Actionable Steps

How one key phrase significantly improved best practices and clinical value.

Casestudy

Key Takeaways

  • Physicians at RadPartners recognized that referring clinicians were ordering unnecessary imaging follow-up when it wasn’t specified as extraneous.
  • The team decided to combat this problem by incorporating into their best practice guidelines that radiologists include the phrase, “No follow-up imaging is recommended” directly in their reports.
  • Since implementation of best practice guidelines created by RadPartners, including the no follow-up statement, adherence to the guidelines has improved by as much as 81 percent.

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Radiologists as Knowledge Experts in a World of AI

The first RFS AI Journal Club session is available for viewing now!

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The AFR RFS held its first Journal Club session on Dec. 6. 

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Bridging the Gap

University of Chicago radiology residents work to improve the involvement and career advancement of women, URMs, in radiology

Bridging the Gap

Radiology, like many medical specialties, has struggled to train and graduate physicians to match the evolving diversity reflected in regional and national demographics. Despite comprising half of all medical school trainees, women have consistently represented less than 30 percent of radiology training programs, with even more dismal statistics being reported for underrepresented minorities (URMs).

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Radiation Oncology at RSNA

 

RO Corner

The radiation oncology program at the RSNA annual meeting offers a unique opportunity to learn about the latest updates in oncologic and imaging practice. 

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December 2017 JACR Highlights

 

Looking into the future

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Navigating Patients Through the Internet of Misdirection

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“My doctor ordered a CT scan, but I am worried about the effects of radiation. You’re a radiologist, what are your thoughts?” Substitute ‘CT scan’ in the preceding sentence with most radiology studies and a familiar question surfaces.

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Candid Impressions

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The Economics Committee of the Patient- and Family-Centered Care Commission conducts a survey about patients’ imaging expectations, with positive results.

Although much research has been done to gauge patient attitudes toward their imaging experience, it has mainly been confined to hospital-wide or regional surveys. Since the stated goal of the Economics Committee of ACR’s Patient- and Family-Centered Care Commission (PFCC) is to provide input in the development of ACR-backed value-based payment models and measures that deliver patient-defined value, committee leadership decided to assess what patients currently value in the process of obtaining a diagnostic image, as well as their expectations for the radiologist in that process.

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Cost Lacking in Shared Decision-Making Discussions

Lack of awareness of the price of imaging keeps patients from making informed choices on care.

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Shared decision-making is a term applied to the communication process between a physician and patient. It balances information asymmetry: the physician knows the medical aspects and the patient knows values, lifestyle and treatment preferences. Discussions between physician and patient include available treatment options, potential outcomes, risks versus benefits, and patient values and preferences. 1-3

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 A Moving Target

As patients assume more responsibility for financing their own health care, price transparency in imaging should be on every radiologist’s radar. 

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Ever since taking a spill two weeks ago, Mr. Grant has experienced lower back pain. Worried about the lingering aches he’s feeling, he sets up an appointment with his primary care physician (PCP). After an evaluation, his PCP recommends that he get imaging work done at an outpatient imaging center affiliated with the hospital.

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RSNA Primer - Navigating Your RSNA 2017 Visitlook into RSNA

First, welcome and know that you will have an incredible experience ahead of you at RSNA’s 103rd Scientific Assembly and Annual Meeting! Here are some tips that may be helpful as you prepare for a week of learning and exploring at McCormick Place in Chicago.

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A Resident’s View of ACR Capitol Hill Day and Radiology Advocacy

A resident learns about ACR advocacy thanks to the generosity of MORADS.

captiol columnsAs one of the fortunate radiology residents chosen to represent the Missouri Radiological Society (MORADS) at the ACR 2017 Annual Meeting and Capitol Hill Day, I had the pleasure of learning some hands-on advocacy information on what it takes to support radiologists’ interests as they pertain to patient care and other important aspects.

