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1993-04-08
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THE WEEKHEALTH & SCIENCE, Page 26Making a Profit From Self-Referrals
Ownership of clinics by doctors is helping run up the U.S.
medical bill
The growing trend for physicians to invest in the clinics,
treatment centers and laboratories to which they send their
patients -- a practice known as self-referral -- is blamed by
many experts for contributing to excessive treatment and soaring
national health-care costs. Two reports in the New England
Journal of Medicine provide new ammunition for the critics. In
one, researchers analyzed 6,581 California workers' compensation
cases and found that physiotherapy was recommended twice as
often by physicians with a stake in physical-therapy centers as
by doctors who had no financial ties to the facilities.
Moreover, 38% of body scans ordered by physicians who owned
imaging centers were deemed unwarranted, in contrast to 28%
requested by independent doctors. Another study of Florida
radiation-therapy centers concluded that self-referral increased
the frequency and cost of treatment. Moreover, researchers found
that none of the centers were located in inner-city or rural
areas, though service to these communities is a major rationale
offered for doctors' ownership of health-care facilities.