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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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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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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RFS Member Experience at ACR 2017: Part 1

RFS acr2017The 2017 ACR meeting was an incredible behind-the-scenes experience into the political side of medicine and radiology.

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My Amis Fellowship Experience

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The stage lights were shining so brightly as I peered out into the enormous ballroom filled with hundreds of attendees at the 2017 ACR annual meeting in Washington, D.C. Nearly a year ago, when I had been selected for the ACR’s Amis Fellowship in Quality in Safety, I never imagined that I would be serving as a member of one of ACR’s four Reference Committees. Yet, here I was, sitting center-stage alongside much more senior ACR members, recording member comments regarding the rules and regulations that we had proposed.

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May 2017 JACR Highlights

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TI-RADS, social media enhancement of peer reviews journals, and exposure to medical imaging with RadiologyInfo.org — These are a few articles that may be helpful reading and practice for radiology residents in training.  A supplemental edition was also printed in order to focus on revised ACR Appropriateness Criteria guidelines in nearly all modalities.

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ACR 2017 CEO and BOC Chair Reports

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On Sunday, James A. Brink, MD, FACR, and William T. Thorwarth Jr., MD, FACR, reported on the state of the ACR from the BOC chair’s perspective and the CEO’s perspective, respectively.

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Ace Your Interviews

Get specialty-specific tips from a radiologist on the other side of the interviewer’s desk.

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There’s no shortage of advice online about preparing for an interview. But what about radiology-specific information? At ACR 2017, attendees received advice tailored to the specialty from someone who’s interviewed many radiology candidates: Susan J. Ackerman, MD, FACR, associate professor of radiology, vice chair for clinical affairs in radiology, and division director of ultrasound at Medical University of South Carolina in Charleston.

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ACR 2017: A Day on the Hill 

Radiologists from around the country flocked to Capitol Hill to take radiology’s message to Congress.

ACR 2017 1326On Wednesday, ACR members went to Capitol Hill to advocate for the specialty and be the voice of radiology. Check out some of the action shots below. If you'd like to learn about the talking points for this year's Hill Day, please visit the Hill Day Prep page.

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Connecting Hearts and Minds

Teamwork session offers tips for effective leadership.

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Effective leaders connect their heads (how they think) and their hearts (how they feel) with their hands (what they do). That was one of the key takeaways from Tuesday’s educational session titled Teamwork: The Critical Enabler of Transformational Change. Bob Cancalosi, director of GE Global customer leadership education and member of the ACR Commission on Leadership and Practice Development, delivered the presentation to a group of about 50 conference attendees.

Cancalosi said a manager’s approach is important because research from the Corporate Leadership Council shows that “more than 70 percent of an employee’s commitment is based upon their manager’s actions” and that “engaged employees can yield up to 57 percent more discretionary effort.” It’s also well documented that the number one reason people leave their companies is because of their immediate managers.

“Here is something to think about,” Cancalosi said. “Every single day as a leader, when you wake up, where do you want to be on this equation? Do you want to be influencing the 70 and the 57, or do you want to be the reason that somebody is putting their resume out on Monster.com, trying to get the heck out of your organization?”

Leadership Steps

Managers can take several steps to ensure they have a positive impact on their teams, including helping their employees understand how their work aligns with their team’s and organization’s goals. One way they can do this is by repeatedly reminding employees how their work fits into the larger picture, Cancalosi said.

“When you repeat the same message six times over a period of time, you drive up retention of the message to 70 percent,” he said, citing a study from the University of California. “I just keep telling leaders: repeat to remember and remember to repeat, repeat to remember and remember to repeat. Keep telling the same story over and over.”

Another way leaders can build high-performing teams is by cultivating a sense of trust with their employees, Cancalosi said. Managers can foster trust by recognizing excellence, sharing information broadly and in context, and creating a candid environment where everyone can speak freely.

Along those same lines, Cancalosi noted that leaders should pay close attention to their body language. For instance, he said, when managers roll their eyes at employees, it immediately signals that they’re not interested in their employees’ contributions, and their employees will stop sharing ideas. “Your body will always say what your mouth will not,” Cancalosi said.

Tailored Approach

While numerous leadership models exist, Cancalosi said simply deploying a cookie-cutter style will not work. Leadership is situational and must be tailored to different environments and different moments in time. “As leaders, I believe one of our goals is to breathe life into people,” he said. “But there are times you do need to deflate them a little bit [when egos take over],” he said, adding that leaders must find the appropriate ratio for each scenario.

To close, Cancalosi repeated an acronym that he said he often shares with his clients. He asks them if they “H.A.V.E.” what it takes to be a great leader. “Are you humble, are you authentic, can you show vulnerability, and then do you show empathy?” he asked. “If you can get that on top of the brilliant IQs that we all won in the DNA lottery, that’s what makes up the best leaders and the best teams.”


