In Case You Missed It

ACR 2015: Sunday, May, 17  


May 2015

ACR 2015 started off with a bang. Here are the goings-on from day 1 of the conference.

Presidential Address: What If?

Paul H. Ellenbogen, MD, FACR, presents his report as president of the ACR.

“What if the ACR didn’t exist?” asked Paul H. Ellenbogen, MD, FACR, when he kicked off ACR’s first all-member meeting on May 17, 2015. Ellenbogen began his address by acknowledging the reality in which members currently practice. “Challenges to our profession both external and internal, and opportunities as well, have probably never been greater,” he said. Ellenbogen outlined the process of charting a course for the organization by launching a new strategic plan. “In that process we were asked to consider: what are our core values? Why do we exist? Do we deserve to continue to exist?” he recounted.

“One point was made very clear,” said Ellenbogen. “The American College of Radiology can do anything, but the ACR cannot afford to do everything.” With that understanding, the task became understanding where the ACR provides the most value to its members. This was summed up in the ACR’s new Core Purpose: “To serve patients and society by empowering members to advance the practice, science and profession of radiological care.”

In contemplating the value radiology brings to patient care, Ellenbogen wondered how different our world would be without the specialty. “What if a streetcar had hit Wilhelm Conrad Roentgen on Nov. 7, 1895, the day before he made his discovery of what he called X-rays?  What if Marie Curie had moved at age 21 from Poland to Prague instead of Paris? What if she never discovered radium and polonium and became an artist rather than a scientist?”

At each of these crossroads, the course of radiology could have diverged significantly. Ellenbogen added one last event to the list: “Dr. Albert Soiland founded the ACR in 1923. He died of a heart attack while visiting his homeland, Norway, in May 1946. What if his heart attack had come in 1922?” What would radiology be like without the ACR? Ellenbogen concluded his address with a famous quotation. “If we were given a long enough lever and a place to stand, we could move the world,” wrote Archimedes. “Well, you and I have a place to stand,” said Ellenbogen. “It is the American College of Radiology.”

CEO Report: Building the Future of Radiology

William T. Thorwarth, MD, FACR, delivers his second annual report as CEO of the College.

William T. Thorwarth Jr., MD, FACR, began his CEO report with a tribute to John J. Curry, former ACR executive director. Curry oversaw multiple important ACR programs, including quality standards (now practice parameters), accreditation programs, and appropriateness criteria. “On a personal note, it was at John’s urging that I became involved in ACR Economics, a life-changing event,” said Thorwarth. “We are all indebted to John and his impact continues as a foundation of the College today.”

The ACR’s strategic plan featured prominently in Thorwarth’s address. Thorwarth related that the ACR undertook the strategic planning process with the following assumptions:

  1. There are always more opportunities than there are volunteers, staff, and financial resources.
  2. There was substantial unnecessary duplication in the 54 radiology organizations.
  3. A selected group of high-quality high-demand programs is superior to a broad menu of programs.

The committee evaluated each of the College’s more than 300 programs and projects, based on the program’s attractiveness to members, consistency with the strategic plan, and uniqueness in the radiology community. “This is an ongoing process and programs will be periodically reassessed,” said Thorwarth. “This was not simply a budget balancing exercise, but rather a systematic refocusing and optimization of all of the College resources.”

Thorwarth also highlighted recent ACR developments. First up was the recent sustainable growth rate legislation. “After a long sustained effort by organized medicine, there will be no more quarter to quarter or year to year games of chicken played by Congress with our patients’ access to care on the line,” said Thorwarth. In addition, earlier this year, CMS officially announced coverage for lung cancer screening.

Overall, said Thorwarth, quality patient care underlies everything we do at the ACR. “The Imaging 3.0 strategy, supported by the numerous case studies written by many of you describing your successful experiences, has gained increased recognition both within and outside the world of radiology,” he said. “We know that the patient must remain at the center of care.”

BOC Chair Report: The Value Proposition

Bibb Allen Jr., MD, FACR, presents his report as chair of the BOC.

