
that's not real. It's not there, you know, like you
find a little clumps of tissue that looks like a tumor,
(02:06):
but it's not cancerous, it's not a problem, and now
you're going to get biopsies and do all this other
stuff for no reason at all. You're going to go
through the emotional anxiety. So you know, people say, well,
that's ridiculous. Wouldn't you rather know than not?
Speaker 1 (02:20):
Yea, wouldn't you rather know? Because what's the worst case scenario?
You find out, you do a biopsy, pain pain in
the ass as well as painful, and then you're paying
whatever medical costs. But then you go at least it
went the right way as opposed to not having done it.
Speaker 2 (02:37):
And it would have been a real problem. Yeah.
Speaker 3 (02:41):
So I mean there's probably some people that would take
that approach, and you know, if you have the time,
money and effort, go to town. But I don't want my
health insurance premiums to go up because a bunch of
people want to feel better about themselves after getting this MRI.
Because Number One, the MRI is this is a big view. Right,
it's not focused view of your lungs or your liver
(03:02):
or your kidney. It's a it's kind of an overview
of the body. So it's not the detailed MRI that
you get when you get an MRI of your lungs
or an MRI just looking at your kidneys. It's completely
different than that. So it can Number one, so think
about a screening test is like a ven diagram or
some overlapping circles. Right, you got two overlapping circles. You
got a part on the left. It's by itself that
(03:23):
would be false negative. So it's it was negative, but
we missed it. There's something there. Then you got the
far right. It's false positive. You know it was positive,
but it's not real and you're wasting your time. And
then the overlap is the true findings, right, the true positives,
true negatives, and you'd hope that the circles perfectly overlap,
(03:45):
so everything is either true positive or true negative. But
that's not the case in any test. There's no such
a test that's like that. And this test is particularly
low on it's what we call sensitivity. It's it has
a high false and it has a relatively high false
negative rate as well, so you may be reassured. And
(04:07):
if it's just you know, and the advantage is it's
only rate, it's only magnetic radiation, so probably nothing bad
will happen from you just by getting this thing. It's
the it's the problems that happen afterwards that when you
get by biopsy. By the way, that's taking a chunk
of your tissue out of your body. So it's a
procedure that definitely has has bad effects. I mean, when
(04:28):
you do one in the liver, the liver is so
filled with vasculature that your chances of hitting an artery
are kind of high. And then now you have bleeding
and you have a blood transfusion, and you have all
you have to have open surgery to try and stop
the bleeding. I mean bad things can happen.
Speaker 1 (04:44):
All right, let's take a break. You've just convinced you
have convinced me even more to do it. Thank you
for that, Jim. We got news yesterday. Actually we now
are FK Junior, who is my favorite Human Health and
Human Services secretary, because man, we do a good job
with these cabinet positions, don't we.
Speaker 3 (05:07):
Well, what he's done for your show is incredible.
Speaker 1 (05:09):
Yeah, he's really helped. Just a quick aside. I was
just in the elite. You were there and I had
gotten married, and as we went around. I don't know
if you talk to people, but in reference to what's
going on in this country, it wasn't good bad. It
was we don't understand. We just don't get it. What
the hell is going on? And one of the we
(05:32):
don't get it is RFK Junior and his comments yesterday
about autism, starting with it used to be one in
I don't know how many thousands of kids were diagnosed,
and now it's come down to one in thirty one children,
and he has called this an epidemic.
Speaker 2 (05:50):
Your comments, please, Yeah.
Speaker 3 (05:52):
I mean I don't understand how someone has parlayed a
complete lack of understanding of certain things into some type
of special understanding that no one else. You know that
as if you know his understanding is above and beyond
everyone else. I mean, it is true, huge jump in
diagnosis over time. Right, So in two thousand it was
one in one hundred and fifty and like you said
(06:13):
before the break, now it's about one in thirty. It's
a fivefold increase. That's not necessarily because there's more cases.
There's clearly better awareness, right, I mean we used to
just call people like this quirky. Now we realize they're neurodiverse.
There's something different there, their brain operates on a different
operating system that we have more access to screening and
(06:35):
services now. I mean there was a think about that
fell under psychiatric care before, and psychiatric care still hasn't
come up to what we need it to be to
really serve the public as well as it should. And
so now it's actually it's not just a psychiatric disorder.
