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Dick Turkanis MD May 15, 2019 a 5:05 pm PDT
Of course, diagnostic imaging quality is an important aspect of caring for injured workers, and many of the quotes in your article seem reasonable. There are algorithms available that take into account the age of imaging equipment, recent software or coil updates, national accreditation status, subspecialty training levels of radiologists, etc. to help locate the “best” imaging providers.
But the real issue of how to deliver the best quality imaging to patients is in the execution of the referral process.
Who decides where patients get referred? How do they make their decisions? What incentives are involved in those decisions? In work comp, many companies that refer such patients make their money by re-selling the medical services of radiologists to payers at a hidden profit (the wholesale-retail spread between the payer’s charge and what rate a particular provider is willing, or forced, to accept for that referral).
For me, that seems to create a direct conflict between what's “best” for the patient and what makes the referring company the most money. Given the importance of quality care, I suggest everyone be more transparent in how they make decisions.
Dick Turkanis, M.D.
Marko Vucurevic May 15, 2019 a 7:05 pm PDT
This article expresses the basic problem with our entire healthcare system...everyone wants tomorrow's technology at yesterday's prices. And in the world of workman's comp they usually want to throw in a middleman or two to coordinate and authorize the process.