IMAGING CENTER INSTITUTE
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THE BIG PICTURE
The Usual SuspectsREGULATORY REPORT
Regulatory Report: Gains Made in Campaign to Limit Self-referral IMAGING FUTURES
Health Care Tomorrow: A Revisionist Preview RADINFORMATICS
When Worlds Collide: Integrating Radiology and Cardiology Imaging
RADIOLOGY BUSINESS JOURNAL
Negotiating for Better Reimbursement RADBRAND BUILDER
Retail Metrics: Opportunity Knocks Every Time the Threshold Darkens REVENUE TRACK
Packaging Versus Bundling: Let the Battle Begin THINK TANK
Think Tank Time to Unwind, and Other Effects of the 2009 MPFS 
THE BIG PICTURE
Readers Response
Curtis,
I thoroughly enjoyed (if that's the right word) and related to your current article . You articulated very clearly the situation, and dilemma, we face in the radiology business. I am a senior manager in a nationwide diagnostic imaging firm, and as you know, we face these issues every day, amongst myriad other issues with which we are dealing. It hasn't been a fun past year or so.
Being part of the independent diagnostic imaging provider community, I believe we are exempt from criticism surrounding the temptations of the self-referral matter. We are compelled to garner support for our centers the old-fashioned way: we earn it by having to provide a level of service that our referrers and patients demand and expect. I also believe any outspoken criticism of self-referral arrangements would probably be received with certain levels of suspicion and eye rolling, since the potential of serving my own self-interests would come into question. Let's face it: Independent centers would clearly benefit from the elimination of self-referring imaging practices.
I had a few recent interesting conversations on this matter with my very business-experienced, 80–year-old father. His instinctive reaction was that good old capitalism best serves our society, and that if referrers are legally allowed to provide such services, let the best provider win. I understand that logic and am a big fan of capitalism, but after we got into the details of what typically happens to referral patterns when a physician owns, versus uses, the services of an imaging center, his original conviction became shaken.
You see, his wisdom includes not only awareness of the high-roads approach in life (good competition, high-quality service, and outstanding intentions), it also includes the reality of self-preservation, temptation, and greed. As he finally acknowledged to me, he was aware that physicians have been under strain for a number of years to develop alternative avenues of income generation, so choosing the potential of a self-sustaining imaging business looked like it would be ripe with conflicts of interest.
Alas, I don't have the answer to this situation. What I do know is that your article hit a number of issues dead on; I intend to forward it to a number of my members of Congress with the hope that a smart aide will actually take the time to read it, digest it, and stick it under the nose of his or her employer as a must-read article. We need this issue to be on the table and understood; it needs real debate, and then we need to make decisions on how best to address it.
Thanks for taking the time and effort to state it so well.
Brian W. WoodburySenior Vice President and General Manager
InSight Imaging
Lake Forest, Calif