"Turf battles" over imaging and interventional procedures in community hospitals: survey results

A survey of nonacademic community hospitals was conducted to ascertain the degree of control radiologists have of 38 selected imaging or imaging-related interventional procedures. Responses from 187 hospitals showed that community hospital radiologists totally controlled or strongly dominated almost half of these procedures, including all computed tomographic and magnetic resonance imaging studies, bone radiography, breast needle localization, emergency department radiography, arthrography, obstetric ultrasound (US), renal and peripheral angioplasty, percutaneous abscess and biliary drainage, percutaneous nephrostomy, cerebral angiography, and interventional neuroangiography. Radiologists dominated in prostate and vascular US, myelography, urethrography, cardiac nuclear medicine, percutaneous lung biopsy, ureteral stent placement, and pulmonary angiography, but there was also significant participation in these studies by nonradiologists. Radiologists and nonradiologists had roughly equivalent roles in hysterosalpingography, peripheral atherectomy and laser angioplasty, and percutaneous inferior vena cava filter placement. Nonradiologists dominated in echocardiography, endoscopic retrograde cholangiopancreatography, biliary and kidney stone lithotripsy, percutaneous gastrostomy, coronary angiography and angioplasty, and pediatric angiocardiography.