Medical Imaging War Pits Doctor vs. Doctor

The fallout is just beginning in Maryland over the state’s highest court’s decision last month that upheld a state law prohibiting physicians from referring patients for MRI, CT and radiation therapy services to providers in their own group practice.                                                                              

Radiologists, who applauded the court’s decision, and orthopedists, who were on the losing end of the court’s determination, each say their arguments were made on behalf of patients. But the court battle also was about doctor vs. doctor, over money, with the backdrop of healthcare reform in the debate.

The radiologists say the case was one of selfish self-referral, pure and simple. “Studies have shown that there is very little, if any patient benefit to self-referral of advanced imaging and radiation therapy,” says John A. Patti, MD, chair of the American College of Radiology board of chancellors, quoted by John Commins in HealthLeaders Media. “Instead the practice often results in significant unnecessary utilization of imaging, unwarranted radiation exposure, lower quality of care and increased cost that is ultimately passed on to patients.”

Siding with the radiologists, Baltimore Sun columnist Jay Hancock also wrote recently that having the door open for such self-referrals is, “what’s choking American healthcare.” He added, “The system is becoming unaffordable because of many unneeded heart stents, lab tests, surgeries and MRI scans.”

Lost in all this, says the American Academy of Orthopaedic Surgeons, is that having the in-office referrals makes healthcare easier for patients. “Significant technological advances have been made in our field so that patients can receive timely and available screenings from the comfort of their doctor’s office,” says John J. Callaghan, MD, president of the academy.

“This ruling could have a dramatic effect on the treatment and quality of the care of Maryland patients,” Callaghan says. “In the interests of our patients, the academy will maintain our commitment to this issue.”

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