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April 7, 1993

Physicians and Outpatient Diagnostic Imaging: Overexposed?

JAMA. 1993;269(13):1633. doi:10.1001/jama.1993.03500130047013

To the Editor.  —The article entitled "Physicians' Utilization and Charges for Outpatient Diagnostic Imaging in a Medicare Population" by Hillman et al1 is another in a long line of comments and articles noting the increased use of diagnostic tests by physicians who have a so-called financial interest in the procedure. As is usually the case, the methods and statistical analyses always appear to have been exhaustively reviewed and the results are persuasive. Unfortunately, some very basic details of medical practice, patient-physician relationships, and medical expertise and competence are ignored.As a cardiologist in practice for over 10 years who has commonly used noninvasive diagnostic procedures available to him in the office setting, I can relay some nonquantifiable, "unscientific" information with regard to why I would obviously perform more procedures in my office rather than referring them to centers mainly operated or controlled by our radiology colleagues. The first is