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Related Experiment Video

Updated: Jun 8, 2026

Ultrasonography of the Adult Male Urinary Tract for Urinary Functional Testing

Ultrasonography of the Adult Male Urinary Tract for Urinary Functional Testing

Published on: August 14, 2019

Imaging use among employed and self-employed urologists.

John M Hollingsworth¹, John D Birkmeyer, Yun S Zhang

¹Robert Wood Johnson Foundation Clinical Scholars Program, Department of Urology, Division of Health Services Research, University of Michigan, Ann Arbor, Michigan 48105-2967, USA.

The Journal of Urology

|October 19, 2010

Summary

Self-employed urologists order diagnostic imaging more often than employed urologists. This suggests practice ownership influences resource-intensive styles, particularly for conditions like urolithiasis and hematuria.

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Area of Science:

Urology
Health Services Research
Medical Economics

Background:

Physicians who own their practices may be incentivized to provide more care compared to salaried physicians.
The impact of practice ownership on the utilization of ancillary services, such as diagnostic imaging, is not well understood.

Purpose of the Study:

To investigate whether urologist employment status (self-employed vs. employed) influences the use of diagnostic imaging during outpatient visits.
To explore the association between practice ownership and resource utilization in urology.

Main Methods:

Utilized data from the National Ambulatory Medical Care Survey (2006-2007) for outpatient urology visits.
Categorized urologists as either employed or self-employed.
Calculated and compared the proportion of visits involving diagnostic imaging ordered by employed versus self-employed urologists.
Employed multivariable logistic regression to adjust for patient, provider, and practice characteristics.

Main Results:

Diagnostic imaging was ordered in over 20% of urology visits.
Self-employed urologists ordered imaging in 24.2% of visits, compared to 13.2% for employed urologists (p<0.001).
Patients seen by self-employed urologists had nearly double the odds of receiving imaging (OR 1.84).
A significant association was found for urolithiasis (OR 4.76) and hematuria (OR 5.52) visits.

Conclusions:

Self-employed urologists exhibit more resource-intensive practice styles regarding diagnostic imaging compared to their employed counterparts.
Practice ownership appears to be associated with increased utilization of ancillary services in urology.