Looking on the Bright Side
Here are five reasons why it's a good day to be a radiologist.
It's easy to sometimes let the challenges of the specialty overshadow its successes. Questions like "How will health-care reform affect my practice?" and "Will reimbursement cuts continue?" plague many ACR members.
But the College fights every day to ease your concerns and help answer your questions. Fortunately, with hard work to ensure radiology's future and to demonstrate added value to the specialty come a number of rewards. From advancing technology to powerful advocacy campaigns, it's a good time to be a radiologist. Here's why:
1. Quality is King
By Jan. 1, 2012, all imaging providers who bill for the technical component under the Medicare Fee Schedule must be accredited through a CMS-approved accrediting organization, according to a CMS mandate to enhance the quality of patient care. As of Nov. 31, 2011, the ACR accredited more than 20,000 facilities and 30,000 units closely looking at image quality in each machine. Joel M. Schwartz, M.D., an ACR CT accreditation reviewer, explains, "I've had the opportunity through the ACR accreditation program to personally review CT protocols with the imaging center managers and technologists. The goal is to improve image quality and/or decrease radiation dose by optimizing the features that are available on their specific systems."
Other quality initiatives, including the use of the decision support and practice guidelines, exist throughout radiology and continue to expand. ACR Appropriateness Criteria® are purposed to ensure the right test for the right indication. Campaigns, such as Image Wisely™ and Image Gently®, also demonstrate the community's broader dedication to safety and quality patient care. Radiologists are more closely associated with both quality and safety and are ready to address public and patient concerns.
2. Technology Continues to Advance the Specialty
As a visually intensive and technology-based field, radiology has always invested in the use of cutting-edge equipment. From the integration of PACS and increased use of digital imaging systems, these technical advances have kept a strong pace. "We're in a period where we're ahead of our clinical colleagues in many ways," explains Howard P. Forman, M.D., M.B.A., FACR, professor of diagnostic radiology, management, public health, and economics at Yale School of Medicine in New Haven, Conn., who notes that nearly all practices use digital equipment rather than plain film.
In addition to these advances, technology created for the general public is now being applied to imaging departments and practices with promising results for streamlining workflows. With the advent and adoption of smart phones and tablet computers, speech-recognition software, electronic health records, and cloud computing, information is accessible anywhere. In this sense, radiologists can provide valuable consults to referring physicians while maintaining a manageable workday. "There's real truth in the fact that we have technology that makes everything more available and sharable," explains Forman.
3. Radiology Attracts the Best and Brightest
Though it may not be immediately apparent, radiologists' salaries are actually increasing. According to a report by health-care firm Merritt Hawkins & Associates, the average radiologist's salary for 2009-10 was $412,000 — a $26,000 boost form 2008-09.1 With the 6.6 percent increase, radiology exhibited the fourth highest gain in salary offers among medical specialties.
The slight surge has helped radiology's recruiting efforts. "We are attracting the brightest and most ambitious of our graduating medical students in this country," wrote Forman, in an article appearing in the American Journal of Roentgenology.
According to recent ACR research, radiologists also report working an average of 50 hours per week, another lifestyle benefit that may boost recruitment.3 And despite the fact that studies show workloads are increasing, "new technologies, such as 2- and 3-dimensional viewing and PACS, are probably the main methods by which radiologists are doing so much more work without working much longer hours," according to ACR research.3
So, despite CMS cuts to imaging, radiology may be in better shape than one realizes. "We've successfully proven that despite reductions in reimbursement from every payer, radiologists can continue to have competitive salaries compared to other specialties," Forman tells the ACR Bulletin. "We may face some additional aggressive reductions, but we're very well positioned for some really great opportunities."
4. Education and Training Are at Your Fingertips
Increased education and training are but another way to demonstrate the field's commitment to quality; by participating in continuing education, radiologists show a desire to provide the highest quality care possible. Today, education is changing to become more interactive and lifelike. "We want a process that simulates the work environment, evaluates learners' progress in that setting, teaches them based upon the results of that test, and then retests them," explained Cheri L. Canon, M.D., chair of the ACR Commission on Education and chair of the University of Alabama Department of Radiology in Birmingham, in "Ahead of the Curve," an article from the July/August 2011 ACR Bulletin.
As John A. Patti, M.D., FACR, chair of the ACR Board of Chancellors, wrote in "An ACR Triumvirate of Excellence in Education," (October 2011 ACR Bulletin) "three jewels distinguish ... the ACR from any other organization in providing education to our specialty." First, the College has been actively adapting to its members' educational needs — especially at the ACR Education Center in Reston, Va. In a survey from the center's October 2011 Breast Imaging Boot Camp, 94 percent of the attendees said the learning experience could be applied to improve his or her practice, and 100 percent responded that they would participate in another course at the center.
Meanwhile, the College's transition of the Armed Forces Institute of Pathology into the American Institute for Radiologic Pathology is improving resident understanding of the connections between radiology and pathology. Lastly, the recent launch of the Radiology Leadership Institute ensures that imagers acquire management and leadership qualities to set them apart in today's workforce.
5. Radiologists' Voices Are Louder than Ever
With health-care reform, cuts to reimbursement, the USPSTF's recommendations on mammography, and other challenges, the past years have necessitated massive vocalization from the radiology community. Radiologists from across the country have proactively led the way by forming a variety of advocacy and public information campaigns. In September 2010, the Mammography Saves LivesSM campaign launched to clarify confusion about the USPSTF's mammography screening guidelines. Then, in July 2011, the Radiology Saves LivesSM campaign took shape in anticipation of deficit reduction talks on Capitol Hill. Both coalitions were heard not only among the medical community but throughout Congress and the public.
Radiologists are also stepping out of the reading room to dispel misconceptions associated with the profession. The Face of Radiology campaign, developed by James P. Borgstede, M.D., FACR, past ACR president, and designed to educate patients and physicians on radiologists' skills and education, along with radiologists' increased direct communication with patients, have begun to emphasize how a radiologist adds value to patient care. Furthermore, residents are continuing a tradition to distinguish radiology's place in medicine through the Heart of Radiology campaign, initiated by Resident and Fellow Section President Arun Krishnaraj, M.D., M.P.H., from Massachusetts General Hospital in Boston. The campaign is a means to give back to local communities and simultaneously enhance radiology's image through resident volunteerism in local communities.
Despite the challenges the specialty faces today, more people are recognizing that radiology services are vital to care. In fact, more than 80 percent of registered voters in the United States think imaging is essential to diagnosis and treatment. And with a closer look at salary and workforce trends, technology advances, advocacy campaigns, quality initiatives, and training opportunities, one thing is clear: "The specialty will maintain a very central role in clinical care in this country," says Forman.
1. Correspondence, Pamela A. Wilcox, RN, M.B.A., ACR Assistant Executive Director for Quality and Safety. Aug. 31, 2011.
3. Forman HP. “Radiologist’s Salaries: Should We Worry?” American Journal of Roentgenology 2007;189:755–756.
By Alyssa Martino