Outpatient Studies

My practice has six physicians. Because of this we open on the weekends and we have walk-in patients. This, of course, has the benefit of generating much needed revenue in this current system where volume seems to be the only way primary care physicians can generate any significant revenue.

We have two hospitals and several outpatient imaging centers in the area. The imaging centers are all closed on the weekends as well. During the weekdays, there is no problem getting "stat" or "asap" studies for things like an ultrasound for a swollen lower extremity, CTs, etc. However, on the weekend this becomes much more problematic.

Since the imaging centers are all closed on the weekends, we have to go through the hospitals to get any type of "stat" or "urgent" study. The interesting thing is that even though we have spoken to the hospitals about it, they refuse to allow our office to order these studies as an outpatient on the weekend. You would think that the added revenue would be an incentive to let us do this.

I can only think of a couple of reasons they would do this. First, they will make much more on an ER visit than just an outpatient imaging visit. Secondly, most of the imaging staff in ultrasound or CT are only on call on the weekends and they don't want us willy-nilly ordering tests that cause them to pay overtime to the imaging staff. I think both of these reasons are in play.

Once again, a huge cost to the taxpayers of this country having to duplicate care and forcing ER visits. What use is there for me to see a patient with a potential DVT, then do an H&P, only to send them then to the ER for another doctor to do the very same thing and order the test I could have ordered as an outpatient. What would have only cost a few hundred dollars now is costing probably close to $5000.

This is another example of one of the problems I see with the healthcare system as we know it.