News | December 30, 2008

Nonradiologists Acquiring CTs at a Rate Faster than Radiologists

December 30, 2008 - Nonradiologist physicians are acquiring or leasing CT scanners in increasing numbers, and the growth trend is much more rapid among them than it is among radiologists, reported a study published in the December issue of the Journal of the American College of Radiology (JACR).

From 2001 to 2006, the CT acquisition or leasing rate among U.S. radiologists was just 85 percent compared with 263 percent among nonradiologists, researchers show in the study, Ownership or Leasing of CT Scanners by Nonradiologist Physicians: A Rapidly Growing Trend That Raises Concern About Self-Referral.

The study also found that the nonradiologic specialties with the largest volumes in 2006 were primary care (192,255 scans), internal medicine subspecialties other than cardiology and medical oncology (184,991 scans), urology (125,850 scans), cardiology (104,739 scans), and medical oncology (61,976 scans). Excluding CT scans performed in independent diagnostic testing facilities (for which physician ownership cannot be determined), nonradiologists’ private-office CT market share rose from 16 percent in 2001 to 28 percent in 2006.

One of the questions raised about self-referring physicians is whether the scans they perform are related to their areas of expertise.

“Thus, one might ask whether cardiologists confine their studies to cardiovascular CT scans, urologists to body CT scans, medical oncologists to body and head CT scans, neurologists to head and spine CT scans, and vascular surgeons to cardiovascular CT scans,” remarked the researchers. According to the data, in 2006, 99.6 percent of urologists’ scans were of the body, 99.4 percent of medical oncologists’ scans were of the body or head, 74 percent of vascular surgeons’ scans were cardiovascular, 72 percent of cardiologists’ scans were cardiovascular, and 67 percent of neurologists’ scans were of the head or spine.

The researchers noted, “At a time when the costs of imaging and the exposure of patients to radiation are coming under intense scrutiny, it is of concern that many nonradiologist physicians are going outside the scope of their original specialty training and practice experience by acquiring or leasing advanced imaging equipment such as CT scanners.”

Because self-referral leads to higher utilization of imaging, the researchers suggest that this growth trend among nonradiologists utililizing CT scanners is a significant driver of imaging utilization and cost increases, and also leads to greater exposure of patients to radiation.

Source: American College of Radiology. J Am Coll Radiol 2008;5:1206-1209.

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