Radiologists Performing More Paracenteses, Thoracenteses

The proportion of paracentesis and thoracentesis procedures performed by radiologists is continuing to increase, according to a study published online in the Journal of Vascular and Interventional Radiology.

Ravi V. Gottumukkala, M.D., from Massachusetts General Hospital in Boston, and colleagues used data from carrier claims files for a 5 percent national sample of Medicare beneficiaries to compare disparities between paracenteses and thoracenteses performed by radiologists and nonradiologists over time. Paracentesis and thoracentesis examinations were retrospectively classified by physician specialty, day of the week, and complexity of a patient's condition.

The researchers found that from 2004 to 2016, there was an increase in the proportion of all paracentesis and thoracentesis procedures performed by radiologists (70 to 80 percent and 47 to 66 percent, respectively). On both weekends and weekdays, radiologists increasingly performed more of both services, but a lower proportion was performed by radiologists on weekends. Radiologists performed paracentesis in patients with more complex conditions than those treated by nonradiologists for most of the first nine years of the study period, but in recent years, the complexity of patients' conditions was similar. Across the study period, for thoracentesis, the complexity of patients' conditions was similar for both specialty groups.

"The present findings suggest that previous implications from analyses of diagnostic imaging services, including the possibility of selective referral to radiologists of imaging studies performed off-hours and on more complex patients, do not apply to at least this subset of image-guided procedures," the authors write.

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