Increasing Our Presence in Organized Medicine
A trip to the AMA House of Delegates shows that our role in healthcare extends beyond the dark room.
Easing the Burden
We’re all searching for strategies to thrive in a demanding environment.
As physicians, we go to work every day to provide high-quality and safe care for our patients. But what about our own health and well-being? Are you feeling exhausted, depersonalized, or unengaged? Could you be burned out? Unfortunately, you wouldn’t be the only one.
How will the ACR support members for the future of our specialty?
This is my first Bulletin column as ACR BOC Chair. I am honored and privileged to assume this office. I have been truly fortunate to serve as vice chair under the expert leadership of my predecessor, James A. Brink, MD, FACR. I extend my gratitude to Jim for all he has done to advance our profession and for all that I have learned from him. I am also grateful to my home department at Weill Cornell Medicine. Without the support of Robert J. Min, MD, chair of radiology at Weill Cornell, and my generous colleagues, I would not be able to commit to this responsibility.
Your Dues at Work
Where do membership dollars go, and how are they spent?
As chair of the ACR BOC, I have enjoyed welcoming several new members to the board. Each time, I remember the exhilaration I felt when I joined the board and saw first-hand the scope and scale of ACR activities. Having volunteered for several radiology professional societies in the past, I felt privileged to be part of an organization that truly makes a difference in the lives of practicing radiologists.
It Takes an Army
Radiologists should foster a team environment to ensure their practices run efficiently and effectively.
Those of us in the trenches know what it takes to run a successful radiology practice. The bigger the group, the more unique roles are necessary to ensure that all the moving parts are well-oiled and running seamlessly. From front-office staff to billers and coders, radiology practices need a host of different contributors to function as a cohesive unit. Within this unit, radiologists are typically captains of specific care teams, and practice leaders function like admirals of the fleet. Regardless of one’s role within a practice, whether it be private practice or academic, radiologists at all levels need to lead diverse groups, even if it means simply guiding the team through the daily schedule of patients.
How Do You Connect With the College?
Members can tailor their interactions with the ACR more than ever before, based on interests, career path, subspecialty, and more.
Truly valuable organizations provide a community that allows dynamic access to information and interaction between members. The Internet has dramatically changed how all of us connect. And the ACR is keeping pace, offering members a variety of ways to interact in our College’s digital space: websites, social media, ACR Engage community discussions, and of course, email.
ACR's Strategic Plan — Time to Refresh and Look Forward
The updated plan adjusts the College's vision and brings increased focus to AI and data science.
At the fall meeting of the ACR's BOC and CSC, volunteer and staff leadership met to revise the ACR Strategic Plan. From the beginning, this charter was approached as a living document.
Artificial Intelligence: Friend or Foe to Radiology?
What really is AI and how will it affect the field of radiology?
Radiology and Population-Based Reward Systems
What role will imaging play in the next generation of payment models?
With the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), the way physicians will be paid going forward will look very different from how we have been paid in the past.
From the Battlefield to the Reading Room, Making Service Priority One
“Arma virumque cano” – Aeneid
I first read Virgil’s stirring poem as a ninth grader, not knowing I would one day count myself among the warrior class, part of the story “of arms and the man” that begins Virgil’s Aeneid. When I first took the Oath of Office in 1991, I never envisioned I’d commit myself to that cause for 25 years.
Breast Cancer Screening Today
New radiologist-created recommendations reinforce the importance of regular screening starting at age 40.
Who would have thought that getting the facts out — and getting them straight — on breast cancer screening would be difficult? There is strong evidence that regular screening results in a substantial reduction in breast cancer mortality for women age 40 years and older, and yet controversy continues.
Sometimes Innovation Is Saying No
Aligning college resources with our strategies and priorities
Steve Jobs once said, “People think focus means saying yes to the thing you’ve got to focus on. But that’s not what it means at all. It means saying no to the hundred other good ideas that there are. You have to pick carefully. I’m actually as proud of the things we haven’t done as the things I have done. Innovation is saying no to a thousand things.”
