As 2013 comes to an end, have we met our goals?
Last January my column was titled “Realistic Resolutions.”(Read the article at http://bit.ly/DrGResolutions.) I talked about ways that we as radiologists could take concrete steps to demonstrate our value. So as we head into 2014, where are we as a specialty, and are those resolutions still relevant?
At the time of this writing, in early November, we were cautiously optimistic that we might actually see the use of clinical decision support (CDS) using specialty-specific guidelines, such as the ACR’s, mandated for the Medicare program. This is significant recognition for our Imaging 3.0™ campaign. The language in the SGR repeal bill was the only specialty-specific language and represented the result of a multifaceted effort by the ACR staff and volunteers, including many of you. A key part of the effort was the Stand Up for Radiology program in the first quarter of 2013, for which members flew in to meet with their elected representatives to discuss the value of what we do. Later, hundreds of you who attended the AMCLC met with lawmakers during the annual Hill visits armed with a beta version of the ACR Select program on your smartphones. Your enthusiasm and your ability to tell the story of why radiologists are a critical part of the path towards high-value health care were crucial in building support among lawmakers for embedding the use of CDS into Medicare payment policy.
It’s impossible to know whether in the hurly burly of the legislative process our CDS language will have survived by the time you read this. Add to the usual uncertainty the fact that our Congress is bitterly divided after the debacle of the government shutdown of last October, and I am sure you’ll agree that we need to manage our expectations. But if we got coal in our Christmas stockings from Congress, we should not feel that we have achieved nothing.
Last year saw us make a fundamental change in our approach to how we present ourselves to the health care community. We continue to fight for fair reimbursement for our services, of course, but we have firmly planted our Imaging 3.0 flag to show that we as a specialty are committed to being part of the future of health care and that we are critical to its success.
So back to last year’s resolutions. I’m sorry to say that the shoe closet is fuller than ever in my apartment, but what I’m hearing from you all suggests that you embraced the Imaging 3.0 principles I outlined for 2013 and ran with them.
I will speak to a referring physician at least once a day.
The radiology and radiation oncology teams at Lahey Clinic have taken the notion of cross-specialty collaboration to a high level with their lung cancer screening program (learn more at www.lahey.org/lungscreening). Working with their pulmonology and thoracic surgery colleagues, Andrea B. McKee, MD, and her team have built trust and confidence in the ability of radiologists to manage the program. The opportunity to improve population health through lung cancer screening is an exciting one, and radiologists are the natural leaders of this important initiative. Forging stronger links with our clinical colleagues at all of our institutions will undoubtedly drive the success of this effort.
I will speak to a patient at least once a day.
A subcommittee of the Council Steering Committee is currently working through updating the ACR practice guideline for the communication of diagnostic imaging findings. In the interim, it is exciting to see patient consultation services popping up all over the country. Are there potential pitfalls and hurdles? You bet, but nothing will demonstrate our value as effectively as having our patients understand that we are their doctors. As Garry Choy, MD, a radiologist at Massachusetts General Hospital who runs the patient consultation clinic, said in an interview with Diagnostic Imaging magazine, “The consultation clinic allows radiologists to ‘be on the front lines.’”1
I will volunteer for a committee at my hospital or in my state medical society.
2014 sees two of our dedicated ACR members and volunteers take this resolution to a whole new level. Sanjay K. Shetty, MD, MBA, has assumed the role of president of the Steward Health Care Network in Boston, the second largest physician network in New England. Jon S. Lewin, MD, FACR, will be combining his position as chair of the radiology department at Johns Hopkins with a new role as senior vice president of integrated health care delivery. It is really inspiring to see radiologists taking on these kinds of health system leadership roles, and it underscores our value to the health care delivery system.
I will remember why I love my job.
Accompanying a dear friend for her needle localization procedure after making the diagnosis of a very small breast cancer, I planned on staying in the background and holding her belongings. But I wanted to be there just in case the radiologists at the big academic center had any concerns or questions about the images my friend had brought from my practice. I did not expect to be invited into the exam room, shown the post-localization mammogram, and complimented for making the diagnosis by the attending radiologist and his fellow. Such collaboration and generosity is why I continue to love being a radiologist.
By Geraldine B. McGinty, MD, MBA, FACR, Chair
1. Jones SB. “The Rise of Radiology Patient Consultation Services.” Diagnostic Imaging. Available at http://bit.ly/RadConsult. Accessed Nov. 4, 2013.