Diagnostic
imaging procedures are necessary in order to treat many conditions.
Multiple conditions complex, and not so complex, require imaging in order to
get a diagnosis and treatment program. An MRI, CT scan, or X- Ray may do the trick,
but are they always necessary? In some cases it’s necessary to repeat the
procedures in order to find out if certain conditions are responding to
treatment, in other cases it’s not really necessary. So are they necessary when
a physician has the equipment available? Apparently, physicians that have the
equipment are overusing it, in some cases.
It appears that physicians that have scanners, x-ray
machines, and anything else available are not yielding the kind of results that
are favorable to the patient. In terms of result, it’s cost that’s becoming an
issue. Many physicians will order the test because they have the ability to do
so. Associated with these tests is a great deal of issues, such as cost to the
patient, the cost of upkeep for a piece of equipment, and the ultimate problem
that it’s causing for everyone involved.
If a physician writes a referral for himself or
herself, to do the test, they are exposing themselves to a question of the
proper vs. improper way of doing things. An article on the subject stated that
“Studies on
self-referral's effects on imaging use have been criticized for their inability
to assess the appropriateness of the exams ordered -- a task confounded by
factors such as clinical setting, disease prevalence, referral biases, and terminology
differences between interpreting radiologists. That's why Amrhein's team wanted
to assess the rate of normal exams (i.e., negative studies) as well as compare
the prevalence and severity of disease within the subject population.”
It’s important to make sure that a patient is okay but if a test isn't
called for, the interest in keeping a machine active should not be a
physician’s reason. Let’s assume a physician has a mammography machine. Is it right
to send a woman for a mammogram that she doesn't need, especially if she is not
at risk or breast cancer. The same would apply if a woman was not pregnant and
ordered to have an ultrasound for no real reason.
The bigger problem is that this is the kind of situation that drives
procedural costs up, and forces the hands of many providers to put a narrow cap
on the amount of diagnostic imaging procedures allowed. In part this is a
question of ethics that fall on the shoulders of people that are interested in
making money by undercutting specialized facilities and hospitals and
performing procedures themselves.
This problem does have a resolution but it will take time. There are
likely to be arguments for self-referrals that will refer to patient confidence
and trust. Hopefully the future will see a happy medium that will ultimately
please everyone, especially the patients.
If you have any questions about diagnostic imaging procedures please
feel free to give us a call. Our dedicated team of professionals here at
Clermont Radiology looks forward to answering all your questions.
Charla
Hurst
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