 By Jenny Jones, Imaging 3.0 specialist

In Case You Missed It

ACR 2017: Tuesday, May, 23  

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Here are the goings-on from day three of ACR 2017

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In Case You Missed It

ACR 2017: Monday, May, 22  

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ACR 2017 has begun! Here are the goings-on from day two of the conference.

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#ACR2017 in Tweets: Sunday, May 21

Find out what people are talking about at the ACR Annual Meeting.

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The ACR’s first all-member annual meeting has been buzzing with social media activity from members from throughout the College. We've rounded up our favorite tweets from the meeting, highlighting memorable parts of this year's program. What were your top tweets this year?

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In Case You Missed It

ACR 2017: Sunday, May, 21  

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ACR 2017 started off with a bang. Here are the goings-on from day one of the conference.

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How Mentoring Can Benefit the Specialtymentoring benefits

Although women make up nearly half of all medical students, they represent a significantly smaller proportion of radiologists, with the 2016 ACR workforce survey revealing that only 21.4 percent of radiologists are female.

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Meet the Moreton Lecturer

Jeffrey C. Bauer, PhD, gives a sneak peek at his ACR 2017 session — and his take on the future of health care.

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Health futurist and medical economist Jeff Bauer, PhD, recently talked to the ACR Bulletin about his upcoming Moreton Lecture at ACR 2017, Forecasting Futures of Radiology at the Crossroads: It’s All Downhill from Here on Up.

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Primer on Radiology Advocacymcadams radiology advocacy

 

"An idea is like a play. It needs a good producer and a good promoter even if it is a masterpiece. . ." — David Bornstein in How to Change the World: Social Entrepreneurs and the Power of New Ideas

Residents and fellows are perfectly positioned to be effective advocates as we are accustomed to championing our patients and specialty from our reading rooms, angio suites and clinics every day; however, most of us are not comfortable pursuing state and national advocacy opportunities. This daunted me, too when I was first getting started, but rest assured, there are countless opportunities to get involved (and options compatible with almost everyone’s time budget).

Let’s review a few pieces of advice I have learned along the way and share some opportunities for you to get started advocating today!

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Meet the ACR Leadership: Bibb Allen Jr., MD, FACRmeet ACR leadership

This is an installment of a series titled “Meet the ACR Leadership.” Throughout the series, we interview the ACR Leadership to get insight into their background and involvement in the ACR. For this installment, we talk with Bibb Allen Jr., MD, FACR.

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Is There a Doctor on Board?doctor on board

The thought of this title may send shivers down your non-clinical spine. Colleagues often jest that radiologists are loners hiding in a dark room away from civilization, who have little interaction with any patients.

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Social Media Primersocial media primer

Four years ago, the night before my very first ACR national meeting, I signed into an, until that point, unused Twitter account.

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YPS Executive Committee – Yearly Recapyearly recap

Over the past year, the ACR YPS Executive Committee (EC) has been busy and productive.

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Part I: ACR 2017 Advocacy Essentials and Capitol Hill Day; What You Need to KnowACR 2017

A crucial component to the yearly ACR meeting is advocacy, including the Capitol Hill Day visits. This year, exciting new elements will be unveiled in addition to the traditional programming which has been so effective in our profession’s advocacy efforts.

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Onboarding: Achieving Long-term Success for the Practice and New Radiologistlong term success

The many years of education and training physicians undergo provides them with multiple transitions to new environments as learners and professionals.

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Why I Got Involvedwhy i got involved

Several years ago as a second year resident, one of my senior residents approached me in the hallway and said, “I think you’d make an excellent leader. You should join the Massachusetts Medical Society.”

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Resident Work-Life Balancework life balance

There’s an alarming trend across radiology: physician burnout. Recent articles in the JACR® and RSNA News have highlighted the declining job satisfaction of radiologists.

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Meet the ACR Leadership: William T. Thorwarth, Jr., MD, FACRLeadership

This is an installment of a series titled “Meet the ACR Leadership.” Throughout the series, we interview the ACR Leadership to get insight into their background and involvement in the ACR. For this installment, we talk with William T. Thorwarth, Jr., MD, FACR.

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Primer on Patient and Family Centered Care

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Radiology is changing and not in the way you may think. Advances in imaging technology have always shaped our chosen profession and will continue to do so throughout our training and during our future practice. But it is not a new technology or imaging modality that is bringing change to radiology. Rather, it is a concept that is not new at all: patient- and family-centered care (PFCC).

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The Moorefield Fellowship Experiencemoorefield fellowship experience

This past October, I was honored to participate in the American College of Radiology Moorefield Fellowship in Economics and Health Policy.

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A Day in the Life of UVA Resident Connor Louden, MD

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New and prospective residents are often curious about what their daily life will be like as radiology residents. Here’s a typical day described by Connor Louden, a third-year diagnostic radiology resident at UVA.

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