Studies question benefits of self-referral

The practice of physician self-referral involving imaging facilities—when doctors who aren't radiologists refer their patients to facilities they own or lease—does not consistently benefit patients and often leads to unnecessarily higher costs, according to a set of studies appearing in the Dec. 7 issue of the journal Health Affairs.

The studies looked at a variety of issues surrounding the supposed benefits of physician self-referral and reached several conclusions that challenge the supposed merits of the practice.

For example, senior researchers from the American College of Radiology looked at 2006 and 2007 Medicare data and found that only 15% of patients received same-day services when they were sent by self-referring physicians for high-tech imaging studies such as CT, MRI or nuclear scans. The authors noted that because high-tech equipment is so expensive, facilities often schedule appointments several days or weeks out to better predict income flow. That practice limits same-day scans, which are a supposed benefit of physician self-referral. The authors recommend that Medicare consider only allowing physicians to self-refer for X-rays.

In another study, researchers found that orthopedists and neurologists more frequently referred patients for MRI scans once they became owners or leasers of such facilities, and in a third study, researcher determined that physician self-referral seldom results in patients experiencing speedier recoveries from their illnesses.