"Follow the money," suggested Deep Throat, the source Washington Post reporter Bob Woodward consulted during the Watergate scandal in the 1970s, as the journalist tried to understand the Nixon administration's covert activities.
Today, that same advice applies if you're trying to figure out why some physicians might be ordering too many tests and procedures.
Over-ordering tests has been an issue for years in many aspects of healthcare. It's been investigated by outside agencies and continues to be—with one of the primary questions involving self-referral. The term "self-referral" describes arrangements in which a physician refers a patient to a healthcare facility in which the physician has a financial interest. Self-referrals can be considered legitimate, because of what many consider a loophole in the law.
Sometimes though, docs themselves get suspicious and upset when they see too much money being funneled to their colleagues or competitors.
That's how a number of urologist groups have been feeling as word spreads that some of their colleagues have been getting a lot of money by self-referral arrangements between urologists and pathology groups. The result? Too many tests, too many evaluations and money too easily made. It was all too convenient, too cozy, too much of an opening for abuse of the system.