To the Editor.
—Hillman et al1 should be congratulated in their zeal to rid medicine of self-referral practices. However, they should look into the practices of their own specialty, where self-referral is rampant. Every practicing physician knows that radiologists frequently recommend additional studies to be sure some elusive pathologic process is ruled out. The clinician commonly will agree, if for no other reason than to avoid fear of a malpractice suit. Perhaps this isn't really a self-referral, but rather an "auto-referral."Not only do radiologists "auto-refer," but in my experience they only recommend procedures that they perform. For example, radiologists at our local hospital started recommending MRI studies only after their scanner was placed in operation. Beforehand, they conveniently suggested computed tomographic scans. On the other hand, radiologists at a freestanding imaging center (solely owned by radiologists, I might add) rarely if ever recommend MRI studies, a procedure not
Varipapa RJ. Physicians and Outpatient Diagnostic Imaging: Overexposed?. JAMA. 1993;269(13):1633-1634. doi:10.1001/jama.1993.03500130047015