Data and Analysis
A number of important studies and journal articles discuss the increase in advanced medical imaging and the escalating problem of physician self-referral. Below are links to the studies and journal articles that highlight the problems with self-referral and the need for quality standards in advanced imaging.
Report to the Congress: Medicare Payment Policy. Medicare Payment Advisory Commission Report to Congress, March 2005. (PDF - 1.86MB)
Turf Wars in Radiology: The Overutilization of Imaging Resulting from Self-Referral
David C. Levin, MDa,b, Vijay M. Rao, Mda
Journal of the American College of Radiology (JACR) 2004; 1:169-172.
(PDF - 69KB)
Practice Management Issues for Radiology-Residents: Focus on Self-Referral
Gregory Iafrate, MD, and Alan Kaye, MD
Journal of the American College of Radiology (JACR) 2004
Assessing Payment Adequacy and Updating Payments for Physician Services. Medicare Payment Advisory Commission Report to Congress, March 2003. Hackbarth GM, Reischauer RD, Miller ME. (PDF - 241KB)
The Effect of Imaging Guidelines on the Number and Quality of Outpatient Radiographic Examinations
Moskowitz H, Sunshine J, Grossman D, Adams L, Gelinas L.
AJR 2000; 175:9-15.
(PDF - 455KB)
Measuring performance in chest radiography
Potchen EJ, Cooper TG, Sierra AE, Aben GR, Potchen MJ, Potter MG, Siebert JE.
Interpretation of Emergency Department Radiographs -
A Comparison of Emergency Medicine Physicians with Radiologists, Residents with Faculty, and Film with Digital Display
John Eng, William K. Mysko, Gregory E. R. Weller, Regis Renard, Joseph N. Gitlin, David A. Bluemke, Donna Magid, Gabor D. Kelen and William W. Scott, Jr.
AJR 2000; 175:1233-1238
Design of a Privileging Program for Diagonostic Imaging: Costs and Implications for a Large Insurer in Massachusetts
Diana K. Verrilli, MS, Stephen M. Bloch, MD, Jeanine Rousseau, RT, Matthew E. Crozier, MM, Steven B. Yecies, JD, MBA Radiology 1998
(PDF - 6.21MB)
Referrals to physician-owned imaging facilities warrant HCFA’s scrutiny: General Accounting Office Report to the U.S. House of Representatives. Washington, DC: GAO, 1994:5 Publication GAO/HEHS – 95-2. Aronovitz LG
(PDF - 2.36MB)
Practice Patterns of Radiologists and Nonradiologists in Utilization of Noninvasive Diagnostic Imaging among the Medicare Population 1993–1999
Andrea J. Maitino, MS, David C. Levin, MD, Laurence Parker, PhD, Vijay M. Rao, MD, Jonathan H. Sunshine, PhD Radiology June 2003
(PDF - 188KB)
Radiology performed by non-radiologists in the United States: Who does what?
Sunshine JH, Bansal S, Evans RG.
AJR 1993; 161:419-429.
(PDF - 28KB)
Physicians' utilization and charges for outpatient diagnostic imaging in a Medicare population.
Hillman BJ, Olson GT, Griffith PE, et al. JAMA. 1992;268:2050-4.
(PDF - 2.39MB)