Is that your nose growing, doctor?

July 1, 2007

How much would you pay to avoid spending the rest of your life in prison: $2 million? How about 30 years in prison: $1 million? Even if we lowball it and say a radiologist makes about $250,000 a year, 30 years of your life would be worth more like $7.5 million. What if I told you it would cost you only $10,000. A steal, right?

"Look at all these MR cases that have to be protocoled. Did you ever dream that we would be so successful?"

"No, but let's work quickly. This stack of requisitions is all routine r/o adultery protocols, and this stack is all r/o embezzlement protocols."

"This stack is a mix of 'Is my spouse/boy/girlfriend/son/daughter gay?', but last night I read this paper in the Journal of Judicial Radiology that showed the old r/o homosexuality protocol is not reliable in teenagers and bisexuals. The authors had developed new, more accurate protocols. I brought them with me."

"Okay, why don't we do those last, then?"

"Ka-ching! Here's a requisition, 'Is my husband stealing from our business to support a gay lover?' That's three CPT codes right there. At this rate, I'm definitely going to buy that yacht and the villa in France."

"Hold your horses. We got a call yesterday from Ken. There's a problem."

"Ken our lawyer?"

"No, Ken our lobbyist in DC. He says support from the president and the congressional reps sponsoring our bill to expand our contract to all the federal courts and IRS offices is starting to evaporate."

"But we've already given them millions of shares of our stock. They can't take our money and back out now."

"Seems those centers we put up in Washington are making them nervous that our deal with them could be exposed."

"Every single peer-reviewed study has shown that politicians and lawyers don't know the difference between a lie and the truth. If they ever had to testify, our machines would be useless at detecting their complicity. They have no need to worry."

"They know that. They're worried about the people around them who might know something being asked to testify. Seems an accountant for a lobbying firm knew about kickbacks to congressional reps and . . ."

"Why are we even discussing this? Ken dealt with this problem at the state level. We overcame these concerns then and can do it again. Back to the reqs."

"By the way, you were the late guy last night, weren't you?"

"Yes. Why?"

"Because when I came in this morning, there was a huge stack of unread cases at the console."

"Must have been put there after I left."

"Funny, I spoke to the tech, and she says she handed them to you in person."

"She is mistaken."

"We happen to have this cancellation at 8:30 a.m. Why don't you just pop in the machine, and we can see . . ."

How much would you pay to avoid spending the rest of your life in prison: $2 million? How about 30 years in prison: $1 million? Even if we lowball it and say a radiologist makes about $250,000 a year, 30 years of your life would be worth more like $7.5 million. What if I told you it would cost you only $10,000. A steal, right?

Joel Huizenga, CEO of No Lie MRI, is offering just such a chance, with one teeny tiny caveat: You have to be telling the truth. Otherwise, he will prove to everyone that you are lying.

Our legal system presumes innocence and professes that its goal is to uncover the truth. In reality, the truth is rarely self-evident, and lawyers are far more concerned with winning their cases than uncovering the truth.

Every day innocent people are convicted of crimes, and guilty people go free. Only with the advent of DNA testing are some of these convicted people being proved innocent and released, but sometimes not until 25 years later.

Make it personal: What do you do if a tech accuses you of assault after the office closes? Or if a younger relation, through recovered memory therapy, says you sexually abused him or her as a child? Take a polygraph test?

In 2003, the Department of Energy commissioned the National Academy of Sciences to conduct an 18-month study of polygraph tests. Contrary to what the administrators of polygraph tests will tell you about their accuracy, the study found little or no scientific evidence that such tests can determine who is telling the truth. They primarily detect who is nervous. If you have a 30-to-life sentence hanging over your head, I can pretty much guarantee you will be nervous, unless you're a total Ted Bundy sociopath.

Since 1988, federal law has kept most companies from screening employees with such tests. Not surprisingly, the U.S. Supreme Court upheld state bans on their use in legal proceedings in 1998. Every state except New Mexico bans their use. So what is current gold standard?

Dr. Daniel D. Langleben found in his paper, "Telling truth from lie in individual subjects with fast event-related fMRI," published in Human Brain Mapping in 2005, that increased activity in very specific areas of the brain correlated with lying. Huizenga immediately saw the implications of this research and licensed the patent rights from the University of Pennsylvania. With the assistance of experts in computer analysis, he now has software that-when run on a 3T machine-can offer 93% accuracy. With further refinements, he predicts 99% accuracy soon.

The company's first test site opened in Tarzana, CA, in December 2006. Its first client was a man accused of burning down his deli for the insurance money. The courts cleared him, but the insurance company still would not pay.

Innocent people trying to prove their innocence and lawyers trying to get an edge are current clients, but Huizenga has fielded inquiries from Russia and countries in Africa, where trust is in short supply and graft rampant. Even the Chinese police have made inquiries. This is odd, since in China you are presumed guilty, and the burden of proof falls on the accused to prove his or her innocence. Over a billion people trying to prove their innocence could be a lucrative market, however, especially for the police if they have the license rights.

What does this have to do with you? You haven't done anything wrong-yet. The Deficit Reduction Act may suddenly make many outpatient imaging centers unprofitable, and new revenue sources will be necessary. If you don't want to sneak in pets at night from the vet down the street, this may be an opportunity for you. If you don't want to become a zombie reading breast MRI, or your hospital MRI is underutilized at night, remember there are more than 40 lawyers to every radiologist in the U.S., over a million of them, all looking for ways to win their cases. Not to mention all the government agencies who are interested, from Homeland Security to the IRS.

No Lie MRI is opening its next center in Switzerland. Huizenga doesn't say this, but I wonder if the location isn't for those clients who think it may be better to stay in Switzerland if they don't pass. (Where did I put my passport?) No Lie MRI is looking for partners in the U.S. with 3T magnets who want to sign up as licensed centers under the VeraCenter brand name. Who knows? You may soon find yourself sitting for the ABR CAQ examination in Judicial Radiology.

There are always risks, however. When you get home, your spouse could ask, "Does this outfit make me look fat?" The correct answer is, "Did I tell you I'm going to law school?"

Dr. Trefelner is a radiologist and cofounder of NightShift Radiology. He invites comments by e-mail at ericxray@pacbell.net or fax at 650/728-5099.