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February 22/29, 2012

Physician Billing and Cardiac Stress Testing Patterns

Author Affiliations

Author Affiliation: University of Nebraska Medical Center, Omaha (

JAMA. 2012;307(8):781-783. doi:10.1001/jama.2012.189

To the Editor: Dr Shah and colleagues1 reported that cardiac stress testing after revascularization was more frequent if patients were treated by physicians who billed for cardiovascular imaging testing than by physicians who did not. Before accepting this conclusion, perhaps the authors should consider the study by Hendel et al2 that found, in a prospective analysis of self-referred practices, a statistically significant higher rate of inappropriate studies ordered by noncardiologists compared with cardiologists.

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