Self-referral of imaging does not imply overutilization

Area of Science:

• Radiology
• Healthcare Economics
• Neurology

Background:

• Concerns exist regarding physician self-referral in radiology, with arguments suggesting it increases healthcare costs due to potential technology overutilization.
• Older literature suggested financial incentives from self-referral lead to increased utilization of imaging services.

Purpose of the Study:

• To investigate the relationship between physician self-referral and the utilization of medical imaging.
• To determine if self-referral practices contribute to increased healthcare costs through overutilization of diagnostic imaging technology.

Main Methods:

• A comprehensive review of existing literature on physician self-referral and imaging utilization.
• A poll study comparing imaging referral patterns of neurologists who self-refer versus those who refer to radiologists.

Main Results:

• The most extensive analyses found little evidence of overutilization associated with self-referral.
• A poll study of 33 self-referring neurologists showed no indication of overutilization compared to 900 neurologists referring to radiologists.
• The surge in imaging demand (1999-2002) was primarily driven by technological advancements, not self-referral.

Conclusions:

• Physician self-referral does not appear to be a significant driver of increased medical imaging utilization.
• Technological improvements in imaging modalities are the likely cause of increased demand.
• Self-referral may potentially reduce healthcare costs by shifting care from hospitals to outpatient settings.