Navigation Links
Self-referral leads to more negative exams for patients
Date:11/29/2011

CHICAGO Physicians who have a financial interest in imaging equipment are more likely to refer their patients for potentially unnecessary imaging exams, according to a study presented today at the annual meeting of the Radiological Society of North America (RSNA).

"Self-referral," whereby a non-radiologist physician orders imaging exams and directs patients to imaging services in which that physician has a financial interest, is a concerning trend in medicine and a significant driver of healthcare costs. "Self-referred medical imaging has been shown to be an important contributor to escalating medical costs," said Ben E. Paxton, M.D., radiology resident at Duke University Medical Center in Durham, N.C.

"Attempts to date at reducing healthcare spending on medical imaging have come in the form of across-the-board cuts that threaten to reduce access to vital imaging services," said the paper's senior author, Ramsey Kilani, M.D., associate faculty member at Duke. "We believe patients would be better served if we instead eliminated underlying drivers of unnecessary imaging spending."

Between 2000 and 2005, ownership or leasing of MRI equipment by non-radiologists grew by 254 percent, compared to 83 percent among radiologists. The U.S. Government Accountability Office (GAO) reported that the proportion of non-radiologists billing for in-office imaging more than doubled from 2000 to 2006. During that same time period, private office imaging utilization rates by non-radiologists who control patient referral grew by 71 percent.

For the study, the researchers set out to determine if utilization of lumbar spine MRI differs, depending on the financial interest of the physician ordering the exam. They reviewed 500 consecutive diagnostic lumbar spine MRI exams ordered by two orthopedic physician groups serving the same community. The first group had financial interest in the MRI equipment used (FI group), and the second had no financial interest in the equipment (NFI group).

For each group, the researchers analyzed the number of abnormalities per positive scan, the mean age of the patients and the negative exam result rate.

The results of the study showed that among the 500 MRI exams (250 per group), between the two groups there was no significant difference in the number of abnormalities per positive scan. However, the mean age among patients in the FI group was 49.6, compared to 56.9 for the NFI group.

There were 86 percent more negative scans in the FI group than the NFI group, indicating a significantly higher number of potentially unnecessary exams. Of the 163 negative exams, 106 belonged to the FI group, compared to 57 for the NFI group. In the FI group, 42 percent of patients referred for exams had negative scans, compared to 23 percent of the NFI group.

"Orthopedic surgeons with financial interest in the equipment had a much higher rate of negative lumbar spine MRIs," Dr. Paxton said. "In addition, they were much more likely to order MRI exams on younger patients. This suggests that there is a different clinical threshold for ordering MRI exams in the setting of financial incentivization."

Dr. Paxton added that increased imaging utilization due to self-referral may not yield medically useful information and may place the patient at risk for potential adverse consequences.

"It is important for patients to be aware of the problem of self-referral and to understand the conflict of interest that exists when their doctor orders an imaging exam and then collects money on that imaging exam," he said.


'/>"/>
Contact: Linda Brooks
lbrooks@rsna.org
630-590-7762
Radiological Society of North America
Source:Eurekalert

Related medicine news :

1. Self-referral: A significant factor in imaging growth
2. Unsaturated fat breakdown leads to complications of acute pancreatitis in obese patients
3. ASU leads $5 million NIH-sponsored research initiative to advance diabetes care and treatment
4. Rise in Vulvar Precancers Leads to New Guidelines
5. Project leads next decade of aging research across Europe
6. Project leads next decade of ageing research across Europe
7. X-ray protein probe leads to potential anticancer tactic
8. Insulation from public pressure leads to more accurate suicide reporting by death investigators
9. Unconventional hunt for new cancer targets leads to a powerful drug candidate for leukemia
10. Stronger social safety net leads to decrease in stress, childhood obesity
11. Drug improves brain function in condition that leads to Alzheimers
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/26/2016)... ... June 27, 2016 , ... Quality metrics are proliferating in ... ways they remain in the eye of the beholder, according to experts who offered ... The American Journal of Managed Care. For the full issue, click here . ...
(Date:6/26/2016)... ... 2016 , ... Pixel Film Studios Released ProSlice Levels, a Media Slicing Effect ... videos a whole new perspective by using the title layers in ProSlice Levels ... , ProSlice Levels contains over 30 Different presets to choose from. FCPX ...
(Date:6/26/2016)... NC (PRWEB) , ... June 26, 2016 , ... Brent Kasmer, a legally blind and ... to be personalized through a fitness app. The fitness app plans to fix the two ... currently only offer a one size fits all type program , They don’t ...
(Date:6/25/2016)... ... June 25, 2016 , ... Experts from the ... AcademyHealth’s Annual Research Meeting June 26-28, 2016, at the Hynes Convention Center in ... topics including advance care planning, healthcare costs and patient and family engagement. , ...
(Date:6/25/2016)... ... ... of Bruton Memorial Library on June 21 due to a possible lice infestation, as reported ... head lice: the parasite’s ability to live away from a human host, and to infest ... in the event that lice have simply gotten out of control. , As lice are ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... Any dentist who has made an implant supported ... Many of them do not even offer this as a ... laboratory costs involved. And those who ARE able to offer ... high cost that the majority of today,s patients would not ... Zadeh , founder of Dental Evolutions Inc. and inventor of ...
(Date:6/23/2016)... , June 23, 2016 ... CAPR ), a biotechnology company focused on ... today announced that patient enrollment in its ongoing ... Duchenne) has exceeded 50% of its 24-patient target. ... in the third quarter of 2016, and to ...
(Date:6/23/2016)... and BOGOTA, Colombia , June 23, 2016  Astellas today announced the establishment of ... Farma Brasil as the company,s second affiliate in Latin America . ... ... Manager of Astellas Farma Colombia ... ...
Breaking Medicine Technology: