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Counsel That You Can Trust & Depend On


Guy DiMartino Nov. 4, 2014

LaPorte Indiana medical malpractice lawyer discusses a recent article that shows urologists who purchase radiation equipment overuse the treatment for profit.

For those of us who are altruistic and think doctors are like Marcus Welby, doing home visits and taking care of people over profits, you may want to read a recent article in the New England Journal of Medicine. A review of 45,000 Medicare claims saw a 146% increase in radiation treatments for prostate cancer due to self-referral when the urologists owned the equipment. The research compared the treatment patters before and after urologists purchased the equipment. Another commenter said it was clear that men were receiving unnecessary radiation therapy for their prostate cancer. The article concludes that allowing urologists to self refer for IMRT prostate treatment leads to unnecessary treatment and increased medical costs, which Medicare is picking up.

The same system is true with a lot of urology groups and lithotripsy (the ultrasound machine that breaks up kidney stones). For years, lithotripsy machines were in hospitals. The urologist would schedule his/her patients at the hospital and perform the procedure. The urologist would bill the patient for the professional component of the procedure and the hospital would bill for technical component of the procedure and for the outpatient or inpatient service.

Now, in some parts of the country, urologists get together buy a lithotripsy machine and lease it to the surgery center, where they might own a piece of the action. The patient goes into the surgery center, has the lithotripsy performed by the urologist is making more money. He/she is still billing for the professional service but now his company is billing for the technical component and if he is part owner of the outpatient surgical center, he will get his cut of the facility services. I do not know whether doctors have had to seek alternate ways of making money because insurance reimbursements are lower nowadays or they just want more of the health care pie.

What are your thoughts about doctors over-treating patients because of their income stream?