ACR Bulletin February 2019

Changing Tides

Radiologists approaching retirement may have a sustainable role in a swiftly moving healthcare landscape.

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When considering what the future of radiology will look like — maybe 10 years from now — you might have visions of AI commanding imaging practices. You may see women and minorities assuming top leadership positions. Perhaps you believe behemoth healthcare groups will continue swallowing up smaller practices. Your best guesses aside, one future change is certain — a significant, aging physician workforce
will give way to younger radiologists with different skill sets.

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News from the ACR and Beyond

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TMIST and DBT: A Game Changer for Breast Imaging

During a session held at RSNA 2018, practice leaders were encouraged to participate in the first large randomized controlled trial that would identify women for whom digital breast tomosynthesis (DBT) may outpace 2D digital mammography in reducing the occurrence of advanced-stage breast cancer. The Tomosynthesis
Mammographic Imaging Screening Trial (TMIST) will be comprised of 165,000 healthy women, ages 45 to 74, at 130 sites throughout North America. “Decision-makers rarely update clinical or payment policy without randomized controlled trial data,” says Etta D. Pisano, MD, FACR, principal investigator and ACR Chief Research Officer. “I urge imaging practices to take part in TMIST and help shape future breast imaging care.”

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AI Use Cases: What Radiologists Need to Know

While computer science experts understand how to train computers, it falls to radiologists to help AI developers understand which problems need to be solved to improve patient care.

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Working to solve problems that don’t exist is a waste of everyone’s time. Preventing that fruitless pursuit is a key goal of the ACR Data Science Institute™ (DSI) Data Science Subspecialty Panels.

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QPP in Year 1

How did radiologists do in the first performance year?

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The Quality Payment Program (QPP) performance scores are in for 2017 — the first performance year under the QPP. These results provide an early glimpse into how physicians and other healthcare providers fared under the program. In general, physicians (including radiologists) did quite well in year 1, but the bonus payments were underwhelming.

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Final Read

How is diversity and inclusion in radiology improving?

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Radiologists and Internet Transparency

Why does your online reputation matter, and what can you do about it?

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When Richard Duszak Jr., MD, FACR, professor and vice chair for health policy and practice at Emory University School of Medicine, talks about online reputation to a room full of radiologists, the slide that gets the most attention compares the Google results for him with one of his former private practice “invisible” radiologist colleagues. A leader in both health policy and IR, Duszak has an active Twitter feed and makes frequent presentations at conferences. A Google search brings up his profiles from prominent medical centers, but also awards he has won, articles about his work, and his perspectives on the field. In contrast, the search results for the “invisible” radiologist bring up a couple of third-party online rating sites over which that radiologist has no control.

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Imaging 3.0: Battling Blind Spots

Radiology leaders are first movers in Vanderbilt’s training efforts to recognize and mitigate unconscious bias.

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“I hope you like country music.” That’s what friends told Reed A. Omary, MD, MS, FACR, when he left Chicago to lead the radiology department at Vanderbilt University Medical Center (VUMC) in Nashville, Tenn. “That’s a perfect example of unconscious bias,” he says. “We may be known as ‘Music City,’ but healthcare is actually Nashville’s biggest industry.”

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The Art of the Apology

Patient conversations following a life-changing diagnosis or medical error may prove challenging to unprepared radiologists.

As imaging continues to drive clinical diagnosis, it has become a source of medical errors. Most of these errors are attributable to radiologists’ interpretations — through missed, incorrect, or delayed diagnoses.1

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Proving Our Value in the RBRVS

Radiologists must understand the building blocks of current FFS payment systems as medicine transitions to a value-based reimbursement landscape.

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After three years attending and participating in the AMA/Specialty Society RVS Update Committee (RUC) — which makes recommendations to CMS on assigning appropriate relative values for Current Procedure Terminology (CPT®) codes — I strongly feel that more radiologists should understand the valuation process. As we prepare for changes in the healthcare system, the reality is that future value-based payment systems for radiologists will likely be predicated on the principles established by the resource-based relative value scale (RBRVS).

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From the Battlefield to the Reading Room

How can radiologists lead their teams in high-stakes environments?

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“A good general, like any true leader, does not actually do anything, but only sees that enough people with proper training and the right weapons (in working order, and calculated to be effective against a specific enemy’s way of fighting) are in the right place and time with a motivation to fight.”1

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The Future Is Now

New power dynamics can help us find our place in an old-power world.

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The opportunities and challenges of finishing training and beginning a career in the current medical landscape are multifaceted: mounting medical school debt, burnout, corporatization, and anxiety about AI and its implications for the profession, to name a few. However, emerging radiologists are also benefitting from a robust job market and exciting new technological advances.

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