Saturday, February 23, 2008

A Modest Proposal

Jonathan Swift's tongue-in-cheek treatise, "A Modest Proposal" was anything but modest. I'll leave it to you to read the original, but suffice it to say that his "solution" to the problem of hunger in Ireland was entirely unacceptable to say the least.

I've been ranting for some time now about the problem of imaging self-referral, and for all the good I'm doing, I might as well be talking to myself. While CMS seems to slowly trudge toward doing the right thing, it will probably take years before they accomplish anything. In the meantime, we see self-referring docs gutting the system, almost literally "eating their young" in the process.

But what to do? CMS seems to grasp the problem. Sort of. Occasionally. Congress doesn't get it at all, and gets conflicting information in the form of the ACR alternately decrying self-referral in one session and sitting with the self-referrers in another.

But it is on the state level where I think something can be done. Look at Maryland, and West Virginia as I mentioned in an older post. They are doing something about imaging self-referral, and so far the effort has been effective, angering our self-referring pals no end.

So, here is MY modest proposal: There needs to be a delegation, a road-show, if you will, sent to visit every state legislature and every governor that will consent to see them. This group needs to include those who have studied this problem extensively, and have published about the situation in peer-reviewed journals. I won't name names, but they know who they are. The delegation should include like-minded physicians from the particular state.

I have the childish opinion that members of government want to do the right thing, and will do so if given the opportunity. I'll bet you a tall latte' that the majority of those in government, at the state and the federal level, haven't got a clue about imaging self-referral. So somebody out there with credibility needs to tell them and let them help us solve the problem.

Now, when word gets out about this, there will be a lot of lobbying from the self-referrers, and the equipment companies, too, because they will not like their golden pacifiers plucked from their mouths. They will testify with all the usual drivel about patient convenience and dead grannies. The members of the "road-show" will have to be prepared for this, as I'm sure they would be. I wouldn't be totally surprised if they received threats for coming forward; $16 billion is a lot of money to be taken away from the self-referrers, and they won't be at all happy. But it needs to be done.

Anyone want to sign on for this modest little proposal?

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