MD Self-Referrals- Front and Center in #HeathCareReform debate

In August 2005, doctors at Urological Associates, a medical practice on the Iowa-Illinois border, ordered nine CT scans for patients covered by Wellmark Blue Cross and Blue Shield insurance. In September that year, they ordered eight. But then the numbers rose steeply. The urologists ordered 35 scans in October, 41 in November and 55 in December. Within seven months, they were ordering scans at a rate that had climbed more than 700 percent.

Self referral is one of those highly contentious issues that was bound to be part of the overall health care reform agenda.

There is a growing body of literature that suggest that physicians ownership of MRI and CT scanners has led to significant over-utilization and thus cost.

With all due respect to my colleagues, I have to agree with the majority of the *experts* and Rep. Weiner that limits on self referral should be part of the overall reform legislation as it winds itself out of committee.

Sure there are convenience issues for patients, perhaps a improvement in the time to diagnosis and perhaps improve access in rural areas— but I do not see how those arguments justify the enormous cost of over-utilization and the argument to continue with the status quo.

Compromise is painful, and this appears to be one issue that physicians are going to be forced to compromise on—But this is one of those issues that can make a significant impact on the cost burden to the system.

What’s the next issue docs will be forced to compromise on?


About hjluks

A busy Academic Orthopedic Surgeon, Digital Strategist, Chief Medical Officer and father... intently and efficiently navigating the intersection of Social Media and Health Care.
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One Response to MD Self-Referrals- Front and Center in #HeathCareReform debate

  1. JessicaCorwin says:

    Agreed! Compromise will be essential and this is definitely an

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