Helene Pavlov (Huffington Post) - Radiologist Editorial on Self Referral

(NEW YORK) - As Helene Pavlov, the chief of radiology at the Hospital of Special Surgery, self referral again strikes. As many radiologists are aware of, the DRA (Deficit Reduction Act) has been a major issue within the world of imaging. Recent data by Levin, et al as evaluated the relationship between the DRA and self-referral patterns. Data would suggest that as the implications of the DRA are fully realized, self-referral patterns have not abated but actually increased.

Dr. Pavlov states that "The issue is not with the imaging, it is with self referral patterns. This is not (as nonradiologists with imaging equipment in their offices claim) about quality patient care, convenience or offering the best services available. It is about greed and defensive medicine over medical ethics and reasonableness. Radiologists are trained to understand and minimize hazards of ionizing radiation, interpret images properly and provide an unbiased evaluation of the patient's condition."

Radiologists do order or request studies. In fact, perhaps radiologists should be the gatekeeper and the perils of self-referral will hopefully be realized by lawmakers.

Pavlov states that "The newer, and expensive, imaging technologies are capable of earlier and more specific diagnosis than ever before, especially when the examinations are acquired and interpreted with expertise." Hence, many physicians cannot resist the immediacy and accuracy of diagnostic imaging.

She continues to emphasize the type of training radiologists receive: "Only the American Board of Radiology (ABR) validates four years of post medical school training and expertise in all aspects of imaging and provides a mechanism through peer review and recertification for this expertise. Radiologists are physician consultants to nonradiologist physicians and provide expertise on appropriate imaging for their patients' suspected condition. Radiologists are "unbiased patient advocates." The problem is not with the imaging, it is with self referral."

Read more at the Huffington Post and Dr. Helene Pavlov's column.