Center of Support
Radiation oncology is alive and well represneted within the College.
The ACR Commission on Radiation Oncology serves as the nexus for radiation oncology activities within the ACR. Radiation oncology has been an important component of radiologic practice since the founding of the ACR.
The five pillars of the ACR — advocacy, economics, education, quality and safety, and clinical research — are all represented prominently. The commission also serves as a means for radiation oncologists to interact with other specialties within the College, as well as with other national radiation oncology organizations. In many ways, the ACR is the face of radiation oncology, representing physicians who treat and cure cancer and alleviate suffering. We are fortunate that our past chair and the current ACR president, Albert L. Blumberg, MD, FACR, left our commission in a strong position. Thanks to his leadership, we are able to demonstrate the value that the ACR can bring to its radiation oncology members and to support radiation oncologists in advocating on behalf of our specialty.
Two of the commission’s most important areas of focus — advocacy and economics — are actually intertwined. There has been a great deal of activity regarding the Medicare Physician Fee Schedule, CPT codes, and advocacy at the RUC with respect to practice expense. We were successful in mitigating the most severe cuts that were initially proposed in the 2014 fee schedule.
Education has also been a focus for the Commission on Radiation Oncology. We are developing an American Institute of Radiologic Pathology course to serve the needs of radiation oncology residents and practicing radiation oncologists. There have been well-attended CME courses at the last four AMCLC meetings. In 2014, the AMCLC course will be titled “The Future of Radiation Oncology in the World of Value-Based Care.” Work is underway on developing radiation oncology programming for the 2015 ACR All-Member Meeting. Enduring materials are available to practicing radiation oncologists through the ACR website to obtain CME and SA-CME credits.
A new initiative related to education has been the ACR Journal Advisor™ (formerly Cogent Medicine). This website, with over 5,000 subscribers, allows physicians to receive journal articles along with expert commentary to help keep them current with the literature in radiation oncology. Last year in just one month, the website received over 1,500 visits, including over 1,000 unique visitors to the website.
In addition, the commission has been very active in quality and safety. The ACR Radiation Oncology Accreditation Program has been in existence for over 25 years and has nearly 600 accredited sites. ACR accreditation is a demanding process and involves an on-site review by both a radiation oncologist and a physicist. Our program is robust, with a cadre of surveyors, dedicated staff, and radiation oncology facilities, including my own, who are proud to say that they are ACR accredited.
Guidelines and standards is another area of activity for radiation oncology. Each year topics are reviewed, often collaboratively with societies such as ASTRO and the American Brachytherapy Society. These guidelines are used by radiation oncologists, payors, hospitals, and our colleagues in other specialties to indicate how oncology procedures can be performed and implemented in a way that maximizes quality of care and safety for our patients.
The ACR Appropriateness Criteria® in radiation oncology currently has nine panels covering 45 topics, including bone metastasis, brain, breast, gastrointestinal, gynecologic, head and neck, lung, lymphoma, and prostate malignancies. In a recent one-year span, 18 of these topics were published in a variety of leading journals. These evidence-based guidelines are widely utilized by residents and practicing physicians to help ensure that their patterns of practice are within national norms. Because these topics focus on issues of special interest to radiation oncologists, they are of great value to the radiation oncology community.
Finally, although the research pillar of the ACR is undergoing strategic changes, radiation therapy has long been represented by the Radiation Therapy Oncology Group® (RTOG®). Radiation therapy is now also represented in the Imaging and Radiation Oncology Core (IROC) organization, which is the quality assurance organization for the entire National Clinical Trials Network (NCTN), in which the ACR is the grantee. In recent years, the RTOG has been the center of multidisciplinary clinical research in radiation oncology. Each year scores of publications arise from RTOG trials. At the 2013 ASTRO meeting, all four plenary presentations featured RTOG research. The RTOG is based in the ACR Clinical Research Center in Philadelphia, and the College is developing its relationship with the RTOG as the RTOG enters into the NRG Oncology Group along with partners from the National Surgical Adjuvant Breast and Bowel Project and the Gynecologic Oncology Group.
Through our activities in advocacy, economics, education, quality and safety, and research, the Commission on Radiation Oncology helps to provide a focal point for radiation oncology activities within the College. It allows opportunities for members to be involved from their residencies throughout their careers as physicians. Advocacy and economics activities allow us to preserve the economic viability of our specialty so that we can have the resources to devote to quality and safety on behalf of our patients. We offer professional development through education and the advancement of the long-term interests of oncology by our involvement in clinical research. The commission also allows us to coordinate with other organizations both inside the house of radiology and throughout the realm of medicine. We could not pursue these activities without the active involvement of our radiation oncology members, dedicated volunteers, and the ACR staff who support our activities.
By Seth A. Rosenthal, MD, FACR, Chair, ACR Commission on Radiation Oncology