Comparative analysis of radiographic interpretation of orthopedic films: is there redundancy?

Cost containment is becoming the watchword in today's medical care environment. In an effort to determine possible areas of unnecessary patient cost secondary to redundant services, we decided to compare prospectively interpretations of plain orthopedic films by radiologists and orthopedists. Without performing a physical examination of the patient, orthopedic surgical attendings and radiology attendings independently read 507 consecutive radiographic studies of acute orthopedic injuries sustained by 438 patients. All readings were dictated, and the reports were reviewed by the senior author and statistically analyzed. The cost of the radiologists' readings was computed. Analysis of the two types of readings showed that both were highly sensitive and very specific, and that there was no statistically significant difference (p = 1.0) between them. The average cost of the radiologists' readings in the local area was approximately $16,100. There was no fee for orthopedic interpretations in this study. The authors conclude that because the two interpretations were accurate and not statistically different, interpretation of orthopedic films by a radiologist seems to be an unnecessary expense.