I'm coming to terms with the fact that I may be part of a dying breed of physicians whose mentors back in the day used to berate them for ordering any scan without being able to clearly articulate what exactly you're looking for and what the pretest probability is Instead now CT scans have essentially been continually abused as an extension of the physical exam. All anyone needs to articulate is: I think something bad's happening.... Let's get a CT scan or even…. I'm not sure if there's anything bad going on, let's make sure there isn't anything bad on the CT scan. It doesn't even appear to be necessary anymore to explain what you mean by 'something bad' I sound like a grumpy old man, I know, but I think it's a sad state of affairs. The perverse thing about it is there's no real incentive on the part of any emergency room or hospital system to curtail this kind of behavior because they get paid for every single scan.