Turf Wars in Radiology: Updated Evidence on the Relationship Between Self-Referral and the Overutilization of Imaging

In a previous article in this series, published in 2004, the authors reviewed the medical literature for evidence on the relationship between self-referral and the utilization of imaging. That evidence demonstrated that self-referral led to substantially higher levels of utilization with its attendant increases in cost and the exposure of patients to unnecessary radiation. Since then, much new information has been published on this controversial subject. In this article, the authors update their previous article by summarizing all the recently published material. Once again, the evidence clearly indicates that self-referral results in the overutilization of imaging. Because radiologists have an important stake in the matter, it behooves them to be familiar with this recent evidence so they can bring it to the attention of policymakers in their areas.

Key Words: Medical economics, radiology and radiologists, department management, socioeconomic issues, self-referral, utilization of imaging