Article on excess in medicine, with imaging as a target

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Imaging is a target in this NY Times article - I'm not sure what kind of physician the author is, but I'm confident in assuming he's not a radiologist.

"Many Doctors, Many Tests, No Rhyme or Reason"

http://www.nytimes.com/2008/03/11/h...05899200&en=dcb0862c675fdff2&ei=5070&emc=eta1

"Last year, Congress approved steep reductions in Medicare payments for certain imaging services. Deeper cuts will almost certainly be forthcoming. This is good; unnecessary imaging is almost certainly taking place, leading to false-positive results, unnecessary invasive procedures, more complications and so on."

My question is, do you think steep reductions in reimbursement decrease the rate of unnecessary imaging?

I suspect not. If anything, I think it will result in a decrease in the quality of the reports while not affecting the rate of unnecessary imaging. Sure, the government will be paying less, but this will do nothing to prevent unnecessary imaging.

 

[OHMAN0125]

Imaging is a target in this NY Times article - I'm not sure what kind of physician the author is, but I'm confident in assuming he's not a radiologist.

"Many Doctors, Many Tests, No Rhyme or Reason"

http://www.nytimes.com/2008/03/11/h...05899200&en=dcb0862c675fdff2&ei=5070&emc=eta1

"Last year, Congress approved steep reductions in Medicare payments for certain imaging services. Deeper cuts will almost certainly be forthcoming. This is good; unnecessary imaging is almost certainly taking place, leading to false-positive results, unnecessary invasive procedures, more complications and so on."

My question is, do you think steep reductions in reimbursement decrease the rate of unnecessary imaging?

I suspect not. If anything, I think it will result in a decrease in the quality of the reports while not affecting the rate of unnecessary imaging. Sure, the government will be paying less, but this will do nothing to prevent unnecessary imaging.

Honestly, proposed imaging cuts is an old issue. That article isnt saying anything new. Like most ppl have said already, Higher paying fields are always first on the list to be cut.
The author is a cardiologist, did you even read the whole article? He does imaging as well and is just talking about the problems faced in this society. He's probably angry that diagnostic cath and angiography are facing steep criticism and payment cuts. And they probably will lose the war of Cardiac MR and CTA (very few CTA and Cardiac MR training programs).
And lastly, Imaging vs lawsuit. Hmm...let me see which one the ER doc is gonna pick.

 

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Honestly, proposed imaging cuts is an old issue. That article isnt saying anything new. Like most ppl have said already, Higher paying fields are always first on the list to be cut.
The author is a cardiologist, he's probably angry that diagnostic cath and angiography are facing steep criticism and payment cuts. And they probably will lose the war of Cardiac MR and CTA (very few CTA and Cardiac MR training programs).
And lastly, Imaging vs lawsuit. Hmm...let me see which one the ER doc is gonna pick.

I now see that the author is a cardiologist, and I agree with your sentiments on that. And I know reimbursement cuts is not a new issue, but this article was the first time I heard someone implying that cuts will result in fewer unnecessary tests. Thinking about it more, if anything, I think the exact opposite is true. Cuts will put more pressure on physicians to meet their overhead expenses.

Not a very well thought out article - I don't think I'll be buying his book.

 

[f_w]

- lower pricing won't reduce the number of tests ordered, it will increase it (think gasoline, pork-bellies).
- the NYT has it in for radiology. someone there must have lost his wife to apache indian (tha man with the 8in radiologist member).
- referring docs are the gatekeepers who determine the frequency and extent of imaging. they don't know prices, they don't care about prices. they care about getting that patient in front of them out the door in the time alloted by their cheapskate HMO (just read films on shoulder, opposite wrist, l-spine and t-spine for 'everything hurts, no trauma'. go figure)

 

[PeepshowJohnny]

- lower pricing won't reduce the number of tests ordered, it will increase it (think gasoline, pork-bellies).
- the NYT has it in for radiology. someone there must have lost his wife to apache indian (tha man with the 8in radiologist member).
- referring docs are the gatekeepers who determine the frequency and extent of imaging. they don't know prices, they don't care about prices. they care about getting that patient in front of them out the door in the time alloted by their cheapskate HMO (just read films on shoulder, opposite wrist, l-spine and t-spine for 'everything hurts, no trauma'. go figure)

Absolutely. How is the radiologist getting paid less for a CT scan going to affect the practice of your standard FP doc? It's not going to stop him from ordering a cover his *** CT scan for liability reasons.

 

[Mariah246]

- lower pricing won't reduce the number of tests ordered, it will increase it (think gasoline, pork-bellies).
- the NYT has it in for radiology. someone there must have lost his wife to apache indian (tha man with the 8in radiologist member).
- referring docs are the gatekeepers who determine the frequency and extent of imaging. they don't know prices, they don't care about prices. they care about getting that patient in front of them out the door in the time alloted by their cheapskate HMO (just read films on shoulder, opposite wrist, l-spine and t-spine for 'everything hurts, no trauma'. go figure)

Well said. My concern isn't about the quantity of imaging decreasing.

My concern is about the reimbursement. Is anyone spooked off by the decreased reimbursement as to even avoid entering the field?

(ie Any 3rd year/4th year med students opt to do something else instead purely because of threats of decreased pay?)

 

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-the NYT has it in for radiology.

Where else in the Times have you seen this bias? I read the health section occasionally, but I haven't noticed any anti-rads bias until I read this article.

 

[hello07]

I am not a radiologist although I wish I was, but from what I hear, radiology field isn't going anywhere but continually up. As to salaries, who knows with reimbursements, but if I had to gamble radiology looks promising from my buddies who are radiologists and make excellent money. Competition has increased to get a spot and is becoming even more and more competitve. Again I am not a radiologist, but my good friend who is a radiologist has an awesome lifestyle!

 

[f_w]

Where else in the Times have you seen this bias? I read the health section occasionally, but I haven't noticed any anti-rads bias until I read this article.

About every 6 months they publish another slanted article quoting some danish/swedish/chinese expert on how useless mammography is and how greedy american radiologists perpetrate this scam on the unsuspecting public. Stuff like that makes me wonder whether I would be better off dumping mammo alltogether.

 

[silhouette]

Where else in the Times have you seen this bias? I read the health section occasionally, but I haven't noticed any anti-rads bias until I read this article.

For get anti-rads, NYT is just anti-doctor. (with rads getting particular attention due to higher salaries.) This is only one of the articles I've found.

http://www.nytimes.com/2007/07/29/weekinreview/29berenson.html?ex=1343361600