AUA Positions, Letters and Talking Points
- Patient-centered Imaging in Urology—The Facts on In-office Diagnostic Tests
- Response to Highmark’s Diagnostic Imaging Standards
- Imaging Talking Points for AUA Members- Self-referral Talking Points for Physicians
- Consensus Statement on Urologic Ultrasound Utilization
- Recommendations for Urologic Office Ultrasound
Coalition for Patient-Centered Imaging (CPCI)
In-office imaging provides the fastest, most convenient and often the most reliable results — results that are routinely used by treating physicians in providing ongoing patient care. The use of office-based imaging allows for quicker diagnosis and prompt treatment.
The American Urological Association (AUA) is concerned about recent allegations that diagnostic imaging performed by physicians other than radiologists is “substandard” and “unnecessary” and that the growth in utilization is principally attributable to in-office testing by physicians other than radiologists. None of the allegations are true. There is no credible evidence that in-office imaging is being conducted inappropriately or is resulting in inaccurate diagnoses. . .
Nor is there any basis for the allegation that office based imaging is the primary cause of increased utilization. Many factors have influenced growth in the volume of imaging services, including improved technology; changes in the standard of care for many illnesses; expansions in coverage for new diagnostic imaging modalities; and shifts in the site of service from hospitals to other health care settings. Much of this growth is in hospitals and Independent Diagnostic Testing Facilities (IDTFs). The improvement in quality has meant that many specialties, including urology are now using imaging for therapeutic purposes rather then simply a diagnosis tool. . .
A prohibition on in-office diagnostic testing would reduce patient access to timely, convenient testing, and disrupt the important continuity of care. According to the ACR, there is currently a shortage of radiologists, and in certain parts of the country there are already long waiting periods for critical imaging studies, such as mammography. Restricting in-office testing could substantially aggravate the problem, resulting is significant delays and reduced quality of care. In addition, Medicare beneficiaries pay substantially more when imaging services are provided in hospital outpatient settings instead of physicians’ offices. According to MedPAC, in 2002 the Medicare coinsurance rate for hospital outpatient imaging services was 53 percent. Coinsurance for these services in physicians’ offices was limited to 20 percent.
While increased costs are a concern to physicians and patients alike, restricting patients’ access to timely and accurate diagnoses by their own physicians is not the answer.