By the time Hippocrates declared medicine a separate science in 500 B.C., physicians had been practicing for centuries. In comparison, “our specialty has only been around 120 years,” said Bibb Allen Jr., MD, FACR, “but look at what we have accomplished together.” During his BOC chair report, Allen emphasized the value radiologists bring to their patients, their referring physicians, and their health systems. “Whether it is ultrasound, computed tomography, or magnetic resonance imaging, the evidence tells us that radiologists matter,” he said.

Allen cited recent research showing radiology’s impact on false positives for appendicitis, reducing the 20 percent negative exploration rate to just 1–2 percent. He went on to reference studies showing radiology’s positive impact on hospital length of stay, breast cancer, and lung cancer. “Whether it’s fewer operations, minimally invasive therapy, better outcomes, or more birthdays for our patients, it’s why we do what we do,” he said.

And to support the profession, said Allen, “the job of your board and steering committee is to leverage the resources of the College to help us keep doing the things we do best. We want the College to help all of us take the best care of our patients and demonstrate our value to the healthcare system.” Allen touched on lessons learned during the strategic planning process: “Many of you view the College as a career partner, and I think the [strategic planning] committee took that to heart. As expected, we heard the most important roles of the College are in advocacy, economics, and quality. But many of you indicated a need to focus on helping practices navigate health reform.”

One way the ACR supports its members in this new world of medicine is by carving out an integral role for radiologists. “In the end radiologists are in the information business — for our referring physicians, our patients, and our health systems,” said Allen. “Our ongoing initiatives, such as clinical decision support for our referring providers, our QCDR-approved data registries like Dose Index Registry®, decision support for radiologists, and actionable reporting are all integrated in the systems we use in our daily workflow.” The Imaging 3.0™ initiative also seeks to establish radiologists as valuable consultants in patient care. “Whether it’s within radiology or within the house of medicine or with patient advocacy groups, building relationships is important for our specialty,” he said. “In order to foster a shared vision for all of medicine, we have to align incentives — and establishing solid external relationships is critical to that mission.”

Convocation: Welcoming This Year’s New Fellows

Fellows wait for their names to be called at Convocation.

The Convocation of the American College of Radiology has always been a distinguished and — for some — emotional event. This year was no exception. More than 100 individuals dressed in black caps and gowns, donned colors representing their medical schools, and marched down the aisles to accept recognition of their fellowship. In addition to the fellows, the celebration honored the 2015 ACR Distinguished Achievement Award Recipient, Honorary Fellows, and ACR Gold Medalist.

Receiving the ACR's first Distinguished Achievement Award “is the highlight of my career,” explained an emotional Donald F. Lavanty, JD, who has spent 42 years advocating for the ACR as its principal legislative consultant. “When you have the foresight and dedication of the American College of Radiology and its policy, how can anyone lose in Washington? ... It's like having six howitzers on the beach in the Marine Corps,” he added, referencing his military career and thanking those who have helped him support and defend radiology.

In addition to Lavanty, the honorary fellows were equally grateful for their recognitions. Luis Donoso-Bach, MD, PhD, from Barcelona, Spain, noted that other countries often look to the ACR as a guide for how to protect and promote the specialty. Valentin Sinitsyn, MD, PhD, from Moscow, Russia, echoed the sentiment, stating that such standards as the BI-RADS® Atlas have provided guidance for the highest professional standard and ethics in radiology in his country.

Carl R. Bogardus Jr., expressed his gratitude for receiving the 2015 ACR Gold Medal. He also acknowledged that the award as well as the recommendation for the award, which came from the American Society for Radiation Oncology, underscored one of the main themes during his leadership in both societies in the early 1990s: unity of purpose. This theme helped radiologists address significant changes in radiology reimbursement. Today, he noted, medicine, not just radiology, will change in the next five years as fee-for-service gives way to a new system. “The point I want everyone to take home today is that you are going to have to design that new system,” he said.

Keynote Address: Taking Charge
General Colin L. Powell, USA (Ret.) delivers the keynote address at ACR 2015.

Sunday morning opened with a keynote address by General Colin L. Powell, USA (Ret.), who spoke to attendees about the leadership lessons learned in his time as general, national security advisor for President Reagan, and secretary of state under George W. Bush. The majority of Powell’s speech focused on leadership. “Leadership is saying, ‘There’s going to be a tomorrow — and I’ll make it better,’” he said. “Always be optimistic for the future.”

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