Patients with low-back pain who visited physicians who owned or leased magnetic resonance imaging (MRI) equipment not only were more likely to receive scans, but also were more likely to receive back surgery as well--at least for those patients visiting orthopedic specialists, according to a new online study this month from Health Services Research.
Over the years, Congress has passed regulations that prohibit physicians from referring Medicare or Medicaid patients to those health services in which they have a financial interest. However, exceptions have been made for various in-office procedures, which have included those procedures using MRIs.
For the study, Stanford University researchers reviewed Medicare claims data for 1,033 primary-care physicians and 1,271 orthopedists before and after they leased or purchased MRI equipment between 1998 and 2005.
They found that orthopedists and primary-care physicians who started billing for the use of MRI procedures--rather than referring patients outside of their practice for the MRI--appeared to use more MRI for their patients with low-back pain: the rate increased by 13 percent for the orthopedists' patients, and 32 percent for the primary-care physicians' patients.
However, among the orthopedists' patient, the likelihood of having surgery for the low-back pain after receiving an MRI increased by 34 percent. For patients of primary-care physicians receiving a low-back MRI, the likelihood of undergoing surgery was not statistically significantly, the researchers said.
While the intent of the study was not to assess whether more surgery was necessary, researcher Jacqueline Baras Shreibati, MD said it did show "a direct relationship from imaging to surgery" among patients where surgery was controversial, reports the Health Behavior News Service.
For more information:
- see the Health Services Research abstract
- view the Health Behavior News Service article