Physicians who acquire MRI equipment "appear to change their practice patterns" and use more MRI for patients with low back pain, according to a study, "The Relationship Between Low Back Magnetic Resonance Imaging, Surgery, and Spending: Impact of Physician Self-Referral Status," published online in the journal Health Services Research. In addition, when orthopedic surgeons acquire the equipment, the probability of their patients receiving surgery for low back pain increases significantly, according to the study.
More low-back surgeries for patients of ortho docs who buy MRI equipment: study
Researchers with Stanford University's medical school compared MRI scan rates for Medicare patients with nonspecific low back pain seen by 1,033 primary-care physicians and 1,271 orthopedists who acquired MRI equipment between 1999 and 2005 either by purchase or lease.
For orthopedic surgeons, the percentage of nonspecific low-back pain patients receiving an MRI within 180 days increased to 27.2% from 21.8% after the doctor acquired MRI equipment. For primary-care physicians, the rate increased to 16.7% from 11.2%.
According to the study's lead author, Dr. Jaqueline Baras Shreibati, further study—via instrumental variables analysis—found that at the margin, among orthopedic surgeons, for every three MRI scans ordered, about one additional low-back surgery was performed.
Among primary-care physicians' patients, receiving a low-back MRI was not significantly associated with a subsequent surgery, according to the report.
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