Very sad, indeed. The government is really the only option to fight this. Maybe the loopholes will be closed, eventually. Too bad the government doesn't have the cojones to actually punish the perpetrators of this scam. Can't you just see the explosion of finger-pointing? "It wasn't the docs idea, it was the business manager's idea! Put him in jail, not us!"
I am a radiologist in a western community of 50k, with both a hospital and outpatient practice.
The cardiologists have a CT
The family practice group has a CT
The neurosurgeons have a CT
The oncologist has a CT, soon to be a PET CT
The neurosurgeons have a MRI
The neurologist has a MRI
The orthopedists have a MR
The family practice group has a MR
This is in addition to the imaging center 50% owned by the rads and hospital with 1 CT and 2 MRs. There are also 2 CTs in the hospital. So, a town of 50k has 7 CTs and 6 MRs. There never was an issue with waits for imaging in our community. If a doctor asked for a study today, we made sure that it got done, today. We call results when asked, and have turn around time for written reports measured in hours. There was not a quality issue, as we have great equipment. Pure and simple, it is about money, and outside consultants promising the moon.
And people complain about insurance getting more expensive.
I suspect that our imaging center will be out of business soon, as they take the cream and we get the indigent (and the mammograms). Legitimate competition I can take, but there is no way to compete against self-referral. I have my hands tied behind my back, and a heavy indigent care "ball and chain" around my feet.
What patient will look their self-referring doctor in the eye, and say "I am going across town" ? They do not want to compromise their relationship with the doctor, after waiting 6 weeks for an appointment.
Many of my partners have left town, and those remaing are burning out, taking care of the indigent population.
I'm still hoping for federal legislation with some teeth, or else, I'm out of here after the next election.
Sunday, May 04, 2008
A Sad Commentary
An anonymous reader from a small town in the west sent this comment: