A study says that physicians who have a financial interest in imaging equipment are more likely to refer their patients for potentially unnecessary imaging exams.

"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.
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"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."
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"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.
Source-Eurekalert