My Rutherford-Lavanty Fellowship Experience
In June, I had the honor of traveling to Washington, D.C., as part of the ACR Rutherford-Lavanty fellowship in government relations. This prestigious fellowship offers radiology residents a rare opportunity to experience, first-hand, how healthcare policies are formed in our nation’s capital. Named in honor of the first ACR lobbyist, J.T. Rutherford, and Donald F. Lavanty, ACR’s principal legislative consultant for 42 years, the fellowship began in 1993 and close to 200 enthusiastic radiology residents have participated in the program. On average, three to eight radiology residents serve as fellows, spending one week at the ACR’s government relations office working with staff on current healthcare issues affecting the specialty.
During my week in Washington D.C., I was fortunate to work closely with the staff, including Chris Sherin, and Rebecca Spangler, ACR government relations experts, and RADPAC® Director Ted Burnes. I attended many roundtable discussions, fundraising events, and receptions on the Hill. I also met with various legislators and their assistants to discuss H.R. 1298, the CT Colonography Screening for Colorectal Cancer Act. If enacted, HR 1298 will require Medicare to cover CTC screening for colon cancer. Medicare now only covers CTC in the case of an incomplete optical colonoscopy. Per the provisions of the Patient Protection and Affordable Care Act (PPACA), private insurers are required to cover CTC without cost-sharing due to the fact that colon cancer screening services, in general, received a Grade of “A” from the U.S. Preventive Services Task Force (USPSTF). However, Medicare is not bound by the same mandatory coverage requirements within PPACA and relies on a national coverage determination process to add services without cost-sharing. The ACR has long supported Medicare coverage for CTC and is committed to ensuring beneficiaries have equal access to this effective, non-invasive screening test.
I also advocated for H.R. 1904/S. 769, the Medicare Access to Radiologic Care Act (MARCA). The MARCA legislation seeks to amend the Medicare statute to recognize RAs as non-physician Medicare providers and to align Medicare supervision requirements with state law. RAs always practice under the onsite supervision of a radiologist and are also explicitly prevented from interpreting images. If adopted, this legislation will allow radiologists to devote more time to reviewing and interpreting complex medical images while preserving quality care.
To further supplement the key points of the face-to-face meetings I attended with the ACR government relations staff, I also participated in conference calls which gave me a deeper understanding of the issues radiologists face in daily practice. Through these activities, I was able to better understand the importance of the various bills and policies, as well as ACR’s stance on these issues. I also realized that knowing the political and economic effects of innovative imaging technologies is equally, if not more, important than a thorough understanding of the clinical uses of the device. During my training as a radiology resident, I yearned to acquire as much radiology knowledge as possible. This high level of exposure to the federal government has augmented my knowledge base. As healthcare payments change, the specialty of radiology has had to adapt and make necessary adjustments to stay current and remain successful. One cannot overstate how important it is that the patients who need our care have adequate coverage for their imaging needs. I am also able to visualize the current trend in radiology from the perspective of the physician, patient, and payer. I strongly believe that being exposed to these topics at this level gives a resident a view of what life is like outside the reading room. I highly encourage every radiology resident to get involved in the ACR’s RFS in some way. I truly believe that such an endeavor will not only guarantee improved leadership in the field of radiology for the future, but will always present enthusiastic radiologists with strong networking possibilities that will positively impact their radiology careers.
Shivam Shah, MD, is a radiology resident at Rutgers University's Robert Wood Johnson Medical School. He can be reached on Twitter @ShivShahMD