BY JAMES M. BRICE

Diagnostic ultrasound may be a hot topic in emergency room physician circles, but in reality, ER doctors rarely perform the procedures.

Working from a summary report of 1997 Medicare Part B utilization, Dr. David Levin, radiology chairman at Thomas Jefferson University in Philadelphia, found that emergency-room physicians performed only 0.6% of the 244,303 emergency room ultrasound studies billed to Medicare in 1997. From the context of the 7.2 million inpatient diagnostic procedures performed that year, only 18,937, or 0.1% were read by ER physicians.

"For all the hype and noise, they did fewer Medicare ultrasound studies nationwide than you'd expect from any large radiology department," Levin said.

The data describe the medical experience of 33 million Medicare beneficiaries, excluding the 16% who are covered by Medicare's managed-care programs. Levin's results were presented Monday in a scientific session at the 1999 RSNA assembly.

In terms of turf, cardiologists are a far more formidable competitor than ER physicians for ultrasound, Levin said. According to Medicare data, cardiologists have firm control over echocardiography, an application that accounted for most of the 24% of inpatient ultrasound studies that radiologists did not read.

ER physicians were a non-factor even when Levin limited his analysis to nine classes of ultrasound procedure most often performed in an emergency room. Other than a 2.7% share of emergency room cardiography, ER physicians interpreted far less than one percent of every application.

"The numbers are fairly consistent. Emergency-room physicians are doing very, very little ultrasound in the emergency department," Levin said.