OUTSIDE FINANCIAL INTERESTS IN RADIOLOGY OFFICES - PREVALENCE, PAYMENT, AND PRACTICE PATTERNS IN INVOLVED OFFICES

OBJECTIVE. The purposes of our study were to (1) investigate the preva lence of different patterns of outside financial interests in radiolog y offices and of different methods of compensating these interests and (2) determine how the professional, operational, and practice charact eristics of the offices vary with the patterns of outside interest. Th e term ''office'' means nonhospital practice sites, including those ca lled imaging centers or clinics; ''outside interests'' refers to parti es other than physicians in the group of physicians who serve the offi ce. MATERIALS AND METHODS. Data are for 516 office sites served by rad iology groups. Data were collected as part of a national, stratified r andom sample survey of radiology groups in the United States done by t he American College of Radiology in 1992. Responses were weighted to m ake the results representative of all radiology groups in the United S tates with offices. RESULTS. Parties other than the physicians in the practice serving an office had a financial interest in 41% of offices. In about half of these (20% of all offices), physicians in the practi ce had no financial interest at all. The most common categories of out side financial interest were referring physicians (21%), hospitals (19 %), and non-physician entrepreneurs (12%); some offices reported more than one type of outside financial interest. All categories were more common in high-tech offices (offices that offered CT, MR imaging, or n uclear medicine studies) than in non-high-tech offices, Overall, 50% o f high-tech offices and 35% of non-high-tech offices had outside finan cial interests. The most common method of compensating outsiders was g iving them shares or dividends or a percentage of the profits. The ave rage number of procedures per full-time-equivalent radiologist was hig her in offices in which only outsiders (and not the group serving the office) had a financial interest than in other offices, and fewer of t he former offices offered mammography. Offices with no outside interes ts were more likely than those with any outsiders to regularly do ches t, spinal, gastrointestinal, and urologic procedures. CONCLUSIONS. Out side financial interests, and the problems of cost and access they may engender, are fairly common in radiology offices. Nationally, joint v entures including referring physicians, which are now under legal atta ck, number more than 500. Differences in who owns radiology offices we re associated with statistically significant variations among offices in workload, staffing, and types of procedures done.