>>And the lab part of IVR isn't even done by physicians, fwiw.

I don't know what IVR is, but many if not most of the labs in NY and NJ are owned by medical groups comprised of of the same physicians who prescribe the tests.

The potential for conflict is huge.

A couple of years ago after being discharged from a hospital after a cardiac false alarm I went to see the cardiologist who looked after me at the hospital.
He prescribed a series of tests, most of which I had taken while in the hospital a couple of weeks earlier and he had used in deciding to discharge me.
I told him that I had taken most of those tests (he had my hospital records in front of him) and he said the lab that he wanted me to use was more reliable.
I told him that I'd pass on the tests.
His medical group owns the "more reliable" lab he wanted me to use.
They didn't even bother to change the name.


Again, this is anecdotal and it might be isolated, but when I see our Medicare costs skyrocketing while that cardiologist drives off in an S Class Mercedes and I get into my Camry, I wonder.