The impact of new diagnostic technologies on health care. An aggregation of expert opinion.

The growing number of applications for both new and existing technologies will act as a catalyst for major changes in the diagnostic testing field over the next decade. The most important single factor affecting diagnostics, however, will be the increasing restrictions on reimbursement for diagnostic tests as traditional payers become much more cost conscious. After decades of growth, we should see a gradual decline in absolute numbers of diagnostic tests and procedures by the early 1990s. The locations of pathology testing may change as well. Free-standing labs will continue to grow in importance while the number of tests in hospitals will decline as hospital admission volumes fall. The number of tests in the home will grow dramatically but will remain a relatively small part of the whole. In diagnostic imaging, rapid growth will occur in the use of some of the newer specialized procedures, but the use of traditional x-rays is likely to fall off slightly. The share of procedures done in hospitals will drop, and the share done in diagnostic imaging centers will show a corresponding growth. These changes are likely to mean fewer radiologists and pathologists, tougher questions about administrative allocation of flat-rate reimbursements, a shift of focus in medical specialist education, and a shift in the role of medical specialty societies.