In March, a Florida physician referred a 100-year-old patient to a medical lab for a brain scan. The expressed reason for the referral was that the man was experiencing "weakness" and "poor balance."
The better explanation for the referral is that the physician is a part owner of the laboratory and profited from the $1,000 CAT scan fee. The apparently unnecessary test was paid for by Medicare - in other words, U.S. taxpayers.In the past five years, a growing number of physicians have invested in a variety of medical labs as an almost foolproof income supplement. The resulting self-referral system amounts to legalized kickbacks for the physicians.
Even some doctors are disgusted by what they see.
These joint ventures may soon become outlawed.
An upcoming Florida state study will show that almost 75 percent of the state's diagnostic imaging labs are now owned by physicians who refer their patients to these labs. That statistic is unnerving considering a federal probe in 1989 revealed that doctors refer their patients for 40 percent more lab work when they own a share of the lab. Rep. Fortney "Pete" Stark, D-Calif., has crusaded to stop the self-referral onslaught. He maintains that it's not only costing patients a fortune but milking Medicare and taxpayers for tens of millions of dollars. Stark wants to make all such arrangements illegal. Sen. Brock Adams, D-Wash., plans to push similar legislation in the Senate.
Physicians' lobbyists maintain that such legislation would rob rural Americans of modern medical equipment. They also argue that such a law would punish honest and dishonest doctors alike. At the very least, they want all existing joint-venture labs grandfathered under any new law. Stark calls it "grandfathering robbery." Today's blue-chip investment in the nation's physician community is the magnetic resonance imaging machine, or MRI. The cost of the diagnostic equipment is often spread out over several doctors who recoup their investment in less than a year, thanks to the steady stream of patients. The basic MRI costs patients about $1,000 a pop for an exam that usually lasts less than an hour. One Florida physician told us MRI labs dot most Miami street corners.
Our associate Jim Lynch has reviewed files on one orthopedic surgeon in Florida who apparently believes all his patients should visit the MRI lab that he jointly owns. Although the doctor is only trained to diagnose bone problems, he routinely refers patients with headaches and possible neurological problems to his lab for testing. Normally such referrals are made by a neurologist. However, as the aforementioned veteran radiologist told us:
"My profession is not a profession anymore. It's a business. It's unconscionable and it makes me sick."