Trying to regulate imaging self-referral is like playing whack-a-mole.

摘要

Nonradiologist self-referral for imaging procedures continues to increase as a fraction of all imaging examinations performed in the United States and is a major contributor to the perception that the unsustainable increase in imaging costs is fueled by financial incentives that engender too many marginal and inappropriate examinations. A recent article by Dr. Jean Mitchell reporting research findings in the journal Health Affairs supports this contention. The article details an increase in creative self-referral arrangements in California, which abrogate ethical and possibly legal restrictions. Specifically, Mitchell's study relates an increase in block-time leasing and pay-per-click for CT, MRI, and PET in California and details how the availability of such dealings promotes serf-referral. To me, the results also show that current regulations governing self-referral-largely generated in the early 1990s-are archaic, ambiguous, and hence ineffective.