Whitney Palmer

Healthcare. Politics. Family.

Imaging in the ‘Ivory Tower’: Academic Radiology

Published on the Aug. 25, 2016, Diagnostic Imaging website

By Whitney L. Jackson

Throughout the radiology community, there’s one thing every provider has in common. At one point in time, you all completed a residency as part of your training.

Some radiologists never left academia. Instead of opting for private practice or choosing a career in teleradiology, they’ve chosen to remain in the “Ivory Tower.” They’re providing care to your patients like every other provider, but being a radiologist in an academic setting carries its own habits, benefits, and challenges.

And, according to Vijay Rao, MD, chair of the Board of Directors for the Radiological Society of North American and radiology chair at Jefferson Medical School at Thomas Jefferson University, as well as Tejas Mehta, MD, MPH, chief of breast imaging at Harvard Medical School, it’s a job selection that they are frequently thankful for.

“I love what I do, and if I had to do it all over again, I wouldn’t change a thing,” Mehta said. “You need to be passionate about what you do, and academic radiology provides a great work-life balance at the same time.”

Still, there is much to consider if you’re contemplating an academic radiology career – or much to learn if you’ve never experienced radiology practice from this perspective.

Benefits of Academic Radiology
Alongside being able to, potentially, work side-by-side with some of radiology’s thought leaders, being an academic radiology has some upshots.

1. Subspecialty Reads: The same way your residency gives you the opportunity to concentrate on a subspecialty, opting for an academic career allows you to focus your efforts in one specific area, said Rao, who has spent her career as in head and neck imaging.

“Only academic radiology allows you the luxury of practicing only in your field rather than having to do reads of all types,” she said. “This is very meaningful in contributing to providing the highest levels of care.”

2. Staying Young: Yes, you’ll age in your career, but choosing to remain in an educational institution ensures you’ll be surrounded by the next generation of radiologists at all times. Not only are they likely to be forward-thinking as individuals, but it’s also a requirement that they keep up with the most up-to-date data and technology in providing radiological care. If you’re constantly training aspiring radiologists, your skill set won’t have time to get rusty or dated.

To read the remainder of the article at its original location: http://www.diagnosticimaging.com/practice-management/imaging-ivory-tower-academic-radiology


August 25, 2016 Posted by | Healthcare | , , , , | Leave a comment

Wanted: Radiology Resident Leaders

Published on the Nov. 26, 2012, DiagnosticImaging.com website

By Whitney L.J. Howell

CHICAGO — With challenges looming on nearly every front, radiology needs a new group of strong leaders to navigate the trials and strengthen the profession, industry experts said at this year’s RSNA annual meeting.

Given proper leadership training, current radiology residents are positioned to be the profession’s next generation of leaders. But their training — if not already underway — must begin now if they’re going to fill the current void in the industry, said Richard Gunderman, MD, professor and vice chair of radiology at the University of Indiana.

“There are lots of radiology departments in the United States that lack leadership. Many have titular leaders, but in fact, they’re not being led or they’re being led poorly,” he said. “A lot of capability of the faculty and resident is lying dormant, and people are becoming more disengaged and discouraged than invigorated and encouraged.”

He recommended that faculty engrain in their residents the importance of team work — group accomplishment over individual successes — and embrace a leadership model that encourages others to work to their potential and contribute to either their practice or department.

It’s also paramount, he said, to encourage residents to think creatively so they will be best prepared to tackle future roadblocks.

“The single most important aspect of our residents isn’t their technical skills or their cognitive knowledge base. It’s their imagination,” Gunderman said. “What are we doing to foster the development of imagination in this next generation of radiologists?”

And, that creativity and outside-the-box thinking will be vital to addressing the difficulties the industry already knows are coming. Declining reimbursement, a new payment model, decreasing case volume, and encroaching teleradiology companies are just a few of the changes that threaten to erode the influence radiology departments and practices currently enjoy, said Vijay Rao, MD, chair of radiology at Jefferson Medical College at Thomas Jefferson University.

Surviving these trials requires a cultural shift in priorities that must start with residents, she said. Rather than perpetuate the culture of entitlement that is pervasive in many corners of radiology, faculty and private practitioners should teach residents to focus on quality and putting the patient first.

“We need to cultivate professionalism and eradicate apathy in the profession,” she said. “We must focus on reducing or eliminating inappropriate studies and doing the right thing by the patient.”

