Reflections on the Moorefield Fellowship

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In medical school, the most common concern I heard from my attending physicians was, “I wish I knew more about business before I started as an attending.” No one talked about the business of medicine with medical students or residents for a variety of reasons, the most vocal being, “medical school and residency is the time to learn medicine.”

The reality was that the majority of people I came in contact with didn’t know much about the business side of our practice. Those who did generally avoided speaking about it because a certain faux-pas surrounds the topic. After all, we’re here to practice medicine. But just as it is important for an individual to have financial competency regarding their personal finances, it is in turn important for any practice—medical or not—to have that same financial awareness and knowledge.

MoneyTreeOne of my more financially-savvy OB-GYN attendings said something I’ll never forget: “The money that you will make is  nothing but fertilizer. It’s up to you to know how to manufacture that fertilizer and know how to use it to grow something beautiful.” Despite the hyperbole, the point—that it was up to me—stuck. It was 2009 at the height of the financial crisis and it quickly became apparent that in an ever-changing landscape, this was not a finite goal but a long and never-ending process not dissimilar to the study of medicine.

Fast forward a few years to when my residency program director discussed the outlined ACGME and ABR criteria for resident evaluations, and one of the topics was the business of radiology. As a second-year resident, I felt I’d found an opportunity to put my interest to use and volunteered to develop a small program for the residents to educate and evaluate them on the business of radiology. My interest was further solidified by attending the RLI® Leadership Summit in the following years, all of which culminated in me being awarded the ACR’s James M. Moorefield Fellowship in Economics and Health Policy.

I was ecstatic to have the opportunity and honor and began reading through countless pages of material in preparation for the two-week program. Suffice to say, within a few days of my arrival I was fascinated by all the ongoing projects and challenges the department of economics and health policy faces every day.

From answering questions and offering guidance to ACR members, to advocating for imaging policies that benefit patients and radiologists, there was no shortage of activities for me to be involved with. By the end of the first week, I’d witnessed discussions with insurance companies on coverage, helped draft recommendations to the U.S. Preventive Services Task Force, and had been a part of strategy discussions regarding recent hot topic issues. Throughout the two weeks, I had the opportunity to meet with many of the wonderful and helpful ACR staff who serve as the backbone of the ACR. Each individual was tasked not only with the duties of their specific job description, but routinely with other responsibilities outside of their roles on an as-needed basis. Collaboration

Perhaps what impressed me most was the united front the department of economics and health policy has for all radiologists. It operates with a long-term vision in mind to ensure a thriving field for years to come. This is all done not from a “shoot from the hip” mentality but an evidence-based, methodical, and thoughtful process that occurs on an everyday basis at the ACR. It truly is “Starfleet headquarters” — providing support and seemingly endless resources to members, as well as doing nitty-gritty research and development into policies and outcomes that influence both the payers and the government.

The folks at the ACR’s department of economics and health policy have built a wholesome, multi-prong approach encompassing both proactive and reactive positions for radiology; proactive by working on projects and doing research on topics that may not have yet come to light, and reactive by addressing the everyday surprises that are thrown into the mix from various groups. I really wish everyone could have the experience I had, if for no other reason than to understand the hard work that goes into securing our future as a specialty.


By Magda Rizer, DO, breast imaging fellow, Brigham and Women’s Hospital, Boston, Mass.

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