Urologists who own surgery centers may be more likely to propose surgery for treating kidney stones than non-owner physicians, suggests a study appearing in the March 31 online edition of the journal Health Services Research.
After tracking the caseloads of 1,498 urologists in Florida between 1998 and 2002, John M. Hollingsworth, MD, a clinical lecturer in urology at the University of Michigan in Ann Arbor, and his research team discovered that owners of surgery centers performed a greater proportion of their kidney-stone surgeries in ASCs than non-owners did (39.6 percent vs. 8 percent, respectively).
In addition to linking physician ownership of ASCs to a higher use of surgical services, the researchers also note that Medicare reimbursements for lithotripsy procedures performed in ASCs are on the rise, which might drive even more kidney-stone cases to physician-owned facilities, resulting in increased healthcare costs.
A potential conflict of interest exists when physicians own surgical facilities, says Dr. Hollingsworth. He believes physician-owners might suggest surgery because they have a financial stake in the facilities that host the cases.
The study’s authors admit that their findings are open to debate. For example, they note that higher surgery rates at urologist-owned facilities may be due to physician specialization or surgical efficiencies that persuade surgeons to invest in the outpatient facilities where they operate.
—Daniel Cook
