A bill introduced in the New Jersey legislature's current session would impose a significant regulatory burden on the state's radiology practices, requiring a strict one-business-day turnaround on diagnostic imaging reports to referring physicians.
Senate Bill 642, co-sponsored by Senator John Matheussen (R-Camden) and Health Committee Chair Senator Jack Sinagra (R-Middlesex), is apparently on hold for now, and will not advance in its present form from the Senate Health Committee, to which it was referred upon introduction January 11. Calls to the senators' offices seeking comment on the bill yielded a voice message from Dr. Jamie Reedy, health policy advisor to Sinagra.
"This bill is not moving forward in the next few weeks to months," Reedy said. "There's quite a bit of controversy around this bill, and we're going to be working with the Radiological Society (of New Jersey) to try and make it a better bill."
S642's origins remained unclear at press time, as did the timetable for its revision and possible advancement to hearings. However, a glance at the bill's text shows why controversy might shadow it in any form.
The bill would direct the New Jersey Board of Medical Examiners to adopt regulations that would apply to all radiologists based in radiological facilities. Without exception, these radiologists would be required to review diagnostic tests and report their findings to referring physicians by the end of the business day following completion of the test.
Radiological Society of New Jersey (RSNJ) president Dr. Mark Baum raised a long list of objections to the bill, beginning with its apparent singling out of radiologists over other physicians. Even more puzzling, he said, the legislation would not apply to all radiologists.
"It only applies to radiology offices, but not to hospitals, and that doesn't make any sense, because if we're talking about a patient-care issue, why should we single out the place of service?" he said.
Far from improving care, Baum said, the bill would usurp the radiologist's role in determining the best course of action for each patient.
"Many practices use subspecialization to provide better quality, and it's a good technique, to, say, wait a day or so until the neuroradiologist reads the study instead of a general radiologist," Baum said. "That's actually in the best interest of patient care, as opposed to having to fulfill some deadline. You're better off having a better-trained person read (the study) if that's how the practice wants to conduct its business."
Sometimes a previous study is also needed, Baum said, and if an old film were not immediately available, the bill would presumably force the radiologist to read the new study without it.
"I don't think there's necessarily a correlation between the timeliness of getting something out immediately versus the quality of the report. I think sometimes they're at odds with each other," Baum said, adding that the American College of Radiology's communication standards already cover the required course of action for urgent or emergent findings -- and that most radiologists are careful to abide by them.
"If we see something that requires immediate intervention, or it's something serious -- the film shows they have pneumonia or a fracture -- most groups let the (referring) doctor know, they call them," Baum said.
Attorney John Fanburg, who has represented the RSNJ in its dealings with the legislature, said he had communicated the society's misgivings about the bill to Sinagra last fall, through a colleague of the senator's. And while the results of that communication could not be confirmed, Fanburg said, he understood that the bill was "pretty much a dead issue," at least in its present form.
"Our society is opposed to the bill, and we hope it will not be carried forth out of committee," he said. "But if it happens that it does, and there are hearings involved, then we would respond."
An aide at Sinagra's office said written comments about the bill could be sent to the senator's district office at 100 Plainfield Ave., Edison, NJ 08817. The senator can also be reached by e-mail at [email protected].
By Eric Barnes
AuntMinnie.com staff writer
February 23, 2000
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