Forecasting the Legal Implications of AI
New deep-learning technologies entering the health-care space bring a host of unknowns for patients and physicians.
Artificial intelligence (AI) represents a transformative technology that has the potential to disrupt the field of radiology, potentially more than any other health-care technology in recent memory.
Investing in Radiology
The College's strategy for financial sustainability ensures a solid foundation for radiologists and their patients.
The ACR was established to serve the needs and interests of radiologists. While the challenges the profession faces have changed over time with the ever-shifting health care environment, the heart of the ACR has never wavered.
Growing the YPS
What is the ACR doing to support members entering practice for the first time?
The ACR Young and Early Career Physician Section (YPS) represents a strong segment of the College at around 7,983 members.
Lung Cancer Screening: The Time Has Come
The ACR responds to recent trial results and the USPSTF.
Screening studies, such as mammography, prostate-specific antigen testing, and EKGs, are under attack. The opponents of these tests claim they are too costly and that there are too many misses and false positives.
What has the ACR been doing to obtain new CPT codes for contrast-enhanced ultrasound?
The College is working strategically to ensure fair reimbursement.
As chair of the ACR Economics Committee on Coding and Nomenclature, I hear from members almost daily since the FDA-approved IV contrast use in liver ultrasound last year.
Speaking Up for Psychological Safety
As radiologists report increasing levels of burnout, how can we support our colleagues and trainees?
At the ACR Annual Conference on Quality and Safety held in Boston this past September, I had the pleasure of sitting down with Steven J. Swensen, MD, medical director of leadership and organization development at the Mayo Clinic and a senior fellow at the Institute for Health Care Improvement.
How can practices shield their patients from "surprise" bills and insurance coverage gaps?
Last spring, I had the pleasure of speaking at the Texas Radiological Society annual meeting, where I learned first-hand the struggles some of our states have had in regard to the issues of "balance billing," also referred to as "surprise billing."
Getting Along in the Sandbox
Working together with colleagues and administrators will help the specialty succeed.
When people ask me what Imaging 3.0® is about, I gauge my response based on the time available and interest expressed by the questioner.
Standing Out from the Crowd
What does your brand say about you and your practice?
This past September, I had the privilege of attending the fourth annual summit of the Radiology Leadership Institute® held at Babson College in Wellesley, Mass. Each year, I have found the programming to be absolutely terrific.
Are you ready to aid a patient experiencing acute contrast medium reaction?
When I began my career, use of ionic contrast medium seemed to prompt several contrast reactions each day.
The Next Technology Wave
How will emerging tools like machine learning affect the specialty?
At this year's intersociety summer conference, the theme was "Big Data and Machine Learning — Strategies for Driving our Value Bus." Jonathan B. Kruskal, MB, ChB, PhD, chair of the Intersociety Commission, led an all-star executive committee to plan an absolutely terrific program.
Cutting Down on Missed Opportunities
Skipped appointments tell us more about our patients' access to care than you might think.
As a professional organization, the ACR has been a tremendous advocate for women's access to screening mammography annually starting at age 40, which gives the maximum life-saving benefit.
Our Place in the House of Medicine
A recent win for patient care demonstrates the value of banding together with our physician colleagues.
In June, I had the pleasure of attending the AMA annual meeting as a representative of the ACR. Arl Van Moore Jr., MD, FACR, former BOC chair and ACR president, leads the ACR delegation and runs a ship as tight as the submarine on which he served many years ago.
Looking Into the Future at ACR 2016
Much of the discussion at this year’s annual meeting revolved around upcoming technologies and emerging shifts in the patient experience.
The ACR 2016 meeting provided a wonderful venue for radiologist from all types of practice to gather and exchange ideas regarding the topics most important to our specialty.
September Is Radiology Expo Month
How can you educate medical students about radiology?
In 2015, the radiology match results brought great anxiety to our profession, with 33 percent of diagnostic radiology residency programs going unfilled.
The chair of the Board of Chancellors outlines priorities for the next two years.
As I looked over the attendees of our annual meeting this year, I was seized with a sense of excitement at the prospect of serving as chair of the Board of Chancellors. I am so proud of our organization, our specialty, and our members.
