April 27, 2018

ACR Clarifies Policy on Radiologist Assistant

Some members have expressed concerns about the ACR’s plan to advocate in favor of the Medicare Access to Radiology Care Act, or MARCA, during its Hill Day on May 23. As ACR leaders we take those concerns seriously. This is your organization. We appreciate the opportunity to address the concerns raised.

Below is an outline of the longstanding history of ACR Council policy on the Radiologist Assistant. We would also like to clarify areas of confusion. Lastly, and most importantly, we detail the processes which are in place to allow for policy resolutions to be addressed at the Council meeting in May 2018.

ACR Council Policy on Radiologist Assistant

The ACR Council, your representative policy-setting body, first voiced its support for a training program and supervisory requirements for Radiologist Assistants (RA) in 2003, and has reiterated this support repeatedly, most recently in 2016. This policy emanated from an environment of concern that physician extenders with no radiology background or experience would insinuate themselves into radiology practices.

The ACR’s support for these RA programs has been years in the making, working collaboratively with the ASRT, ARRT and SRPE (Society of Radiology Physician Extenders) to ensure:

1) A mutually agreed upon RA scope of practice
2) Practice supervision by radiologists is never compromised and
3) An absolute ban on interpretation by the RA

To date, these fundamental tenets have been incorporated into all state laws where RAs are recognized and registered. In addition, the proposed changes to the Medicare program espoused by MARCA contained in HR 1904/S 769 defines an advanced level radiographer (RA or RPA) “as a radiology practitioner assistant to perform [sic] radiology services under the supervision of a radiologist.”

The ACR believes that the recent aggressive posture of Advanced Practice RNs advocating for the independent practice of medicine actually confirms the original concern about physician extenders with no radiology background insinuating themselves into radiology practices and reaffirms our continued support for radiologist-trained and supervised RAs and RPAs, especially for those practices that desire to incorporate “advanced practitioners.”

We understand the health care environment has changed in ways not anticipated, particularly the independent practice of medicine by physician assistants and nurse practitioners. Therefore, it may be appropriate for the Council to either reaffirm its’ long- held support or amend its’ current position. As with any policy decision, this action would be the responsibility of the Council.

As always, we want to make sure that all voices are heard during the May annual meeting regarding issues that appropriately come before the Council. To that end, we want those who would like the Council to revisit this policy to be aware that ACR Councilors may submit Late Resolution(s) if they wish to do so.

Any resolution received after the resolution deadline and at least 72 hours prior to the opening session of the Council will become a “Late Resolution” and must be considered by the Council Steering Committee to be emergent in nature in order to go forward to the Council.

Late resolutions, not approved by the Council Steering Committee, and resolutions introduced from the floor of the Council will require a two-thirds majority vote by the Council before they can be considered.

Information regarding the submission of a Late Resolution can be found on page 4, section 5 of the “Councilor Handbook” under the ‘Submission of Resolutions’ heading at the following link: https://www.acr.org/-/media/ACR/Files/Governance/Councilor-Handbook.pdf?la=en

The ACR Leadership appreciates the opportunity to share how College policy is established and provide its’ concerned members with the tools necessary to further deliberate and craft ACR policy.