5 thoughts on “Authentic Medicine Moment #3: Doctors Ordering More MRIs When They Own MRIs”
A friend of mine(cough…cough) has first hand knowledge of an MD who had a partnership in an MRI facility. This friend(cough…) can’t say with any certainty whether or not said doctor’s associates(aka buddies) ordered unnecessary scans, but is certain that their patients were purposely steered towards his facility. Of course this sort of stuff goes on with regularity, but it’s very difficult to stop with the foxes in the chicken coup, dressed as sheep. The insurance companies compile tons of data, but I’d doubt that it includes “Friends of MD’s who own testing facilities”. Then again, perhaps they do. Someone could take a lesson from Wall Street, where brokerage firms and exchanges have developed pattern recognition software to identify traders who are a bit too friendly with each other to the detriment of the average schmuck trying to make a trade. Of course enforcement is another story…most of those caught are told to cool it for a while and/or get a slap on the wrist, a token fine, and maybe a few days off. Sooner or later they find another way to beat the system, and the cat-and-mouse game continues, like the Spy vs Spy cartoon. On the other hand, the insurance companies should be the last in line to call someone out for unethical practices. It’s always been my contention that one of the worse things that ever happened to this country was the business of insurance. Throw enough money into anything and it creates many more serious problems than it was supposedy intended to mitigate. Involve the government and the problems multiply exponentially. So who can we ever trust to watch the store? Evidently no one when this much money is involved….
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I think this is a chicken/egg which comes first. I am an orthopod. I order A LOT of MRI’s. I don’t own an MRI, but with all of the MRI’s I order, I WISH I owned one. I think it’s a matter of figuring, I ALREADY use this technology quite a bit. I may as well profit from it. And Doug, “a thousand dollars per MRI profit” is WAY off my friend. I would think that with the investment on the machine itself, the overhead (power, space, maintanence, tech salary, liability insurance service contracts, software upgrades etc) the profit is no where near that.
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Good points. The $1000 number came from the reference.
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To some degree, this is the same as psychiatrists involuntarily admitting patients to their own hospitals/services. I suspect that only additional bureaucracy will result just like the massive legal machinations most states now have regarding involuntary treatment.
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I once knew some guys who drank so much Coke that it was most economical to have it delivered wholesale rather than pick it up at the grocer. I think the same thing may be going on here. MR is a powerful diagnostic instrument for musculoskeletal pathology. The orthos who like this technology the most are the ones who have decided to invest in a machine of their own. In other words, the order of causation could go either way: Drs want to profit so they order MRIs OR Drs want to order MRIS and profits result. Just becareful with the Stark violations.
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A friend of mine(cough…cough) has first hand knowledge of an MD who had a partnership in an MRI facility. This friend(cough…) can’t say with any certainty whether or not said doctor’s associates(aka buddies) ordered unnecessary scans, but is certain that their patients were purposely steered towards his facility. Of course this sort of stuff goes on with regularity, but it’s very difficult to stop with the foxes in the chicken coup, dressed as sheep. The insurance companies compile tons of data, but I’d doubt that it includes “Friends of MD’s who own testing facilities”. Then again, perhaps they do. Someone could take a lesson from Wall Street, where brokerage firms and exchanges have developed pattern recognition software to identify traders who are a bit too friendly with each other to the detriment of the average schmuck trying to make a trade. Of course enforcement is another story…most of those caught are told to cool it for a while and/or get a slap on the wrist, a token fine, and maybe a few days off. Sooner or later they find another way to beat the system, and the cat-and-mouse game continues, like the Spy vs Spy cartoon. On the other hand, the insurance companies should be the last in line to call someone out for unethical practices. It’s always been my contention that one of the worse things that ever happened to this country was the business of insurance. Throw enough money into anything and it creates many more serious problems than it was supposedy intended to mitigate. Involve the government and the problems multiply exponentially. So who can we ever trust to watch the store? Evidently no one when this much money is involved….
I think this is a chicken/egg which comes first. I am an orthopod. I order A LOT of MRI’s. I don’t own an MRI, but with all of the MRI’s I order, I WISH I owned one. I think it’s a matter of figuring, I ALREADY use this technology quite a bit. I may as well profit from it. And Doug, “a thousand dollars per MRI profit” is WAY off my friend. I would think that with the investment on the machine itself, the overhead (power, space, maintanence, tech salary, liability insurance service contracts, software upgrades etc) the profit is no where near that.
Good points. The $1000 number came from the reference.
To some degree, this is the same as psychiatrists involuntarily admitting patients to their own hospitals/services. I suspect that only additional bureaucracy will result just like the massive legal machinations most states now have regarding involuntary treatment.
I once knew some guys who drank so much Coke that it was most economical to have it delivered wholesale rather than pick it up at the grocer. I think the same thing may be going on here. MR is a powerful diagnostic instrument for musculoskeletal pathology. The orthos who like this technology the most are the ones who have decided to invest in a machine of their own. In other words, the order of causation could go either way: Drs want to profit so they order MRIs OR Drs want to order MRIS and profits result. Just becareful with the Stark violations.