Imaging Often Triggered By More Than Just Patient Need, UT Southwestern Researchers Find

A physician’s prior image-ordering habits and ownership of the equipment itself are strong indicators of unnecessary orders for X-rays, computed topography (CT), and MRIs, researchers at UT Southwestern’s Center for Patient-Centered Research have found.

The researchers’ study was published in JAMA Internal Medicine, a peer-reviewed medical journal.

“Whether or not you get unnecessary imaging is partly explained by how much unnecessary imaging the clinician orders in general, and whether or not the clinician owns the imaging equipment,” lead author Dr. Arthur Hong, assistant professor of internal medicine and clinical sciences at UT Southwestern Medical Center, said in a release. “For patients who got an MRI but did not need one, which doctor they went to mattered more than the injury or symptom that they had.

“With people more on the hook for the costs of their care,” Hong added, “it’s increasingly important for physicians to offer financially responsible care.”

The study found that uncomplicated back pain and uncomplicated headaches are two of the most common reasons patients with health insurance receive low-value, or unnecessary, imaging. Other studies have shown that such wasteful care may account for up to one-third of all medical expenditures and trigger “downstream cascades” of still more unneeded care and clinical harm, Hong said.

The JAMA Internal Medicine study, which examined the records and characteristics of nearly 101,000 primary and specialist physicians and chiropractors, was completed in partnership with researchers from the Harvard Medical School’s Department of Population Medicine at the Harvard Pilgrim Health Care Institute.

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