The Importance of Speaking Econ
Economic terms are complex, but learning how to apply them can pay dividends.
The language of radiology is complex and, in many ways, different from the language of the rest of medicine. This difference has immediate implications for our profession.
Often, we must communicate what we do in radiology in a manner understandable to physicians outside radiology — or even those outside the field of medicine, such as national policymakers and local decision-makers.
Most of us in radiology understand and speak the language of clinical radiology quite well. It is what we do every day. But the language of economics is difficult for many radiologists to grasp. The constantly evolving economic terms, with the myriad abbreviations and acronyms, are not necessarily intuitive. Radiology definitely has a need for more of us who can speak economics. Radiologists who are fluent in econ speak are in great demand. However, our profession needs more radiologists who can speak it at least superficially. How we accomplish this goal is an important challenge for the ACR and the Commission on Economics.
In September of 2017, I wrote in this column about the shift in economic policy from nationally driven to locally driven actions.1 Let us first discuss economic terminology at a national level. The Commission on Economics has individuals who speak radiology economics extremely well and do so regularly at national venues. They present new current procedural terminology (CPT®) codes to the CPT Editorial Panel, make valuation recommendations to the RVS Update Committee (RUC), and speak on new payment models at the Physician-Focused Payment Model Technical Advisory Committee. Often these talks involve emerging services. Therefore, at every one of these venues, success relies on clinical experts coming to the table with us. Those clinical experts confidently speak in clinical terms about their areas of expertise, but now they must also speak in economic terms. Getting this translation right is crucial to our advocacy efforts.
Many radiologists are doing exciting things locally. Examples include the introduction of new imaging technologies and proposing more comprehensive actions, such as clinical decision support or other value-based initiatives. Hopefully, decision-makers appreciate the goal of improved care, but they will want to know where the initiative fits into the current and future payment system. How much will they be paid? And what is the return on investment? Local radiologists have the opportunity to become the experts, and doing so is not as difficult as one may think. Take the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), the blueprint for future payment models, as an example. Few physician practices report being MACRA-ready. A recent survey of 2,000 physicians found that only 27 percent reported that they are ready. And the remaining 73 percent reported that they either were not at all prepared or needed help to get there. What a great opportunity for radiologists to assume the lead locally and to use that to springboard into greater leadership, responsibility, and stability for their practices.
Having more radiologists who are versed in econ speak is a huge advantage for our profession. But how do we improve economic literacy in radiology? How do we increase the number of radiologists who are knowledgeable about economic policy? The answer is rooted in education. And education must occur throughout a radiologist's career. Economic literacy must begin with our trainees. The ACR and the Commission on Economics are well-positioned to make this happen. For instance, the ACR's Radiology Leadership Institute® offers a resident-education program, which is now in its second year. And many residency programs, such as at Emory University, are providing this content to residents regularly. The ACR will continue to present economic content to those in training, including venues like our Advocacy in Action e-news (sign up at www.acr.org/aia) and more-detailed resources, such as the ACR Radiology Coding Source™, which keeps members updated on coding and reimbursement news (sign up at www.acr.org/rcs). Our ability to advocate for our role in health care may depend on our fluency in the language of radiology economics.
By Ezequiel Silva III, MD, FACR, Chair