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Social Media @RSNA2017

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Happy Fall to All! RSNA is fast approaching! There will be thousands of people to meet, tons of great lectures to go to, and many fun parties. How do you make the most out of such an event? Social Media, obviously!

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Meet Matthew B. Spraker, MD, PhD, Chief Resident in radiation oncology at the University of Washington School of Medicine, and the current recipient of the E. Stephen Amis, Jr., MD, Fellowship in Quality and Safety

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The Spotlight on AI and Machine Learning

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Customer insight, the collective intelligence of teams, lean operations, and value-based imaging…all important topics in radiology today. Still AI and machine learning steal the spotlight every time.

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A Quick Lesson on #Radvocacy

A Rutherford Fellow finds out how the government relations team works directly for radiologists and patients on pertinent issues that will affect your practice.

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Daniel Ortiz, MD, with Martin Heinrich, Senator from New Mexico

This September, I had the honor to be sponsored by the ACR to serve as a Rutherford-Lavanty Fellow in government relations (GR). The fellowship offers a week-long comprehensive experience encompassing introduction to many of the facets of the incredible ACR GR team that works tirelessly to represent the interests of the radiology community and our patients.

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Through the (YPS) Looking Glass

A YPS member reflects on her ACR CSC experience

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This past spring, I was incredibly honored to be appointed to the ACR CSC. While my appointment was met with warm praise from my wonderful YPS colleagues, I knew that by taking on this role the congratulations would have to be earned by hard work and dedication to the College through my service on the CSC.

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 Radiation Oncology Corner

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 An interview with Seth A. Rosenthal, MD, FACR, FASTRO; Chair, ACR Commission on Radiation Oncology

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Meet the 2017 Valerie P. Jackson (VPJ) Education Fellowship Recipients

This year’s VPJ fellows share what they learned about the operations of the ACR Education Department

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The Valerie P. Jackson Education Fellowship provides the opportunity for radiologists to gain direct exposure to the operations of the ACR Education Department. 

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Flying on Autopilot: Epinephrine Autoinjectors on the Radiologist’s Toolbelt

 

At the end of a long shift, are you ready to jump in and save a patient's life?

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As the clock ticks down toward the end of a call shift, you plow through a stack of plain films that steadily increased as you diagnosed uncomplicated diverticulitis in the patient from the emergency department. The end is near; soon you will be out the door. Suddenly, the phone just inches away, piercingly shrieks, shattering the calm silence. Your technologist informs you a patient is reacting to a contrast bolus; he struggles to breathe. You franticly arrive at the gantry. Now what?

 

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Career Planning, Transitioning and Avoiding Burnout

 

Advice to radiology students, residents and fellows on setting realistic goals and achieving work-life balance

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As a medical student and resident/fellow, your career steps are well-outlined. Study for the next test, pass boards, apply for residency, fellowship, or your first job. After training, your next steps become more ambiguous. A wrong move or non-ideal job can lead to significant stress, burnout, loss of income, or even the end of a career. With appropriate planning, savvy decision-making, and smart guidance, mistakes can be avoided and your career can be successful and satisfying.

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The ACR’s YPS BOC Position

 

An excellent leadership opportunity in the ACR

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At the ACR annual meeting in May 2016, Resolution 42b was submitted and sponsored by the BOC and CSC, and was passed by the Council. This resolution was submitted in response to the ACR’s strategic plan to have a renewed focus on the ACR’s Young and Early Career Professional Section (YPS).

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Will Watson Replace Radiologists? 

An extract from the JACR's podcast "Radiology Firing line"

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September 2017 JACR Highlights

ACR Recommendations for Screening Average Risk Women for Breast Cancer

Future Demand a Supply for Radiology Services

Managing Change

JACR highlights

“I’m Not Going to Let You Do Anything to Me”

Lincoln Berland, MD, focuses on a very important topic in radiology and throughout medicine today: the patient-centered approach and shared decision-making. Often, the only tool necessary for persuading a patient that a procedure or diagnostic test should be performed is listening.

