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Self-Referral of Medical Imaging Exams a Primary Factor in Six-Fold Increase to Americans' Radiation Exposure From Scans Since 1980
Date:3/3/2009

the improved health care resulting from these non-invasive, accurate imaging tools, there are concerns about overutilization of these exams.

At a recent international conference David A. Schauer, executive director of the NCRP, cited self-referral, the process by which nonradiologist providers buy imaging equipment and refer patients to these in-office scanners as a primary, preventable driver of this dramatic increase in radiation exposure. Nonradiologist providers often lack even basic radiation safety training and may not be aware of potential repercussions to patients of ordering and often administering high volumes of scans.

Government Accountability Office (GAO) reports as well as peer-reviewed studies published in the Journal of the American Medical Association and elsewhere have shown that when physicians refer patients to facilities in which they have a financial interest, imaging utilization is significantly increased. From 1998-2005, in the Medicare system, the number of self-referred, in-office CT, MRI, and nuclear medicine scans performed grew at triple the rate of the same exams performed in all settings. Private insurance studies indicate that as much as half of this self-referred imaging is unnecessary; in many instances needlessly exposing patients to radiation. Provider fear of litigation, advancing technology, and patient demand may have also contributed to this increase in exposure.

What Has Been Done to Counteract This Trend:

The ACR, in an effort to stem the unnecessary growth in radiation dose that Americans receive from imaging, has worked with other radiology organizations to educate all stakeholders in the principles of radiation safety and appropriate utilization of imaging.

For years, the ACR has promoted radiation safety among radiologist, nonradiologists, and the public through the ACR Practice Guidelines and Technical Standards, facili
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SOURCE American College of Radiology
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