This article is more than 5 years old. Information may no longer be current.
Physicians offices must consider several points before implementing in-office MRI
Practice type, anatomy among the variables for deciding on an extremity or whole-body scanner.
Click Here to Manage Email Alerts
TORONTO – Physicians’ practices are implementing in-office MRI scanners for flexibility, improved accuracy, efficiency and economic returns.
“Office-based MRI is well accepted and it is currently done in over 800 practices nationwide. With an office-based scanner, you control your patient, the manner of practice and who performs your interpretations,” said Michael B. Zlatkin, MD, president of National Musculoskeletal Imaging.
He presented the advantages and considerations for choosing an in-office MRI in an orthopedic practice at the American Orthopaedic Foot and Ankle Society 23rd Annual Summer Meeting.
In-office MRI improves the performance of imaging for a practice, Zlatkin said. Surgeons can use the machine in conjunction with a preferred radiology group and a specialized reader of musculoskeletal imaging. They can also collect revenue from patients who would otherwise go to the hospital imaging center.
Planning aid
In addition, “You can plan when the patient is going to have the scan and how soon. You know when it’s going to be done, you know when you are going to have a report back; and if those patients need surgery, you can plan your surgical schedule accordingly,” Zlatkin said.
Finally, practices that perform research can block out times to perform MRI scan for certain studies, he said.
Physicians’ offices have many MRI scanners to choose from: low-field extremity MRI scanners; whole-field extremity MRI scanners; whole-body open MRI scanners; open, higher-field scanners; and the short-bore higher field systems, which Zlatkin likened to “an imaging center within your office.”
It is important to consider the practice size and patient volume and the types of anatomy that the practice treats also affects the type of scanner they should choose, Zlatkin said.
“If you do a lot of spine and that is important to your practice, then you need to look at whole-body scanners; extremity scanners may not be appropriate, even high-field ones.”
He added: “You can consider a low-field extremity system if you want to be able to do shoulders. If you’re doing mostly knees, elbows, wrists, and foot and ankle, you might want to consider more of a higher-field extremity scanner where you may get a better quality image, but you don’t have as many capabilities.”
Operating, maintenance costs
Operating costs are also important considerations. “You need to have a properly trained technologist on the extremity systems,” Zlatkin said. “You may be able to train someone from within your own staff, like a physician’s assistant or general technologist. If you have a whole-body system, you really need a trained MRI technician.”
Also consider space and location. Practices may have the financial means and the need for a whole-body high-field system, but not enough space.
Upgrades, life of the system
Physicians’ offices also need to consider the life of the system. At present most systems last 5 to 7 years, Zlatkin said, but with upgrades, than can increase to 10 years or more. It is important to match the terms of the lease with the life of the scanner (most offices sign leases for 5 years).
Zlatkin also suggested including service as part of the lease. “[Make sure] you don’t have any hidden costs if something goes wrong,” he said.
He also presented the possibility of leasing arrangements with shared scanners in medical complexes; however, these arrangements have come under scrutiny by payers and government recently, Zlatkin said.
Some of the money earned with the MRI scanner should go towards upgrades, Zlatkin said.
For more information:
- Michael B. Zlatkin, MD, president of National Musculoskeletal Imaging, can be reached at 1930 N. Commerce Parkway, Suite #5, Weston, FL 33326; 877-734-6674; e-mail: mzlatkin@nationalrad.com. He has a direct financial interest in National Musculoskeletal Imaging and is a paid employee of the company.
Reference:
- Zlatkin M, O’Neill W. Symposium: Practice Management – Office MRI for an orthopedic practice. Presented at the American Orthopaedic Foot and Ankle Society 23rd Annual Summer Meeting. July 13-15, 2007. Toronto.