More evidence: Self-referring docs crank up the bill
As if any more evidence were needed. When prescribing doctors profit from expensive procedures through an ownership interest in radiology equipment, they prescribe more of those procedures. From MD News:
Patients with low back pain in the care of primary care physicians or orthopedists who own or lease magnetic resonance imaging (MRI) equipment are more likely to receive an MRI, according to a study published online April 21 in Health Services Research...The investigators found that acquisition of MRI equipment by a physician had a strong correlation with patients receiving MRI scans....
"Orthopedists and primary care physicians who begin to bill for the performance of MRI procedures, rather than referring patients outside of their practice for MRI, appear to change their practice patterns such that they use more MRI for their patients with low back pain," the authors write.
Comments
Yes, it's hackneyed, but still: This is a true Captain Renault moment. ("I'm shocked, shocked to find that gambling is going on in here!")
Posted by: Stuart Levine | May 25, 2011 6:44 PM
On the one hand, I see your point and very much agree with you about the perverse incentives here.
On the other hand, it does stand to reason that your use of something increases when you own it. For example, the number of times I rode a motorcycle increased dramatically after I bought one.
I wonder how many times it happens that a doc says he wants a patient to get an MRI and begins the referral process only to have the patient say, "I can't wait that long!" so they proceed without or find other means.
Could that account for it, at least in part? Also, could there be a way to resolve the expediency issue without creating this situation?
American Radiology placing itself next to Patient First in White Marsh, MD is one example, although I was not entirely impressed with their efficiency last time we had to use their services. Still -- better than the DMV by far.
Posted by: John J. Walters | May 26, 2011 12:46 PM