Newspaper article THE JOURNAL RECORD

Study Shows Conflict of Interest on Clinics

Newspaper article THE JOURNAL RECORD

Study Shows Conflict of Interest on Clinics

Article excerpt

Associated Press

Doctors who treat on-the-job injuries send their patients out for significantly more treatment when they are part owners of the clinics where the services are done, a study shows.

This study of physical therapy, psychological tests and Magnetic Resonance Imaging scans, along with another showing similar trends in radiation therapy clinics, are the latest to demonstrate how the amount of money doctors make can influence the care they give.

In recent years, doctors have begun to own many of the health-care businesses where they send their patients.

The reports suggest that when doctors invest in X-ray labs and free-standing treatment centers, they use them more. This means patients are apt to get unnecessary tests, treatments and medical bills.

Doctors' investments in medical facilities where they don't work are known as joint ventures. Sending their patients to these places is called self-referral.

"None of this new evidence is particularly surprising, but taken together with the results of earlier studies. . ., it convincingly demonstrates that self-referral adds to the cost of medical care," wrote Dr. Arnold Relman of Harvard Medical School.

Relman commented in an editorial in the New England Journal of Medicine, which is publishing the two studies today. Until his recent retirement as editor of the journal, Relman was one of the nation's most outspoken critics of conflict of interest in medicine.

In one of the two studies, Dr. Alex Swedlow and colleagues from William Mercer Inc. in San Francisco analyzed 6,581 California workers compensation cases.

Among the findings: Doctors who invested in physical therapy centers were twice as likely as those who did not to order patients to receive physical therapy. Patients who complain of work-related stress are routinely given psychological tests. But patients of doctors who invest in centers giving the tests run up average bills of $3,222, compared with $2,550 for those of doctors who do not. Thirty-eight percent of MRI scans ordered by doctors who invest in the imaging centers where they were performed were judged to be unnecessary, compared with 28 percent of those ordered by other doctors. …

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