The federal government is investigating a group of local urologists for possible monopoly and price-fixing in their use of a multimillion-dollar machine that breaks up stones in the kidney and urinary tract.
Their machine - a Siemens Lithostar - is the only FDA-approved lithotriptor in Utah.The Federal Trade Commission's Bureau of Competition is examining Utah-Idaho Lithotripsy, a limited partnership of more than two dozen urologists, to see if it violated federal antitrust laws.
M. Kathleen Kenyon, an FTC attorney in Washington, D.C., would not confirm or deny the investigation.
But some local insurance companies have received letters from the FTC requesting reams of documents - including amounts billed by physicians for lithotripsy-related services and the names of physicians involved in Utah-Idaho Lithotripsy.
However, the FTC said in its letter the existence of the non-public investigation shouldn't be viewed as an accusation by the FTC "of wrongdoing by anyone."
Neither officials for Utah-Idaho Lithotripsy nor its parent company, Lithotriper Inc., would comment on the FTC probe - except to say they were surprised by the scope of the investigation.
Any urologist trained on the machine has access to use it "so there is no attempt to monopolize it," said one partner physician who declined to be identified.
No patients have been excluded from the procedure because of an inability to pay for it, he said. "We have taken the tack that we hope people will pay, but sometimes they can't. The group treats them anyway."
The partners in Utah-Idaho Lithotripsy invested money to purchase a multimillion-dollar Siemens Lithostar - the premier lithotriptor - and a van to transport it.
The group, which registered its name with the state in 1989, is one of several limited partnerships organized in various states by Lithotripter Inc., headquartered in North Carolina.
Local doctors said investment in the partnership was sold as a profit scheme - one that gave doctors a chance to use the latest technology available. It was mobile technology that could be used to treat patients in outlying areas.
At the time the group was organized, LDS Hospital owned a fixed lithotripter, and urologists throughout the state were given courtesy privileges to use the hospital's water-emerging machine. The machine, which required patients to be lowered into a tub where shock waves were delivered, had a major drawback - it wasn't mobile.
And its use was discontinued when Utah-Idaho Lithotripsy succeeded in recruiting many Utah urologists as limited partners.
The only other lithotripter in Utah is operated by Dr. Richard G. Middleton at the University of Utah Medical Center - but only on an "investigational" basis.
The machine owned by Utah-Idaho Lithotripsy is housed in a van, which from the exterior appears much like a mobile home. The van travels to St. Mark's and Holy Cross hospitals in Salt Lake City and to medical facilities in Reno and Carson City, Nev.; Pocatello; Billings, Mont.; and Cheyenne, Wyo.
Patients treated are awake but sedated and lie on a water-filled pillow. A urologist, assisted by a nurse and X-ray technician, performs the procedure.
Qualified urologists who are not limited partners but have gone through a training program have access to the machine and typically treat their own patients.
But partners may or may not treat the patients they refer for the procedure. Members of the partnership, nicknamed "shooters," rotate travel duty. They work in the traveling unit on different days. Many patients, therefore, don't know the so-called "doctor du jour" who treats them.
The machine has been in operation since 1989. One physician estimated that 70 to 80 procedures are performed a month, with a 90 percent success rate.
A patient who recently underwent the 11/2-hour lithotripsy procedure for a kidney stone said he was charged $7,700. After the procedure he got a T-shirt that reads "Stone Busters" on it.