New Rules of Engagement
The world of radiology is changing. Here’s how the ACR is positioning the specialty for success.
This will be my last Bulletin column as your chair of the ACR Board of Chancellors. As I look back, being involved in organized medicine, in particular organized radiology, has made my professional life most rewarding.
More Than Theoretical
ACR’s impact on payment policy goes beyond intangible goals and makes a measurable difference for radiologists and their patients.
After an eventful legislative finale for 2015, I’ve been pondering the impact on radiology of the Consolidated Appropriations Act of 2016 (also called the Omnibus Reconciliation Act) enacted by Congress in December 2015. Our influence resulted in the inclusion of the roll back of the professional component Multiple Procedure Payment Reduction policy (MPPR) from 25 percent to 5 percent.
New Year's Resolutions: Round 2
What will you do this year to become a better radiologist?
Last month, I challenged each of us to embark on a set of professional resolutions for 2016. Since then, I’ve begun new efforts to make my practice more patient centered. Now I’m launching two more resolutions for the new year. I hope you’ll join me in taking a look at our practices and our specialty and charting a course of constant improvement for ourselves, for our health systems, and especially for our patients.
(Slightly Belated) New Year’s Resolutions
What will you do this year to become a better radiologist?
Although January is usually the time for New Year’s resolutions, I decided to wait until February before discussing them. I wanted to give everyone time get moving on goals to lose weight, eat heathier, exercise more, or learn a new language. These are all noble resolutions, but they only relate to our personal lives. How many times do we make resolutions about our professional life? I’m not sure I have ever done it.
Get the latest from the Board of Chancellors and the Council Steering Committee fall meeting, held Sept. 28 through Oct. 1, 2015.
With a packed agenda, the Board of Chancellors (BOC) and the Council Steering Committee (CSC) covered a lot of ground at the most recent meeting. Here are some of the high points to keep you informed.
One year ago, the College launched the ACR Strategic Plan. Where are we now?
For a strategic plan to be effective, it must be a living document with frequent evaluations, additions, deletions, and modifications to ensure we are meeting the goals. After a thorough review, the ACR Board of Chancellors concluded that we are making progress on all of the objectives in the strategic plan. We have made great strides over the past year.
Changing Platitudes to Attitudes
MACRA Legislation means the Time for Action is Now.
In November 2014, David C. Levin, MD, FACR, gave the RSNA’s Annual Oration in Diagnostic Radiology. In his address, Dave challenged us all — radiologists and our specialty societies alike — not to let our specialty societies’ value-based initiatives become merely “convenient slogans” for the specialty.
Protecting Women’s Access to Screening Mammography
These members of Congress got it right.
In August, Senators Keely Ayotte (R-NH) and Barbara Mikulski (D-MD) introduced the Protect Access to Lifesaving Screenings (PALS) Act (S. 1926) in the U.S. Senate.
Remembering John Curry
ACR Executive Director from 1984 to 2003
John J. Curry, former executive director of the ACR, passed away April 5, 2015, but left behind a legacy of love for the College, his co-workers, and his family.
Introducing the ACR Commission on Patient Experience
A newly formed group helps radiologists put our patients in the center.
Now more than ever, radiologists look to the ACR to lead the way in a changing health care system. One of the most exciting areas of change is the push to understand and improve the patient experience. I’m pleased to announce an important step in supporting radiologists as they provide patient-centered imaging care: the ACR Commission on Patient Experience.
Radiology in the News
How do we get a more balanced approach to reporting the benefits and risks of medical radiation?
Helping our patients understand the true benefits and risks of radiation exposure has been challenging. The Image Gently® and Image Wisely® campaigns, which the ACR cofounded, have had success in partnering with the media to publicize patient resources such as the top questions patients should ask their providers about prescribed medical imaging exams. Still, most patients are given little information about risks and few avenues to find more substantial answers. So it was an exciting milestone this past March, when radiologyinfo.org, the patient information site ACR co-manages with RSNA, received over one million monthly visitors.
