Practice patterns of radiologists and nonradiologists: Nationwide Medicare data on the performance of chest and skeletal radiography and abdominal and pelvic sonography

OBJECTIVE. We assessed the relative roles of radiologists and nonradiologists in performing chest and skeletal radiography and nonobstetric abdominal and pelvic sonography. MATERIALS AND METHODS. Information was extracted from the 1993 Medicare file on procedure volume for 65 imaging procedures. Claims were categorized by the specialty of the physician and the location (office or hospital) where the service was performed. RESULTS. In hospitals, radiologists performed virtually all chest and skeletal radiography and nonobstetric abdominal and pelvic sonography. In nonhospital settings such as offices or imaging centers, nonradiologists performed approximately two thirds of the chest and spinal radiography and nonobstetric abdominal and pelvic sonography and larger percentages (78-86%) of the pelvic, hip, lower extremity, and upper extremity radiography. CONCLUSION. Although radiologists perform virtually all chest and skeletal radiographs and abdominal and pelvic sonograms obtained in hospitals, they perform a distinct minority of these procedures in nonhospital settings. The data we present have certain implications for the amount of training nonradiologists receive in diagnostic imaging.