Meeting the challenge of freestanding imaging centers. Options for hospitals and hospital-based radiologists.

Freestanding diagnostic imaging centers represent one of the new types of ambulatory care facilities providing health services today. Like those offering surgical and urgent care to outpatients, centers offering imaging services present an economic challenge to nearby hospitals that now provide outpatient imaging. However, unlike other ambulatory facilities, imaging centers rely precariously upon both expensive, high-technology equipment and other physicians who refer patients. This dependence creates a unique set of relationships among the hospitals, radiologists, referring physicians, and individual consumers in a community, particularly when some of the physicians have financial interests in the success of a freestanding center. This assessment examines many aspects of hospitals' and radiologists' responses to these new, competing imaging centers, and pays particular attention to the legal, ethical, and economic dimensions of several possible alternative strategies.