In Case You Missed It
ACR 2017: Tuesday, May, 23
Here are the goings-on from day three of ACR 2017
Lisa A. Kachnic, MD, president of the ACR Council, took the stage to update attendees on the activities of the ABR. Kachnic began by reinforcing the value of board certification in ensuring physicians meet defined standards, recognizing specialists, and engendering public confidence. “As our boards are currently under fire in state legislatures, we need your help,” said Kachnic. She encouraged ACR members to reinforce the value of ABR certification and maintenance of certification in their messaging to legislators.
In 2012, Interventional Radiology/Diagnostic Radiology (IR/DR) was approved by the ABMS as a separate clinical specialty. In response, the following new ACGME residency training pathways for IR have been developed:
- Integrated Pathway, which includes internship, three years of DR training, and two years of IR training
- Independent Pathway, which includes internship, four years of DR training (residency completion), and two years of independent IR residency training. The IR residency may be shortened to one year by completion of Early Specialization in Interventional Radiology (ESIR) curriculum in the 4th year of DR residency.
Meanwhile, initial IR/DR certification requires successful completion of the DR Core Examination and the IR/DR Certifying Examination, which includes two prescribed computerized modules and an oral exam.
Kachnic also gave a glimpse at what’s next for Part 3 of MOC. The ABR’s new Online Longitudinal Assessment (ABR OLA) will provide “a more continuous assessment of learning (not more frequent secure exams).” Diplomates will have weekly opportunities to participate and will receive repeat questions on topics answered incorrectly. In addition, participants will receive immediate feedback after each question is answered. Initial implementation may begin in early 2019, said Kachnic.
As the ABR works to bring continuing education opportunities to physicians, Kachnic emphasized the value the board brings to her career, saying, “I really count on the ABR material to make me the best doctor that I possibly can be.”
“My purpose is not to tell you where health care is going, because I have no idea,” said health futurist and medical economist Jeffrey C. Bauer, PhD, who presented as this year’s Moreton lecturer. Bauer’s comments focused on the significant uncertainty and chaos facing health care in the U.S. and the impossible task of predicting the future. He forecasted several possible trends in health spending and lauded the ACR for its initiatives, including Imaging 3.0®, which are leading the profession through such unpredictability.
Bauer presented several forecasts, which centered on health care spending:
- There is a 10 percent chance that health care spending will grow within the next five years.
- There is a 50 percent chance that health care spending will stagnate.
- There is a 40 percent chance that health care spending will decline.
So what does that mean for health care, including radiology? For one thing, if spending stagnates or declines, patients will not have disposable income to pay more for care, which will force providers to adjust their care delivery and pricing. Medical organizations are going to need to abandon the one-size-fits-all mentality that asserts that all health care practices are the same or that all clinical paradigms will remain the same. Local areas are diverse, Bauer said, and the practice of radiology in one market will not be the same as that of another. In addition, precision medicine and population are creating a personized, predictive, and preventive care model. “A revolution in biological sciences is shifting providers’ core function from acute care to disease management,” Bauer said.
Another outcome of stagnation or reduction in health care spending is that “clinical management will be key to eliminating care that patients do not need and cannot afford,” Bauer said. The elimination of unnecessary care will be necessary to financial survival in a no-growth market. He praised the ACR’s Imaging 3.0 program and its efforts to put patients at the center of the health care paradigm.
Bauer’s forecast on a national level was understandably nebulous. The upheavals and polarization that currently exist in government will prevent any long-term, enduring reforms, which will contribute to the uncertainty. As a result, Bauer noted, providers will be compelled to develop successful futures on their own. “And I don’t have to tell you, because you get it,” he said, suggesting that the ACR is taking the steps necessary to help shape radiology’s future.