Physician Self-referral - History

History

One of the current areas of change in medicine lies in the location and interpreter of advanced imaging results, including MRIs, CT scans, PET scans, and ultrasounds. The trend for non-radiology physicians to evaluate their patients’ imaging results began more than thirty years ago. In the past, the majority of x-rays were interpreted by radiologists; today, it is very common for physicians to read them. The same trends are occurring for other imaging techniques.

Advanced medical imaging used to be provided only in hospitals and privately owned imaging centers, and, with some notable exceptions, were only evaluated by radiologists. An example of such an exception included the American Society of Neuroimaging, which, with its formation in 1975, incited neurologists to develop interest in the newest imaging techniques of the time to help evaluate their patients in non-invasive ways. Other specialists, such as cardiologists, neurosurgeons, and orthopedic physicians became more interested in using advanced imaging techniques as they continued to be refined and developed over the last two decades.

This change in the delivery of these services has resulted in the debate between radiologists and other medical specialists over the control and use of advanced medical imaging.

Historically, self-referral described the normal practice of a physician diagnosing a patient and then treating that individual if the treatment was within the that doctor's scope of practice. However, several radiology authors have successfully used the term to describe the idea of self-referral for imaging services with the connotation that it is an undesirable and wasteful practice.