Patients with low back pain are more likely to get an x-ray or CT scan within 28 days if their primary physician works in a larger practice as opposed to a smaller facility, according to a study by the Center for Studying Health System Change. The center also found patient satisfaction incentives encourage unnecessary imaging.
Out of 35,039 patients with low back pain, 28.8% were imaged within 28 days of the first consultation with a physician. An additional 4.6% underwent imaging within 180 days of the initial exam (Arch Intern Med 2009;169:972-981). The remainder received no imaging.
Physicians working in practices of 10 or more imaged patients within 28 days as opposed to physicians in solo or two-person practices, who took longer.
Also, physicians tended to order fewer imaging exams when they were exposed to quality incentives.
