To the Editor.
—I read the article by Dr Bree and colleagues1 with great interest. The authors of this randomized controlled trial concluded that an inpatient radiology consultation service did not reduce resource use. Physicians in the control group ordered about the same number and types of tests as those in the intervention group, despite radiological guidance for the intervention group. This suggests that the physicians on these medical services are knowledgeable about this subject. The authors of this article suggested that it might be more appropriate to study the outpatient setting.In their last paragraph, the authors state that "it has already been shown that physicians may overutilize imaging tests when engaged in in-office self-referral," and cite an article by Hillman et al.2 In November 1992, the United Mine Workers of America refused to reimburse nonradiologists for interpretation of imaging studies based on another study by Hillman
Greenberg JO. Reducing Rates of Diagnostic Imaging. JAMA. 1997;277(6):459. doi:10.1001/jama.1997.03540300027023