Self-referring physicians show high utilization rate

December 1, 2007

Physicians who refer privately insured patients to themselves or members of their own specialty for imaging exams order them more frequently than physicians who send patients to radiologists, according to Massachusetts General Hospital researchers.

Physicians who refer privately insured patients to themselves or members of their own specialty for imaging exams order them more frequently than physicians who send patients to radiologists, according to Massachusetts General Hospital researchers.

Principal investigator Dr. G. Scott Gazelle, director of MGH's Institute of Technology Assessment, and colleagues analyzed more than 526 million claims filed between 1999 and 2003. Investigators sought out the provider of the professional interpretation and organized data according to six conditions: cardiopulmonary disease, cardiovascular disease, extremity fracture, knee pain, intra-abdominal malignancy, and stroke. They then categorized each physician's proclivity to self-refer studies or refer them to radiologists (Radiology 2007 Nov;245[2]: 517-522).

Researchers found that self-referring physicians use imaging about twice as often as those who send their patients to radiologists. They also found that patient age and comorbidity do not explain the increased frequency for self-referred imaging.