ACR Bulletin

Covering topics relevant to the practice of radiology

Research That Fills An Important Void

As the Harvey L. Neiman Health Policy Institute (HPI) celebrates 10 years, Richard Duszak Jr., MD, FACR, discusses the HPI’s role in health policy research past, present, and future.
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Our team has focused on some of the thorniest issues that face everyday radiologists because these are the issues that will impact the sustainability and future of the profession.

—Richard Duszak Jr., MD, FACR
June 27, 2022

To say that Richard Duszak Jr., MD, FACR, has had an impact on health policy research in imaging is a bit of an understatement. Duszak was instrumental in planning the Harvey L. Neiman Health Policy Institute® (HPI) and became its founding CEO and senior research fellow in 2012. Since then, he’s served as chief medical officer of the HPI, as well as established and served as director of the HPI’s Imaging Policy Analytics for Clinical Transformation (IMPACT) Research Center at Emory University. Duszak is nationally recognized for his work in imaging health policy and has been instrumental in the success of the HPI. He has generated more than 300 scholarly works, which have consistently provided evidence-based policy recommendations that have been ultimately codified in federal rules and legislation. He has received numerous awards and honors, including the ACR’s William T. Thorwarth Jr., MD, Award for Excellence in Economics and Health Policy, and being named the most influential radiology researcher by the readers of Aunt Minnie. Along the way, Duszak has been a mentor for many radiology researchers, helping them produce high-quality health policy and health services research.

Duszak will soon join the University of Mississippi Medical Center as chair of radiology. Although this move will mark the end of IMPACT at the Emory University School of Medicine, the future of health policy research and HPI remains bright, in part due to Duszak’s contributions. The Bulletin caught up with Duszak to chat about HPI’s legacy, empowering future researchers, and his plans for the future.

Over the past 10 years, how have you empowered radiology researchers to produce high-quality health policy and health services research?
When I first helped start HPI in 2012, I remember a few leaders within the ACR asking me, “What’s your definition of success?” My answer was essentially this — in 10 years, if I were to step away from health policy research, the HPI brand, content, and the interest and value of policy research in radiology would still continue in an organic manner at multiple places across the country. I think we’ve been highly successful there.
For context — 10 years ago, our specialty rarely saw high-quality, rigorous health policy research at the degree we see being published now. Few journals were interested in imaging-focused health policy research, and while a few faculty in scattered academic departments may have been interested in health policy, it wasn’t valued as real scholarship by their leadership. I’d like to think HPI has helped moved that culture forward. Now, there are many investigators at different centers across the country who are interested in this space and who are creating quality work. Part of that is due to HPI’s efforts to mentor and sponsor rising-star investigators to make health policy research a part of their portfolios.

The HPI was established to fill an important void in research that delves into how policy decisions about medical imaging affect individual patients or the healthcare system. Can you describe the gap the HPI fills and why it is important?
In the past, when I was working in advocacy and I served on the Current Procedural Terminology (CPT®) Editorial Panel, I observed that much health policy was eminence-based — meaning somebody says, “Here’s my opinion. This is truth, and here’s what we need to do.” Little of it, particularly as it pertained to radiology, was evidence-based. I’d like to think that over the last decade, HPI helped policymakers shift to more evidence-based imaging decision making. We’ve helped provide meaningful, balanced, credible information and research to inform impactful policy decisions, not only in imaging, but more recently increasingly in health disparities and workforce domains.

When asked why he was so skilled at hockey, Wayne Gretzky replied, “I skate for where the puck is going, not where it has been.” HPI has taken that same approach to its research. Our team has listened and looked for upcoming problems that will impact what the specialty will look like in the future so that research is ready to inform and guide when these problems arise.

What are some of the important ways in which HPI research is providing and promoting objective evidence to ensure future imaging policies benefit patients and make best use of healthcare resources?
Our team has focused on some of the thorniest issues that face everyday radiologists because these are the issues that will impact the sustainability and future of the profession. For example, one of the biggest challenges that radiology leaders are dealing with is whether we’re optimally meeting the needs of the patients. Do we have enough radiologists to get the work done? Are we appropriately recruiting and retaining? Are radiologists appropriately distributed to meet patient needs, particularly in rural communities? We’ve tried to look at these questions through a range of lenses: What does this mean for radiologists, patients, and payers? What does it mean for health systems? The best way to inform the national medical imaging policy debate is to provide information that’s credible to all different stakeholders.
In 2019, you established and served as director for the IMPACT Research Center at Emory. What have been some of IMPACT’s major focus areas or accomplishments?

We strived to conduct timely, meaningful, and impactful research that would be published in peer-reviewed journals and garner the attention of healthcare reporters and ACR members. I believe that the IMPACT team has helped advance interest in research topics that have an opportunity to create meaningful change by informing policymakers about imaging and its contributions. I think we’ve also helped establish health policy research as a legitimate, credible, and meaningful approach to scholarship within radiology departments.

You will soon embark on a new role at the University of Mississippi Medical Center. What do you hope to accomplish there?
The University of Mississippi Medical Center is the only academic medical center in the entire state of Mississippi, the poorest state in the country and the state with the shortest population life expectancy. I want to see the department of radiology at the University of Mississippi Medical Center build on its incredibly solid clinical department and strong educational program. My vision is to take our regional top-tier department to the next level by building its brand as a national top-tier department for clinical care, education, and research.

Author Nicole B. Racadag, MSJ,  managing editor, ACR Bulletin