Imaging: Urologists can take steps to address threats

Urologists' ability to perform imaging in the office has come under attack, thanks to the efforts of legislators, insurers, and competing specialists.

Q. What are the current hot-button issues in imaging for urologists?

A. The one that I think is most visible is CT scanning. As you know, urologists and many other specialists have begun to own CT scanners and to perform these studies in their own offices. The entities that pay for medical imaging are reacting. Radiologists have an economic interest in restricting access to the ownership of these machines. Part of the reason is that utilization of CT scanning has gone up dramatically in the last few years. A large component of the reimbursement to imaging providers is the technical component of the fee that goes to the party that owns and operates the scanner. It's been argued that, when physicians own a financial interest in imaging equipment, their use of imaging services goes up.

Q. How do you feel about that?

Q. Do you think urologists should perform and interpret their own renal ultrasounds?

A. I absolutely do think they should. Urologists have extensive training in the surgical anatomy of the kidney and all of the disease processes that affect it. This gives urologists the unique ability to correlate their imaging findings with the actual anatomic findings. Continuous clinical management of renal diseases provides perspective on imaging findings and their clinical consequences. Thus, urologists have extensive practical experience with imaging and have had access to hands-on ultrasound training through the AUA for over a decade.

Urologists who are well trained should be able to perform renal ultrasounds to answer specific clinical questions.