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Role of Emergency Medicine Physicians in US Performed in Patients in the Emergency Department: How Substantial Is Their Participation?¹

¹ From the Department of Radiology, Thomas Jefferson University Hospital, 111 S 11th St, Philadelphia, PA 19107 (D.C.L., L.P., C.R.B.M.), and the American College of Radiology, Reston, Va (J.H.S., G.B.). From the 1999 RSNA scientific assembly. Received January 18, 2000; revision requested February 9; revision received February 29; accepted March 7. Address correspondence to D.C.L. (e-mail: David.Levin@mail.tju.edu).

PURPOSE: To determine the extent to which emergency medicine physicians have assumed responsibility for performing and interpreting ultrasonographic (US) studies in emergency departments (EDs) in the United States.

MATERIALS AND METHODS: The national 1997 Medicare Part B database was searched by using standard US procedure codes, location codes, and physician specialty codes. The authors determined how many US studies were performed in EDs and what percentage of those studies were performed by emergency medicine physicians, radiologists, or other physicians.

RESULTS: During 1997, 234,820 ED US studies within nine major examination categories were performed in Medicare patients nationwide. Emergency medicine physicians performed 1,551 (0.7%) of these studies. When echocardiographic examinations were excluded, emergency medicine physicians performed 458 (0.2%) of the remaining total of 196,158 studies.

CONCLUSION: Although emergency medicine physicians have claimed to be actively involved in ED US on a broad scale, the data reveal that their involvement in 1997 was minimal. This raises doubt as to whether they can properly train their residents to perform US or maintain their own competence at acceptable levels.

Index terms: Economics, medical • Emergency radiology • Radiology and radiologists, socioeconomic issues • Ultrasound (US), quality assurance, **.1298² • Ultrasound (US), utilization, **.1298

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