This is this is a medical disorder with a neurodiverse brain.
(06:55):
It's different. And then we've broadened the definition of Asperger's
and they call it Asperger's spectrum disease or autism spectrum disease,
and that was broadened in twenty thirteen, so you know,
we because of all these things, we're getting more diagnoses.
But I mean, actually you should have you know, what's
(07:17):
her name, Mary Temple Grandin, that you should have her
on the show. She is incredible. She's an autistic woman
who is well spoken, and she really explains how neurodiversity
is just a different brain and I think it's much
more common than we think. And there's probably a lot
of people running around who are high functioning who are
(07:37):
operating on this different operating system. And so I think
the diagnosis of autism spectrum disease is going to increase
even further, but we may find out it's not. Let
me tell you, when you're autistic, dealing with a neuro
typical person can be challenging because they don't get it,
and vice versa. Right when you're neurotypical, dealing with someone
(07:59):
on the autism spectrum may be challenging, but it just
because they're different with each other doesn't mean that one
is right and one is wrong. I'm really not convinced
that that yet, that the autistic ones are the broken ones,
because they're the ones like Mary Temple Grandin that are
inventing new and amazing stuff. She actually says, if there
were no neurodiverse cavemen, we'd probably still be sitting around
(08:21):
using stone utensils and not using fire to cook her food.
Speaker 2 (08:24):
If I interview her, would she would she look at
me in the eye.
Speaker 3 (08:28):
I don't know.
Speaker 2 (08:29):
No, I don't know either.
Speaker 3 (08:30):
Speaking in large audiences, and so I think she doesn't
have to look Actually, she mentioned that one of her talks,
I don't have to look you in the eye. It's great, hey,
you know, just I.
Speaker 2 (08:39):
Have shared this story with you. My dad.
Speaker 1 (08:41):
It turns out, in retrospect, was severely bipolar, and that
didn't exist as a diagnosis. No one knew from bipolarity,
and certainly no one there was no medication to deal
with it. And here was someone who had We had
the information and what have been part of this world
(09:03):
of psychiatric disorders. So, you know, if we go back,
as you pointed out, if we go back twenty thirty
forty years ago, the number of people who were autistic,
are artistic? Are autistic had to be astronomical relative to today,
well relative to.
Speaker 3 (09:20):
What we thought to relative to what we thought, and
it may not be as big of an increase as
we think we're just doing a better job of identifying
it and helping, you know, especially the more severe autism
where they're having difficulty functioning in society or functioning in school,
learning problems, speech problems, where they can't actually talk. That
you know, we're getting better at helping those people. You know,
(09:42):
we know now that if you intervene early with a
child who's having communication difficulty, you can really change the outcome.
Speaker 1 (09:49):
So bottom line is that RFK Junior is a fruitcake?
Is that fair to say?
Speaker 3 (09:54):
Well, I mean, he's just barking up the wrong tree.
It's you know, it's not an epidemic. An epidemic is
when something is an outbreak, right, it's suddenly happening. It
may appear from the outside as an epidemic, and I'm
not sure epidemic implies that it's a bad thing. You know. Again,
I think humans were possibly made to have some level
(10:15):
of autism spectrum disorder. And it's the people who are
the more severe they're having trouble functioning in society, they
need help. But the other ones like Mary Temple Grand
and I don't think she needs any help.
Speaker 2 (10:26):
Okay, Jim, we'll talk again. Next Wednesday.
Speaker 1 (10:28):
Thank you as usual, you have a good day and
it's always killed somebody for me.
Speaker 2 (10:33):
Okay, oh my god, Okay, we're done. That doesn't matter
you Like, seriously, he's in the R. How bipolar was
your dad? Yeah, well not as bipolar as I am.
He Jim is in the R.
Speaker 1 (10:46):
What do you think we talk about when we hang out,
how many people have died in the er and what
he does but not do to.
Speaker 2 (10:52):
Him He's actually trying to save lives.
Speaker 1 (10:54):
Yeah, but sometimes it doesn't work. And were I talk
about those a lot. Alright, we're done, guys,
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