Fee Tables and the Roentgenologists

Abstract

The Chicago Roentgen Society has a disturbing problem which is partly a manifestation of this changing world, but which is mostly a misapprehension on the part of the medical profession as to the status of a roentgenologist. For several years the profession has been in receipt of published fee tables from both x-ray and clinical laboratories. Physicians have never questioned the custom but rather have been inclined to regard it with favor. It makes it convenient for them to answer questions of patients relative to the cost of the work the physician wishes to have done. The custom practically sets an arbitrary price that must be met by all laboratories and does not take into account the ability of the roentgenologists to perform the work. The problem of the roentgenologist is further complicated by hospital competition. Hospitals must have x-ray departments and should also have the best that there is in the way of a roentgenologist. It is most unfortunate that many physicians consider the roentgenologist a mere photographer. Some of them are. All of the competent men in that specialty resent the implication but to no avail. It is a sentiment as deeply rooted in the minds of the profession as is the belief on the part of the laity that the best doctors are the ones who have the greatest number of patients. The roentgenologists know how this misconception on the part of the profession can be set right, but they are too modest to suggest the way out of the humiliating situation in which they find themselves. No self-respecting physician would refer a patient to an ophthalmologist who would prescribe glasses when glasses are not needed. Neither is a physician humiliated when an ophthalmologist tells the patient that glasses are unnecessary. The patient is perfectly satisfied to pay the ophthalmologist a fee for his advice and the family doctor has not suffered from loss of confidence on the part of the patient. This well-established attitude held by the public, the family doctor, and the ophthalmologist is due to the fact that none of the parties concerned think of the ophthalmologist in terms of a set of trial lenses. The ophthalmologist is considered a capable physician who has confined his work to the care of the eyes. Because of the imposing magnitude of the x-ray machine, the roentgenologist, as a learned physician, is over-shadowed and lost to view. The roentgenologists are expected to take the picture or pictures indicated by the family doctor. They are not supposed to question the referring doctor's opinion as to what part of the body should or should not be x-rayed. Many a patient with heart disease, not discovered by the attending physician, is sent to the roentgenologist with instructions to make a complete gastro-intestinal radiological study that is entirely unnecessary.