Journal of the American College of Radiology
Volume 1, Issue 3 , Pages 169-172 , March 2004

Turf wars in radiology: the overutilization of imaging resulting from self-referral1

  • David C Levin, MD

      Affiliations

    • Department of Radiology, Thomas Jefferson University Hospital and Jefferson Medical College, Philadelphia, Pennsylvania, USA
    • HealthHelp Networks, Inc., Houston, Texas, USA
    • Corresponding Author InformationCorresponding author and reprints: David C. Levin, MD, Department of Radiology, Gibbon 3390, Thomas Jefferson University Hospital, Philadelphia, PA 19107 USA
    • ,
  • Vijay M Rao, MD

      Affiliations

    • Department of Radiology, Thomas Jefferson University Hospital and Jefferson Medical College, Philadelphia, Pennsylvania, USA

References 

  1. Hackbarth GM, Reischauer RD, Miller ME. Assessing payment adequacy and updating payments for physician services. Medicare Payment Advisory Commission Report to Congress. 2003; March
  2. Hillman BJ, Joseph CA, Mabry MR, Sunshine JH, Kennedy SD, Noether M. Frequency and costs of diagnostic imaging in office practice—a comparison of self-referring and radiologist-referring physicians. N Engl J Med. 1990;323:1604–1608
  3. Hillman BJ, Olson GT, Griffith PE, et al.  Physicians’ utilization and charges for outpatient diagnostic imaging in a Medicare population. JAMA. 1992;268:2050–2054
  4. Maloney MC, Grajower MM, Burris JF, Mroczek WJ, Temple PC. Frequency and cost of diagnostic imaging in office practice—a comparison of self-referring and radiologist-referring physicians. [Letters to the editor] N Engl J Med. 1991;324:1371–1372
  5. Alagona P, Cooley DA, Varipapa RJ. Physicians and outpatient diagnostic imaging (overexposed?). [Letters to the editor] JAMA. 1993;269:1633
  6. Referrals to physician-owned imaging facilities warrant HCFA’s scrutiny (report to the Chairman, Subcommittee on Health, Committee on Ways and Means, House of Representatives). Washington, DC: U.S. General Accounting Office; 1994; GAO/HEHS-95-2
  7. Levin DC, Parker L, Intenzo CM, Sunshine JH. Recent rapid increase in utilization of radionuclide myocardial perfusion imaging and related procedures (1996–1998 practice patterns). Radiology. 2002;222:144–148
  8. Maitino AJ, Levin DC, Parker L, Rao VM, Sunshine JH. Practice patterns by radiologists and nonradiologists in noninvasive diagnostic imaging utilization among the Medicare population between 1993 and 1999. Radiology. 2003;228:795–801
  9. Childs AW, Hunter ED. Non-medical factors influencing use of diagnostic x-ray by physicians. Med Care. 1972;10:323–335
  10. Hemenway D, Killen A, Cashman SB, Parks CL, Bicknell WJ. Physicians’ response to financial incentives. Evidence from a for-profit ambulatory care center. N Engl J Med. 1990;322:1059–1063
  11. Radecki SE, Steele JP. Effect of on-site facilities on use of diagnostic radiology by non-radiologists. Invest Radiol. 1990;25:190–193
  12. Strasser RP, Bass MJ, Brennan M. The effect of an on-site radiology facility on radiologic utilization in family practice. J Fam Practice. 1987;24:619–623
  13. Oguz KK, Yousem DM, Deluca T, Herskovits EH, Beauchamp NJ. Effect of emergency department CT on neuroimaging case volume and positive scan rates. Acad Radiol. 2002;9:1018–1024
  14. Fisher ES, Wennberg DE, Stukel TA, Gottlieb DJ, Lucas FL, Pinder EL. The implications of regional variations in Medicare spending. Part 1 (the content, quality, and accessibility of care). Ann Int Med. 2003;138:273–287

PII: S1546-1440(03)00079-6

doi: 10.1016/j.jacr.2003.12.009

Journal of the American College of Radiology
Volume 1, Issue 3 , Pages 169-172 , March 2004

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