Preparing Radiologists for the Future
How is the College supporting radiologists entering new payment structures?
In a recent article in the New England Journal of Medicine, Health and Human Services (HHS) Secretary Sylvia Burwell wrote that by 2016 she expects 85 percent of payments in the Medicare program, including those within the fee-for-service system, will have a link to quality or value.
The Vision to Heal
The SIR's vision of innovation, collaboration, and patient-driven care highlights the value of interventional radiology to our practices.
Those who attended the 2015 Society of Interventional Radiology (SIR) Annual Meeting were introduced to The Vision to Heal, a new brand and vision for the society and the clinical practice of interventional radiology (IR).
Medicare Coverage of Screening CT Colonography
The ACR and its partners have submitted solid recommendations. Now we wait for the results.
March is Colon Cancer Awareness Month, and I cannot think of a better time to reengage policy-makers about the value of CT colonography
A Win for Our Patients and Our Communities
The journey to obtain Medicare coverage for lung cancer screening with low-dose CT
Any new practice innovation is a journey that begins with solid scientific research. The new ACR Strategic Plan emphasizes our commitment to innovation in one of the five goal areas: “Innovation and Research: From Science to Practice and Policy.” However, in the era of health reform, innovation alone will not be enough. We have to do much more than show a new innovation is safe and effective; we also have to demonstrate that it improves outcomes and can be delivered at a reasonable cost.
A Shared Vision
The ACR Strategic Plan calls for stronger connections among radiology societies.
I hope all of you had a great holiday season. As the new year rolls around, we often think about our personal resolutions for the year ahead. For our radiology professional organizations, the fall is also a busy time.
The place for professional networking
As part of the strategic planning process for the College, I have been thinking a lot about why radiologists would want to be members of professional organizations.
The 2014 ACR Strategic Plan
Defining our vision for the future and the roadmap to get us there
The disruptions from health care reform, changing practice patterns, and declining reimbursement that have created unprecedented challenges for our specialty and our practices also challenge our professional organizations to be responsive to the changing practice environments of our members.
Keeping Radiology at the Vanguard
It's more important than ever for radiologists to lead the way in technology innovation.
Radiology has always been at the vanguard of medical care, and it has been our scientific and technological innovation that has kept us there. In 2001, a survey of 225 leading internists rated the value of CT and MRI first among 30 medical innovations of the last 50 years.
RADPAC's crystal anniversary marks 15 years of political engagement.
RADPAC, the American College of Radiology Association (ACRA) bipartisan political action committee (PAC), is celebrating its crystal anniversary this year.
Aligning Incentives in Health Care
The recent SGR legislation brings us one step closer to a blueprint that works for stakeholders throughout the health care system.
In March of this year, I had the pleasure of attending the Oklahoma Radiological Society Meeting. We had a great discussion with radiologists about issues facing their practices and how the College was advocating in Washington on their behalf.
Harvey L. Neiman Reflection
As you’ve probably heard, Harvey L. Neiman, MD, FACR, our longtime and recently retired chief executive officer, passed away in early June. With Harvey’s passing, we lost a dear friend and colleague and an exceptional leader, mentor, and luminary.
Today’s Science Is Tomorrow’s Clinical Practice
Exploring radiology's central role in the age of precision medicine.
In March, I had the pleasure of attending the Massachusetts Radiological Society (MRS) meeting. Phillip M. Devlin, MD, FACR, MRS president, was a wonderful host, and the meeting was outstanding.
Strategic planning: a roadmap to the future.
Before the 2000 presidential election, a Saturday Night Live sketch featured an imitator of President George W. Bush saying the word “strategery.” While this was later attributed directly to President Bush as one of his many mispronounced words, the term became widely popular.
Looking Back: Great to Greater?
“After climbing a great hill, one only finds that there are many more hills to climb.” — Nelson Mandela
In May of 2012, my first Chair Column appeared in the ACR Bulletin. I wrote about the ACR as a battleship — defending our pillars, fighting for the rights of our members, and always keeping in mind the best interests of our patients. Now the time is at hand to write my final column as chair.
