AMCLC Daily Wrap-Up: Monday, May 21, 2007


ACR Leaders Unite in Bold Vision for the College

Leaders of the American College of Radiology (ACR) gathered in Washington, D.C., this week, laying out a bold vision for the future of the College and the radiology profession. In a city known for its divisions, ACR leaders united to call for quality for patients, fair reimbursement for physicians, and the continuing success of the profession.

More than 850 council members attended the 84th Annual Meeting and Chapter Leadership Conference (AMCLC), discussing and debating radiology's future in the democratic style that is the organization's hallmark.

The leadership did not shy away from the difficult challenges ahead. Chief among the concerns voiced at the conference was the need to restructure the government payment system to ensure access for patients and reasonable reimbursements for physicians. The effort to change laws in Congress will be difficult, Board of Chancellors Chair Arl Van Moore Jr., M.D., told the attendees, but it must be done.

"Our patients deserve no less, and our country can afford no less," he said.

Blumberg: First, We Are Physicians

Excitement and optimism suffused the air as the College's leaders officially opened this year's AMCLC. Council Speaker Albert L. Blumberg, M.D., using a crutch to support a knee he injured helping his son move after college graduation, recounted the advice and care he had received from fellow radiologists.

"I'm going to remind us all: Though we may be radiologists of various stripes … we are first, above all, physicians," he said.

Blumberg was the first of several speakers to note the importance of young radiologists. "About 140 residents and fellows are attending the conference," he said, adding, "This is the future of our profession."

Moore: Giant Stirs in Washington, D.C.

Moore called the audience to action on some of the most important issues facing the profession. The ACR must take its message of access, quality, and fair reimbursement to federal and state legislators, he said.

Moore highlighted the ACR's government relations activities, pointing out that PRWeek has recognized the ACR as one of the nation's most effective advocacy organizations.

The College continues to fight the reimbursement cuts enacted in the Deficit Reduction Act (DRA) and remains concerned that this is only a first step by a Congress looking to dismantle "the long-standing, imperfect, but somewhat predictable, resource-based payment system without any clear visions of what system will replace it."

Last year, the ACR was instrumental in organizing and recruiting more than 40 organizations to the Access to Medical Imaging Coalition (AMIC), which seeks a congressional moratorium on DRA imaging cuts. While the lame duck Congress was in session, fixing the DRA proved impossible, but the ACR, in conjunction with other medical organizations, was successful in averting an across-the-board cut in the Medicare Fee Schedule. The Access to Medicare Imaging Act, championed by the ACR and AMIC and aimed at reversing the impact of the DRA, has been submitted in both the House and Senate. The bill is gathering co-sponsors daily, Moore said.

"Despite all these efforts, we have learned that both CMS (Centers for Medicare and Medicaid Services) and Congress continue to explore further avenues to reduce the technical component of imaging services performed in an office setting," he said. "While Congress last year was often paralyzed by its partisan infighting, it now appears the giant is awakening with its new majority, and we may face challenges we never dreamed of before."

In response to the challenges in Washington, D.C., the ACR has been educating radiologists across the country on what they can do to reach legislators. The ACR has also enhanced its Web-based communications to keep members up-to-date and created a more diverse Government Relations Commission to advocate for the profession.

Among other accomplishments Moore highlighted were:

  • Recent acceptance of the Journal of the American College of Radiology for indexing on Medline
  • Investigation of a branding campaign to identify what radiologists do and who we are
  • A white paper issued on radiation dose in medicine to counter concern about patient exposure to medical radiation
  • Meeting with international radiological organizations to look at cooperative efforts
  • Expanded accreditation programs; the ACR now offers a Cardiac MR program and is working on Cardiac CT, Modular MR, and Breast MR programs

Moore also detailed the ACR's clinical research programs. "ACR is far and away the leading organization in radiology and radiation oncology research," he said, noting that the ACR's Philadelphia research office has 40 to 50 trials open at any given time. Earlier this year, the College established a for-profit subsidiary to conduct pharmaceutical research.

"The coming year should be both interesting and challenging," Moore said. "I want you to know that, with your help, the ACR will be ready. It is up to you,it is up to us."

Neiman: State-of-the-Art Education Center

Detailing the ACR's continuous strides to serve its members, ACR Executive Director Harvey L. Neiman, M.D., took the podium. He added to the anticipation over the scheduled opening in January 2008 of the ACR Education Center, a state-of-the art training facility across the street from ACR headquarters in Reston, Va. . The center will offer hands-on learning and large data sets, as well as certificates of proficiency to help in hospital and insurance credentialing battles.

Neiman also flashed an image of the redesigned ACR Web site, which will debut June 1.

Ellenbogen: Solidly in the Black

Secretary-Treasurer Paul H. Ellenbogen, M.D., reported that the ACR is solidly in the black with its revenue from operations. Investment income has also benefited this year from Wall Street's bull market.

Elections

This year's conference was the scene of lively and friendly competition for ACR leadership and committee seats. Candidates were given two minutes to explain their suitability. Council Vice Speaker David C. Kushner, M.D., laughingly stood by with a large butterfly net he brandished when candidates went over their allotted times.

