Resident Highlights: July 2017 JACR
Speaking of Language: Mean What You Say and Say What You Mean
In this month’s “Speaking of Language”, Benjamin Wildman-Tobriner, MD, discusses the need not only to be concise with the impression, but to connect it to the prior impression — thereby, eliminating patient questions regarding whether or not a comparison has been made to previous views, and if such previous findings were considered in this viewing. Through our words, we should strive to make the impression succinctly, while expressing the nature of the clinical question to both the patient and ordering physician. Therefore, the author suggests that you read your impression once for grammar errors and a second time as if you were reading your report from the perspective of the patient and ordering physician.
The authors present a thorough discussion on the creation, by the Department of Health and Human Services, of the Health Care Payment Learning and Action Network, which is designed to formulate a framework for the alternative payment models that will change healthcare delivery in the United States. Most importantly, the authors — Joshua A. Hirsch, MD, Andrew B. Rosenkrantz, MD, MPA, Bibb Allen Jr, MD, Laxmaiah Manchikanti, MD, and Gregory N. Nicola, MD — explore the implications of this model to the future reimbursements of a radiology practice.
As a sort of “part 2” of the previous article, in this article, the future of reimbursement is further examined by authors Andrew B. Rosenkrantz, MD, MPA, Joshua A. Hirsch, MD, Bibb Allen Jr, MD, H. Benjamin Harvey, MD, JD, and Gregory N. Nicola, MD. As payment is quickly changing from a fee-for-service model into an episodic or lump-sum-payment model, which reimburses the hospital based off the procedure or diagnosis codes, the total piece of the payment pie will now be based on how resource- and time-efficiently you can treat a patient, without a 90-day readmission. The idea that these models are not radiology specific should not discourage a radiology practice from shaping this process, as our reimbursements will come out of that lump-sum payment, with or without our input.
The gender gap remains unchanged in radiology, with over two-thirds of the nation's radiology residents being male. By James C. Campbell, BA, Sora C. Yoon, MD, Sarah Wallace Cater, MD, and Lars J. Grimm, MD, MHS, the data suggests possible solutions for exploring rectification in the future. The study shows that the programs with the most success are those with female program directors and those in the Northeast and West.
The shaping and molding of a radiologist from a radiology resident is achieved not only by learning the pathophysiology of almost every disease process, but, say the authors — Vivek Kalia, MD, MPH, MS, Amy K. Patel, MD, Andrew K. Moriarity, MD, and Cheri L. Canon, MD —also by learning the most effective ways of reporting and the best ways to spend your money, once you are making the cheddar. Although book learning will help you become a good future radiologist, it won’t save you from the accidental social media slips, or show you how an RVU becomes a dollar, when you go out and look for your first big job. Your brand has already begun, but the most important steps to improving that brand is learning ways to convey yourself effectively with social media, while diversifying your experiences during residency to market yourself as, not just an average newly minted radiologist, but an invaluable member of a future practice, a member who can help shape a practice for the future changes to come.
Christopher Mutter, DO, ACR-RFS Secretary and Diagnostic Radiology Resident, Michigan State University/Spectrum Health