
                         Roanoke Times
                 Copyright (c) 1995, Landmark Communications, Inc.

DATE: THURSDAY, April 12, 1990                   TAG: 9004120557
SECTION: NATIONAL/INTERNATIONAL                    PAGE: A-10   EDITION: BEDFORD/FRANKLIN 
SOURCE: Associated Press
DATELINE: BOSTON                                LENGTH: Short

STUDY SAYS MORE TESTS TAKEN IF DOCTORS PROFIT

Doctors at the nation's largest chain of walk-in clinics performed about 20 percent more tests and X-rays after the owners began letting them keep part of the fees their patients paid, a study found.

The study implies that whether a sick person receives a test or a procedure can depend on what the doctor makes, rather than strictly what the patient needs. While this conflict of interest may influence care at many levels of medicine, the latest study focused on walk-in clinics, which often pay their doctors a percentage of their patients' total bills.

Some critics contend this system gives doctors a financial incentive to perform more tests and X-rays. If this is the intention, the study suggests that it works: Doctors subjected their patients to more tests and other care when they personally profited from the extra care.

The study compared how 15 doctors changed their practice habits in 1984 and 1985 when their employer switched from paying hourly wages to giving them a cut of the total receipts. It was performed at Health Stop, a Massachusetts-based chain with 80 walk-in centers in six states.

Dr. Mark Shankman, Health Stop's chief executive officer, said the chain's compensation rules have changed substantially since the study was conducted. He said the changes attempt to reward doctors for hard work and good medical practice.

The study is published in today's New England Journal of Medicine.

by CNB