In the running for contested positions were:

Council Vice Speaker (one will be elected)

Alan D. Kaye, M.D.
Bridgeport Hospital, Bridgeport, Conn.
The president of a 21-person radiology practice, Kaye said he is hooked on the ACR's democratic process and noted that he has had leadership experience in almost every facet of our profession. "I have been a consistent advocate of you, the members," he said.

Thomas B. Fletcher, M.D.
Austin Radiology, Austin, Texas
Fletcher has led an effort to promote self-referral laws in his home state and promised to bring that energy to the ACR. "I shall persevere until self-referral is effectively neutralized as a threat to our profession," he said.

Council Steering Committee (three out of six will be elected)

Kimberley E. Applegate, M.D.
Riley Hospital for Children, Indianapolis
Describing herself as passionate about quality, Applegate co-authored the ACR's recent white paper on medical radiation doses and also authored a new guideline for screening pregnant women before an imaging test. "I believe our shared enterprise is to make radiology's future more successful than its past."

Mark O. Bernardy, M.D.
Diagnostic Imaging Specialists, Atlanta
In talking about his history of serving the college, Bernardy said that he is best known for having lots of ideas. "Not all of them are good," he said. "But my ego is not tied up in those ideas."

Robert D. Tarver, M.D.
Indiana University School of Medicine, Indianapolis
Tarver said he needed another two years to finish the work he has begun on the Steering Committee. "I want you to think of me as the guy who always tries to get people to know each other, to shake hands," he said.

Philip S. Cook, M.D.
Wind River Radiology, Lander, Wyo.
Cook said he would apply the same energy to the Steering Committee as he has brought to the position of president of the Florida Radiological Society. "Organizational vitality is a journey," he said.

R. James Brenner, M.D.
UCSF, Mt. Zion Hospital, San Francisco
The theme of accountability permeates everything he does, said Brenner. He also said that the differences among ACR members are less important than the uniting factors. "The common ground will be heard by those who pay us and regulate us."

Edward I. Bluth, M.D.
Ochsner Foundation Hospital, New Orleans
Bluth said that his long history of involvement in the ACR gives him a background of knowledge about the issues facing the Steering Committee. "I appreciate and understand the stresses and huge challenges," he said.

College Nominating Committee (three of five will be elected)

W. Ross Stevens, M.D.
Southern Illinois University, Springfield, Ill.
Stevens said he would work to identify leaders who would be responsive to members. "The ACR is not about us," he said. "It's about the people back home … doing barium enemas for us."

Biren A. Shah, M.D.
Advanced Diagnostic Imaging Inc., Saginaw, Mich.
Shah said he has the enthusiasm and organizational skills to serve on the Nominating Committee. "Leaders take individuals and institutions in new directions and are architects of success," he said.

Aruna Vade, M.D.
Loyola University Medical Center, Maywood, Ill.
Vade said she would search for candidates who are optimistic and fearless. "I promise that if chosen, I will not only be involved but committed."

Isaac Raymond Kirk III, M.D.
St. Joseph Radiology Associates, Houston
Kirk said that radiology by radiologists is a core commitment, but "our leaders must be able to work with other specialties committed to health care reform."

Nancy A. Ellerbroek, M.D.
Providence Holy Cross Cancer Center, Mission Hills, Calif.
As a doctor who has practiced in many settings, including serving medically underserved patients, Ellerbroek said the ACR must promote the College as the primary resource for all radiologists. "We must seek solutions appropriate for all practice environments," she said.

Members-In-Training Representatives to the Intersociety Committee (two out of four will be elected)

Henry Tsai Chen, M.D.
Montefiore Medical Center, Bronx, N.Y.
"If we claim quality is our image, our reports must reflect that image for all to see."

John C. Kirkham, M.D.
VCU Health Main Hospital, Richmond, Va.
"How can we educate the medical community on the appropriate use of our services?"

Javier F. Quintana, M.D.
Geisinger Medical Center, Danville, Pa.
"The most important things I've taken from my experiences are the listening skills I acquired and the compassion they provoked in me."

Colleen H. Neal, M.D.
University of Michigan Hospital, Ann Arbor, Mich.
"We should examine how we can make radiology reports more useful to clinicians and our patients."

Borgstede: Pay It Forward

ACR President James P. Borgstede, M.D., brought a simple, powerful message to those gathered in the nation's capital: Embrace change with a bold vision of the future.

"We must resist the strident pleas for the pseudo-sanctuary of the status quo," he said.

In an address capping years of service in the ACR's highest leadership roles, Borgstede asked members to do four things:

  1. Adapt to change, even if it means merging with other specialties or subspecialties. As an example, he said that radiology and medical oncology might one day be part of the same specialty.
  2. Uphold imaging as a part of a specialty, not as a commodity. Other doctors should not place orders for tests but rather requests for consultation. That may mean curtailing the use of after-hours services, Borgstede warned.
  3. Pay it forward. Invest in the future of the profession as payment to the rich opportunities created by the pioneers of the past.
  4. Embrace patient primacy. Radiologists should put a face on their profession by interacting directly with patients. Borgstede cited as an example a doctor who offers patients CDs of their scans, with a phone number if they have questions. "Behind every test is a patient… a patient who is worried, who is afraid," he said.

Borgstede ended the stirring speech with words about the future. "I've heard people say the golden age of radiology is over," he said. "I don't believe that. Our specialty is at its renaissance, and we must be part of that renaissance."