Study identifies trends in self-referred imaging

OAK BROOK, Ill. Self-referred imaging centers, where people with no health-related symptoms can have imaging exams performed without a doctor's recommendation or prescription, are popping up across the United States, with the highest concentration in areas populated by wealthy and highly educated people, according to a study appearing in the August issue of the journal Radiology. The study found that of 88 imaging centers, 30 were in California, mainly the southern region. New York ranked second with 13 centers.

Self-directed medical care has greatly expanded during the past decade, partially due to the influence of direct-to-consumer advertising and marketing of health products, prescription pharmaceuticals and surgical procedures. Since the late 1990s, some imaging centers have begun accepting clients without physician referral or input. These self-referred consumers typically have full-body computed tomography (CT) exams that include a noninvasive evaluation of the coronary arteries for calcification, or of the lungs, abdomen, and pelvis for cancer.

"Based on historical precedence, we know that once a healthcare service is introduced directly to the consumer, it is exceedingly difficult to interrupt established practice in order to conduct a comprehensive evaluation," said Judy Illes, Ph.D., lead author of the study and senior research scholar at Stanford Center for Biomedical Ethics and the Department of Radiology, Stanford University, Stanford, Calif. "Instead, they tend to become more accessible and more affordable. That is true for cosmetic surgery, pharmaceutical products and other types of healthcare services," she said.

The study identified 88 centers nationwide, which were concentrated on the east and west coasts. More than half offer full-body screening, with heart and lung scans being the most frequently offered procedures.

The researchers analyzed the Web sites of imaging centers accepting self-referred patients

Contact: Maureen Morley
Radiological Society of North America

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