Wednesday, June 6, 2012

A Look At The Effects Of In-House Imaging On A Radiology Practice

If you work as an attending radiologist, you have certainly had ups and downs in your days; the ups may include having to make interesting diagnoses or having to tell your patients that, no, they do not have cancer, and the downs may include discovering that a referring physician is telling you that you cannot perform one particular test when you know that is exactly the test that is necessary. Additionally, there is the inherent bureaucracy and red tape of having to deal with insurance companies when it comes to what tests you can perform on a patient - even though you know that the referring physician ordered the wrong tests, and if you are in this position, you know that you can experience heavy pressure from both doctors and insurance companies. But one of the biggest (and strangest) things you are probably going to notice is "in-house" imaging that is performed in referring physician offices.
Naturally, there are two sides to the idea of self-referral for in-house ancillary services, with one side being the fact that patients feel they are actually getting better care because of the convenience of remaining in-house for their screenings; the other side of this issue, however, is that, quite frankly, most patients are actually receiving far worse care.
For example, some OB/GYN groups have begun to do their own screening mammographies, choosing to use a film screen mammography - which ends up yielding images that are of a lower quality when compared to digital mammographies; additionally, many primary care physicians have ultrasound technologists that now come to their offices to perform a variety of screenings, and many such offices have even purchased their own bone density machines.
Because the majority of patients do not have a thorough knowledge of what role radiologists play in health care delivery - as well as the fact that radiologists in fact have very little say in determining their role in the health care landscape - it is important that the loophole allowing in-house referrals be closed. After all, radiologists are highly-trained in a specialized branch of medicine, in which they have a large amount of knowledge, and the bureaucracy of health care tends to prevent them from operating at an efficient level. Furthermore, when doctors who should be referring patients to radiologists (for the good of the patient, and for the good of the cost of health care) instead choose to keep things in-house, they limit the effectiveness of health care as a whole.
This is a serious issue that radiologists certainly are affected by; if you are a radiologist yourself, you ought to do what you can to make your voice heard, and if you are a doctor, it is time to consider doing right by patients and the health care structure in general, and referring patients to expert radiologists!

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