I just read an article written by Stacey at ACP Internist, talking about how primary care docs are being encouraged to boost their incomes with medical imaging. She notes that some aspects of health care reform proposals – like the medical home model, make it even more attractive for primary care physicians to offer imaging services. And defensive medicine, with “just in case” testing, adds further incentive to include costly testing and imaging for more patients.
When Jay hurt his knee a couple years ago, an MRI was done prior to surgery. We have an HSA qualified health insurance policy, and at the time our deductible was $3000. So we paid for the MRI ourselves, and it amounted to more than a third of the deductible. And that was after Humana reduced the bill to the network negotiated amount. MRIs have helped to make medicine a much more exact science, but they are not cheap.
It seems that any system that pays physicians – directly or indirectly – to order additional testing will end up with excessive testing, adding to the overall cost of health care. Even doctors with the best of intentions are likely to be swayed by the knowledge that they can boost their paychecks by adding a few MRIs here and there.
I believe that the number of tests a doctors orders should not impact his or her income. And it seems that adding more medical imaging facilities in primary care offices will only increase our already burgeoning health care costs.
I found Stacey’s articles in Grand Rounds, hosted in trick-or-treat style over at Code Blog.