‘No Consensus’ for Academic Second Opinions on Outside Imaging Studies

Leesburg, VA, October 2, 2019—According to an ahead-of-print article published in the January issue of the American Journal of Roentgenology (AJR), there is no consensus among academic radiologists regarding how to handle second-opinion consultations on outside studies (OSS). 

Analyzing completed surveys from 91 members of the Society of Chairs of Academic Radiology Departments (SCARD), lead investigators Parisa Khoshpouri and Pegah Khoshpouri found that 70 respondents (76.9%) added OSS to their institutional PACS, and 34 (37.4%) required formal internal reports on all OSS. 

In contrast, 74 (81.3%) allowed at least some OSS into their PACS, without requiring an internal report. 

“Many respondents interpreted outside studies only if specifically requested,” Khoshpouri and Khoshpouri noted.

A majority (67/91 [73.6%]) billed insurers—though not patients (61/91 [67.0%])—for the second-opinion consultations. Meanwhile, 15 (16.5%) preferred repeating studies, rather than including OSS in the PACS. 
With minimal exceptions, the results from the 91 of 160 invited (56.9%) SCARD respondents paralleled the results from the 35 of 106 invited (33.0%) Association of Administration in Academic Radiology members.

“Developing a best practices statement that addresses patient care, medicolegal implications for radiology departments and referring physicians, financial implications, and quality and safety precepts would be a useful endeavor for organized radiology,” concluded Khoshpouri and Khoshpouri. 

“In so doing,” they continued, “radiologists may gain more clarity from a malpractice mitigation standpoint and have greater leverage with payers for appropriate reimbursement for their professional expertise.”

Founded in 1900, the American Roentgen Ray Society (ARRS) is the first and oldest radiology society in the North America, dedicated to the advancement of medicine through the profession of radiology and its allied sciences. An international forum for progress since the discovery of the x-ray, ARRS maintains its mission of improving health through a community committed to advancing knowledge and skills with an annual scientific meeting, monthly publication of the peer-reviewed American Journal of Roentgenology (AJR), quarterly issues of InPractice magazine, AJR Live Webinars and Podcasts, topical symposia, print and online educational materials, as well as awarding scholarships via The Roentgen Fund®.