To read the remainder of the article at its original location: http://www.diagnosticimaging.com/conference-reports/rsna2012/content/article/113619/2116427

December 5, 2012 Posted by | Healthcare | , , , , , , , , , , , , | Leave a comment

Threats to Radiology and the 20 Ways to Beat Them Back

Published on the Dec. 3, 2012, DiagnosticImaging.com website

By Whitney L.J. Howell

CHICAGO — It’s a common topic of conversation in radiology today: The profession is under attack from several fronts. This lament is most certainly true, but there are several ways to conquer these problems, industry experts said at this year’s RSNA annual meeting.

But before you know how to fix the situation, said Jonathan Berlin, MD, associate professor of radiology at Northwestern University Feinburg School of Medicine, you have to understand the forces working against you.

The Threats

1. Declining reimbursement: This issue is no surprise. Since 2006, Medicare reimbursement as slowly dwindled. Until recently, the drops only affected the technical component, but this year, CMS retained the multiple procedure payment reduction (MPPR) to the professional component. It will eliminate 25 percent of the payment you receive for CT, MRI, and ultrasound imaging conducted by one or more providers in the same practice, during the same session, on the same day. Add bundled payments, combined codes, and the new accountable care organization model, Berlin said, and CMS is whittling away your reimbursement.

2. Bad job market: Ask any radiology resident, and he or she will tell you there are simply no jobs available in the field. Confusion around reimbursement and the radiologist’s role in health care has prompted many practices and departments to freeze any hiring efforts. Less job opportunity is already equating to fewer medical students pursuing radiology as a specialty, and existing resident morale is at an all-time low, he said.

3. Commoditization: In recent years, rather than focus on all the work associated with diagnostic imaging — the pre-, intra-, and post-service — radiology has placed the greatest emphasis in image interpretation. And hospitals and referring physicians have followed suit, giving the profession the reputation for being a commodity rather than an integral specialty. Many facilities now outsource their image reading to the lowest bidder, and many insurance companies now steer patients to facilities that offer services at the lowest cost.

4. Teleradiology companies: Although shifting night reads initially seemed like a good idea, corporate teleradiology companies are now expanding beyond nighthawk work. Many are now stealing hospital contracts away from local radiology practices, promising to offer high-quality care at reduced cost.

5. Medically-inappropriate imaging: CMS and other health care agencies now estimate that 35 percent of all imaging studies conducted are unnecessary and don’t contribute to diagnosis. A major reason for this is self-referral, non-radiologists who purchase scanning equipment in order to perform studies without sending a patient to an outside radiology practice. In many cases, the physicians are practicing defensive medicine, but they lack the proper skills to correctly interpret studies.

While these challenges are significant, said Vijay Rao, MD, chair of radiology at Jefferson Medical College at Thomas Jefferson University, there are many strategies at your disposal to reverse these trends.

1. “Take back the night”: Don’t outsource to teleradiology companies, and don’t work for them. Instead, find a way to bring night reads back into your practice.

2. Consolidate: If your practice is too small to handle night reads alone, consider merging with a larger group or multiple groups. This move can also increase your ability to offer subspecialty services. Mega-groups, she said, will likely be very common in the future of radiology.

3. Affiliate: Free-standing practices are vulnerable under the new models of care. Contract with a hospital or a larger multi-specialty group. You could even consider becoming a hospital employee. Any of these decisions would help protect your revenue.

4. Build bridges: Work on your relationships with hospital administration and become more active in hospital management structure and culture. Currently, most of these relationships are strained, Rao said, but you can nurture them by serving on committees, getting involved with quality and safety measures, or participating in strategic planning or marketing efforts. Jumping into the hospital culture will show that radiologists add value.

5. Manage your department: Don’t be afraid to take on more responsibility for your department’s management; Hospital administration is generally amenable to letting you do this, and you could get paid for it. Create financial targets and propose getting a portion of the savings if you meet the goal. The more you show administrators you’re a team player and can help control costs, the less likely you are to lose out to a teleradiology company, she said.

6. Control image utilization, even if it hurts: Do everything you can to make hospital leadership understand the importance of order entry and decision support systems. It might take money out of your pocket, but it’s the right thing to do for patients, Rao said. As with department management, work on an arrangement where your department and the hospital split the cost savings from reduced imaging equally.

To read the remainder of the article at its original location: http://www.diagnosticimaging.com/conference-reports/rsna2012/content/article/113619/2117464

December 5, 2012 Posted by | Healthcare | , , , , , , , , , , , , , , , , , , , , , , , | Leave a comment


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