Imaging Ordering Disparity


Nurse practitioners and physician's assistants are more likely to order imaging than a primary care physician (PCP), according to a recent study in JAMA Internal Medicine.

The Harvey L. Neiman Health Policy Institute (HPI) team examined 2010–2011 Medicare care claims and compared PCP image ordering to that of nurse practitioners and physician's assistants (also known as advanced practice clinicians, or APCs). They found that APCs were 1.3 times as likely to order imaging during an outpatient episode of care. Because APCs are increasingly being seen as a way to alleviate concerns about the PCP shortage and will likely play a greater role patient care going forward, this study under- scores the need to ensure appropriate utilization through tools such as clinical decision support. "Our study suggests that advanced practice clinicians may particularly benefit from these ordering systems, which also educate providers on which exams are best for a patient's condition," said Richard Duszak Jr., MD, FACR, co-author of the study and chief medical officer of the HPI. For more information, visit

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