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Tweet Chat Tips

Don’t forget to participate in the next # JACR Tweet Chat on Thursday, September 28th at noon EDT — Topic: Personal Branding!

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Tweet chats in radiology are a fantastic way to engage in discussion with colleagues and patient advocates across a global scale, during radiology meetings and/or all year round. However, the concept of a tweet chat may be daunting to some who want to participate but don’t know how or where to begin. As radiology-related tweet chats become more frequent, this quick guide has been crafted to demystify the basics of a virtual discussion with the hope that more radiologists at all levels of training will participate in the future.

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 The Union Experience as a Resident-Physician and Future Radiologist

A radiologist-in-training fights for the rights of his fellow residents and comes out with excellent results!

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Contract negotiations are difficult and time consuming.  Whether bargaining over the price of a car or negotiating a three-year contract valued over 100 million dollars per year that affects over 1200 physicians, emotions run high and tempers may flare. I recently participated in the latter as a member of the contract negotiations team representing the resident physician union at the University of Michigan. Regardless of pro-union or anti-union sentiments, readers should agree that we are fervently pro-physician. I am honored to have had the opportunity to negotiate the best possible contract for my fellow resident physicians, all of whom work tirelessly for the health of their patients.

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Comparative Effectiveness Research: A Necessary Tool for Implementing Imaging 3.0.

Radiologists should know the cost effectiveness and the risks-benefits of all tests they have juristiction over.

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As a part of my attendance at AIRP this August, I had the opportunity to participate in the “Introduction to Comparative Effectiveness Research and Big Data Analytics for Radiology” mini-course, a new seminar created to illustrate how comparative effectiveness research can be applied to the practice of radiology. The course is supported by the Value of Imaging through Comparative Effectiveness (VOICE) program at New York University and grants from the National Institute of Health.

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Radiation Oncology Corner

This month: Radiation Oncology, Radiology, and the ACR: A Perfect Union

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 Radiation oncology and radiology are two specialties that are uniquely intertwined. In fact, the history of radiotherapy (RT) began almost immediately after the discovery of X-rays in 1895. As physicians rapidly discovered inventive and practical diagnostic uses of X-rays, it became apparent that prolonged exposure to radiation caused tissue damage, and the first therapeutic utilization of X-rays to treat cancer patients began as early as 1896.

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Tube Check: A Plain Question with Quality Implications

What benchmarks are indications of successful nasogastric tube placement?

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It’s 10 p.m. Your workflow begins to flood with requests from the emergency department. The ICU intern inserts a nasogastric tube into the patient you diagnosed 25 minutes prior with transcortical infarction.

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MACRA and MIPS: A Resident Primer

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As residents, attending physicians often insulate our learning environment from the political whirlpool of insurance reimbursements. However, the education and awareness of the financial climate affecting our daily practice is crucial to our training as radiologists. The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) is frequently reported on in medical news and literature.

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American Alliance of Academic Chief Residents in Radiology (A3CR2):

What Does This Mean to You?

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Members of the A3CR2 Executive Committee gather at the AUR 2017 annual meeting in Hollywood,Fla. Pictured from left to right are Daniella Asch, MD (Secretary); Daniel Ortiz, MD (President); Dexter Mendoza, MD (Vice President); William Sherk, MD (Treasurer).

So you have been bestowed one of the greatest honors you can get as a resident; you are now a chief resident. Surprisingly, this is faced by many with mixed emotions of excitement, honor, anxiety, and isolation. A popular stated quote is “It’s lonely at the top.” However, you don’t have to be alone.

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On the Path to Becoming an American-Trained Radiologist

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The radiologist is the key to a correct diagnosis. Radiology has a large number of examinations to achieve that objective — conventional radiology, ultrasound, CT, magnetic resonance, hybrid imaging, SPECT scanner, PET-CT, and PET-RM. But the art of radiology is in the accurate selection of these tests.