In Search of a New CEO
Introducing William T. Thorwarth Jr., MD, FACR
The next CEO of the ACR needs little introduction to most of you. He is William T. Thorwarth Jr., MD, FACR. I will come back to him in more detail in a moment.
The Colors of the College
“There are only 3 colors, 7 notes and 10 digits; it’s what we do with them that’s important.” — Jim Rohn, American entrepreneur, author, and motivational speaker
The Crimson Tide of Alabama, the burnt orange on the jerseys at the University of Texas, and the Black Knights at West Point. Colors instantly bring a picture into our minds.
Volunteers: The Heart of the ACR
"Research has shown that people who volunteer live longer." — Allen Klein
The ACR has an organizational structure similar to that of the federal government, with policy-setting and policy-implementing units functioning in concert. Councilors, who are elected and selected by state chapters, specialty organizations, and a few federal departments, meet annually to establish policy.
Announcing the ACR Head Injury Institute
"Chances are someone you love will sustain a brain injury at some point during your lifetime. When they do, you'll want the best research, you'll want top-quality care, and you'll want local services and support that make life worth living." — Susan H. Connors, president and CEO, Brain Injury Association of America
"The American College of Radiology has formed the ACR Head Injury Institute (HII) to use its skills in the areas of image management, transfer, and archiving; education; research and the development of appropriateness criteria; guidelines and standards to help advance the diagnosis; and understanding and treatment of head injuries," states Alexander M. Norbash, MD, FACR, steering committee chair for this latest ACR initiative.
RadiologyInfo.org, Approaching 15 and Going Strong!
"One of the things I realized...is how few success stories there are in websites or products or businesses that exist primarily for an altruistic purpose." — Andrew Mason, founder and former CEO of Groupon
Last month in this column I told you about a new website, RadiologyCentral.org, created by the ACR and the Intersociety Committee. Now I want to focus on a tremendous success story of collaboration between the ACR and RSNA in the form of a patient-education website: www.RadiologyInfo.org.
RadiologyCentral.org, A First Step
“Houston. Tranquility Base here. The Eagle has landed....One small step for a man, one giant leap for mankind.” — Neil Armstrong (upon landing on the moon on July 20, 1969, and then stepping out onto the lunar surface the following day)
Maybe I am giving a wee bit too much drama and importance to the recent creation of another website. But it is a step forward for our profession. RadiologyCentral.org comes to you from the ACR and the Intersociety Committee (ISC).
ACR Searches for a New CEO
"Leadership is the capacity to translate vision into reality." — Warren Bennis
In case you haven't heard the recent announcements, you may not be aware at the American College of Radiology is looking for a successor to Dr. Harvey L. Neiman, MD, FACR, CEO of the College, who has decided to retire.
Climbing to New Heights at the RLI Expedition
"The greatest ability in business is to get along with others and influence their actions." — John Hancock
The ACR Radiology Leadership Institute™ (RLI) was launched in July 2012 at the Kellogg School of Management on the campus of Northwestern University. I was there, and by all accounts the attendees at the sold out event felt that the program with keynote speaker Jeff Immelt, chief executive officer of GE, was a huge success.
The ACR and Carnegie Hall
The College reaches out to members in pursuit of excellence.
You know the old joke: How do you get to Carnegie Hall? Answer: Practice, practice, practice.
ACR Supports the Appropriate Decision
"The limitation of the ethical phenomenon to its place and time does not imply its rejection by, on the contrary, its validation. One does not use cannons to shoot sparrows." — Dietrich Bonhoeffer, Ethics1
The ACR Appropriateness Criteria® are evidence-based guidelines intended to assist referring physicians and other providers in making the most appropriate imaging or treatment decision for specific clinical circumstances. These criteria now cover over 180 topics and 900 variants.
"The whole is greater than the sum of its parts." — Aristotle, Metaphysica
There are many parts to the ACR. They include you the members, our professional staff, and our facilities. As you probably know, the ACR represents more than 35,000 radiologists, radiation oncologists, interventional radiologists, nuclear medicine physicians, and medical physicists.
