Patients expect their physicians to make health care decisions based on the best available science rather than financial gain. But a new study suggests that financial incentives may have an influence on doctors’ behavior. The investigators tracked how often primary care physicians and orthopedists ordered magnetic resonance imaging or MRI scans. Specifically, the scientists compared scan rates before the doctors purchased or leased an MRI scanner to after they obtained such expensive equipment.
The primary care providers increased their self-referred MRI scan orders by 13 percent and the orthopedists increased their MRI recommendations by 32 percent after they acquired an MRI machine. Perhaps even more worrisome, patients who consulted an orthopedist who self-referred the person for an MRI scan, were far more likely to end up with back surgery over the next several months. The lead author of the research notes that she does not want patients to doubt their physicians’ recommendations, but she does point out that patients may need to realize that “financial incentives may influence the care they receive.”
[Health Services Research, Online, April, 2011]