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Waiting It Out

A doctor-turned-patient’s point of view

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My eyes fixed on the ultrasound monitor, I watched as the core biopsy needle was advanced into the lymph node and then deployed with a loud click. It wasn’t the first time I’d been part of an ultrasound guided biopsy.

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  Harnessing Artificial Intelligence (AI):Do deep-learning machines still need human radiologists? 

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Radiology and the Evolution of Battlefield Medicine

Imaging has been integral to wartime medicine since the early days of radiology. How is the specialty adapting to support the changing needs of patients on the battlefield?image battlefied

When you picture the development of military medicine, how prominently does imaging factor in? The evolution of radiology has been intertwined with modern-day warfare for the past 120 years.

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From East to West; the Pain of Waiting Is the Same.

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The last time that I was in Ann Arbor, Mich., my Uber driver asked me where my home was. I truly didn’t know the answer. I was born and raised in Tehran, Iran, where I graduated from medical school. Then I moved with my family to Toronto, Canada. And now I’m living in Baltimore, Md., where my husband works. And, every month, for one week, I travel to the University of Michigan in Ann Arbor for research. I think my driver was as confused as you are right now about my home!

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Young Professionals and Radiology Advocacy Network

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The Radiology Advocacy Network (RAN) is a group of radiologists across the country working to ensure that radiology’s voice is heard at the local and federal levels. The ACR® Young Professional Section (YPS) is seeking to increase participation of early-career members in political advocacy and engage them in advancement of our specialty.

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Greetings from the Chair of the Resident and Fellow Section (RFS)

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Congratulations to everyone as you complete training and transition to practice, survive yet another of residency, begin radiology residency, or graduate medical school!

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Deep Learning, Clinical Data Science and Radiology

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At a packed ACR 2017 session on machine learning that delved into artificial intelligence (AI) and deep-learning algorithms, co-moderator Raym Geis, MD, FACR, vice chair of the ACR Informatics Commission, posed the question: What should radiologists think about machines that think?

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The Medical Student Experience at ACR 2017

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For as long as I can remember, I’ve been exposed to images and radiology equipment. My dad is a service engineer for medical imaging equipment, and I remember going to work with him and scrolling through images on a screen, or taking screws out of a CT cover, or seeing how close I could get to the MRI before the magnet started pulling on my braces.

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RFS and Member Experience at ACR 2017: Part 2

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ACR 2017 was a great success to say the least! Medical students, residents, and fellows gathered from around the country with a common goal; to learn how to advocate for our patients, make connections with our colleagues, and contribute to the dynamic evolution of radiology.

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The Voice of Radiology Is Strong

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Radiologists head to the Hill to meet their representatives and advocate for their patients.

This May, over 500 radiologists, fellows, and residents attended the annual Capitol Hill Day during the ACR® annual meeting.

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Resident Highlights: June 2017 JACR

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The future of radiology reimbursements, big data, machine learning, residency training, and imaging abroad are some of the themes found in June’s featured articles…plus an opinion on burnout on the profession, a how-to on succeeding in the academics of radiology, and reducing errors from cognitive biases. Check out the following highlighted articles.

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Advocacy in Action: Updates from the AMA 2017 Annual Meeting

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Advocacy remains a top priority for the RFS, ACR, and our profession as a whole. Participating in the AMA is one way through which radiologists and radiation oncologists can add value to our health-care system, providing fresh ideas on how to improve care for our patients and support a sustainable workforce.

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What Happened at AUR 2017?

Get a resident’s-eye-view of one of radiology’s biggest meetings

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It was that time of the year again... when you meet the people that helped you grow or that grew with you, have good meals together, celebrate achievements, get valuable advice, and welcome new members to the family. No, I am not talking about Christmas or Thanksgiving. On May 8–11, 2017, the 65th AUR Annual Meeting attracted academic radiologists from around the country to sunny Hollywood, Fla., with the theme “Leading Change and Bringing Value.”

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