David C. Levin MD, Presenter: Consultant, HealthHelp Board of Directors, Outpatient Imaging Affiliates, LLC

Vijay Madan Rao MD, Abstract Co-Author: Nothing to Disclose

Laurence Parker PhD, Abstract Co-Author: Nothing to Disclose

Andrea J. Frangos MPH, Abstract Co-Author: Nothing to Disclose

Jonathan H. Sunshine PhD, Abstract Co-Author: Nothing to Disclose

Emergency medicine physicians (EMs) have long advocated for a major role for their specialty in ultrasound (US) and plain radiography (XR) done in emergency departments (EDs). Their role in 2001 was very minor, and our purpose was to see if any substantial changes had occurred more recently.

The national Medicare Part B Physician/Supplier Procedure Summary Master Files for 2001 through 2005 were utilized. Using these datasets’ place-of-service codes, all XR and noncardiac US exams done in EDs were identified. The specialty of the physician providers was determined using Medicare’s physician specialty codes. Professional component and global claims for all ED XR and noncardiac US CPT codes were analyzed.

In 2005 among the Medicare fee-for-service population, a total of 448,675 noncardiac US exams were performed in EDs. This was a 60% increase since 2001. Of these, EMs did 4195 (0.9%), radiologists 393,897 (87.8%), vascular surgeons 17,206 (3.8%), and other surgeons 14,578 (3.2%). In 2001, EMs’ share of noncardiac US in EDs had been 0.3% and radiologists’ had been 91.3%. With regard to XR, in 2005 there were 10,029,738 exams performed in EDs, a 29% increase since 2001. EMs did 236,250 (2.4%), while radiologists did 9,645,136 (96.2%). In 2001, EMs’ share of XR done in EDs had been 2.2% and radiologists’ had been 96.5%.

There was a considerable increase in the number of Medicare XR and US studies done in EDs between 2001 and 2005. The shares of ED-based US and XR performed by EMs rose slightly during those years. However, their role in 2005 still remained minimal – only 0.9% of US and 2.4% of XR. Thus their experience at formally interpreting these exams must be quite limited. Despite advocacy efforts by EMs in recent years, radiologists still strongly predominate in imaging performed in EDs.

Does not apply.

Levin, D, Rao, V, Parker, L, Frangos, A, Sunshine, J, Ultrasound and Plain Radiography in Emergency Departments: What Was the Role of Emergency Medicine Physicians in 2005?.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5006068.html