The College is turning up the heat on its international activities.
I admit that I am neither a meteorologist nor a climatologist, but I can tell you that in Texas we had a warm winter and a hot summer in 2012.
A New Year, A New Beginning
The freshly minted Commission for Women and Diversity turns the spotlight on one of our specialty's most important topics.
A new member will soon join the ACR Board of Chancellors. The ACR bylaws permit the board from time to time to create or eliminate a commission, committee, or task force "to aid the Board of Chancellors in carrying on specific activities of the College."
Introducing the Harvey L. Neiman Health Policy Institute
The new ACR institute aims to explore radiology's place in the ever-evolving territory of health-care delivery and payment models.
I am very pleased to announce the inauguration of a new ACR institute: The Harvey L. Neiman Health Policy Institute. This new institute is designed to help radiologists shape their future through education, advocacy, and research.
No Tricks, Just ACR Treats
My momma always said, "Life is like a box of chocolates; you never know what you're gonna get." — Forrest Gump
Halloween is not far away, and many of us find our thoughts turning to tricks, treats, and boxes of chocolates.
Back to School
ACR has a lot to offer, whether you're looking to keep your skills current or pursue something new.
It's that time of year. The days are cooling off and the leaves are getting ready to change color and fall. Meanwhile, kids and parents are getting ready for a new school year. Nervous stomachs and first-day jitters abound.
Welcoming the New Board
The ACR Board of Chancellors (BOC) held its spring meeting at the AMCLC in April 2012. The meeting included updates on progress made since January 2012.
Meet the ACR Board of Chancellors, Your Executive Body
The College's executive body is designed to meet the needs of ACR members.
A Meeting for all Members
The 2015 ACR annual meeting will be designed to attract all members. But why are we making a change?
In May of 2015, ACR members attending the AMCLC will engage in a new experience unlike any prior ACR annual meeting — the new conference will include clinical and scientific content. Those who have attended and enjoyed the past meetings may wonder why the ACR leadership has chosen to undertake this adjustment. Let me explain.
The College is moving full speed ahead.
In previous issues of the ACR Bulletin James H. Thrall, M.D., FACR, has written about navigating change, and John A. Patti, M.D., FACR, has written about staying ahead of the curve.1,2 I have great admiration and respect for these and other past chairs, and I want to thank them for their mentorship.
Your Board in Action
The ACR Board of Chancellors held its winter retreat during the last weekend of January. The meeting included updates on progress made since October 2011.
Looking Back So We Can Move Forward
As we approach the ACR Annual Meeting and Chapter Leaders Conference, we anticipate the excitement and energy that flows through this meeting as a catalyst for forward motion and progress.
Point, Counterpoint, Recommendations, and Action
In January, I reported the news from the October Board of Chancellors meeting, and I outlined the elements of discussion contained in three point-counterpoint sessions, on RBMs, self-referral, and our identity as radiologists.
Planning for the Future in Chicago
The Scientific Assembly and Annual Meeting of the Radiological Society of North America presents a multitude of opportunities for radiologists to learn, network, and plan for the future each year in Chicago.
The fall meeting of the ACR Board of Chancellors was held Oct. 17-20, 2011 and was attended by the Council Steering Committee (CSC). Initial presentations by the chairman, president, CEO, and treasurer updated the board on progress made since May.
Looking in the Mirror
As we strive to reach higher and higher goals, there are no truer words of guidance than those in the chorus of a famous Michael Jackson song: "I'm starting with the man in the mirror, I'm asking him to change his ways, And no message could have been any clearer, If you wanna make the world a better place, Take a look at yourself and then make a change."
Recognizing the Gold in Our Midst
Professional careers are defined by myriad events and experiences that occur over a course of time that spans generations. Average practitioners of family medicine often care for the grandchildren of the patients who entered their offices at the outset of their careers.
Recapturing the Center
Over the past 115 years, radiologists have been blessed by the technological advances of our specialty. In each new era of health-care delivery, some new technology has captured the hearts and minds of physicians and patients.