Self-referring physicians have high utilization of their scanners
Same-specialty self-referring physicians tend to utilize imaging more frequently than physicians who refer their patients to radiologists, according to a new study published in the November issue of Radiology.

The investigation by the Institute of Technology Assessment at Massachusetts General Hospital analyzed more than 526 million claims filed between 1999 and 2003 with an employer-based health insurance plan having about four million members.

G. Scott Gazelle, MD, lead author of the study, director of the institute and a professor of radiology at Harvard Medical School, categorized each physician's behavior for conditions that included: cardiopulmonary disease, coronary and/or cardiac disease, extremity fracture, knee pain, intra-abdominal malignancy and stroke. The researchers then established if the physician self-referred or radiologist-referred the patient for imaging.

For the conditions evaluated, physicians who referred patients to themselves or to other same-specialty physicians for diagnostic imaging used imaging between 1.12 and 2.29 times as often per episode of care, as physicians who referred patients to radiologists.

The researchers found that in adjusting for patient age and comorbidity, the likelihood of imaging was 1.196-3.228 times greater for patients cared for by same-specialty self-referring physicians.

The results indicate that when people have a financial incentive to order or perform a procedure, they're likely to do it more often than when no financial incentive exists, according to Gazelle.