ACR Bulletin

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The House of Radiology

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Important work has been done to provide the highest quality care for patients and families through intersociety collaboration, but there is still a lot of ground to cover.

COVID-19 has highlighted many of the unjust structural inefficiencies of our healthcare system when it comes to vulnerable groups. We have to solve this problem.

—John E. Jordan, MD, MPP, FACR
October 21, 2020

In 1925, only four radiology societies existed in the U.S. — the American Roentgen Ray Society (ARRS), the RSNA, the American Radium Society, and the ACR. Today, that number has grown exponentially. More than 50 radiology societies represent every facet of the specialty.1 Having many voices can be a challenge, as different groups may have vastly different needs and goals. However, a spectrum of societies also provides a chance at valuable collaborations that not only improve radiology for patients and radiologists, but for healthcare altogether.

“We overlap with nuclear medicine, with our imagers, with IR,” says William Small Jr., MD, FACR, FACRO, FASTRO, chair of the ACR Commission on Radiation Oncology and the American Society for Radiation Oncology’s representative to the ACR BOC. “We all have our niches, but we’re all one house of radiology.”

One of the most prominent ways that radiological societies work together is to advance quality of care and information, notes John E. Jordan, MD, MPP, FACR, chair of the ACR Commission on Neuroradiology, a member-at-large for the American Society of Neuroradiology (ASNR) and a member of the ASNR board of directors. “Collaborative efforts between the ACR and societies like the ASNR have existed for decades and are only growing in importance,” he says. “We and others work very closely together to develop the ACR Practice Parameters, as well as projects like white papers that reduce variability in clinical decision-making and patient care.” To be truly effective, these guidelines require voices from around the specialty, says Jordan. “This highly specialized clinical or evidence-based experience wouldn’t be readily achievable or validated without close collaboration,” he explains. And this work goes beyond the boundaries of radiology. Guidelines such as the ACR Practice Parameters and the Appropriateness Criteria® are often used by physicians outside of radiology, Jordan says.

Collaborating in a Crisis

During the pandemic, radiology organizations quickly swung into action to share information as they learned more about COVID-19. A key multi-society initiative is the Medical Imaging and Data Resource Center. Created by RSNA, ACR, and the American Association of Physicists in Medicine (AAPM), the open-source database contains thousands of COVID-19 images and helps physicians better understand, diagnose, and treat patients with this new disease. Furthering the collaboration, the resource is hosted by the University of Chicago and funded by the National Institute of Biomedical Imaging and Bioengineering. Mary C. Mahoney, MD, FACR, chair of the RSNA’s board of directors and a member of the ACR’s BOC, says, “Group efforts like this, which leverage the strengths of each of the partnering organizations, will also prove valuable to advancing the specialty post-pandemic.”

Collaborative meetings like the annual summer conference of the Intersociety Committee — a freestanding committee of the ACR, established to promote collegiality within the field of radiology — give societies a chance to come together, collaborate, and share ideas. These meetings have resulted in expanding residencies to meet impending shortages resulting from the rapid increase of CT and MRI, shaping the future of the ABR examination, and more.2

“Between COVID-19, reimbursement changes, and other difficulties facing the specialty, it’s more important than ever to bring associations together to speak to what unites us and what we need to work on further,” says Angelisa M. Paladin, MD, MS, president-elect of the Association of Program Directors in Radiology and the ARRS Executive Council’s instructional courses committee chair. “We need to gather rigorous scientific data and provide evidence to demonstrate the value of our work,” says Michael D. Dake, MD, FSIR, president of the Society of Interventional Radiology. “This will become increasingly necessary as healthcare systems, private payers, and CMS continue to prioritize cost savings.”

Paladin agrees that collaboration has never been more important. “Radiology is at a crossroads right now. Our budgets have decreased, volume has increased, and many of us are lacking the resources to go to different society meetings. When societies work together on meetings such as the Intersociety Summer Conference, there is a greater chanceof having an agenda that reaches a larger audience. We are able to get more out of the few meetings we’re able to attend,” Paladin explains.

Between COVID-19, reimbursement changes, and other difficulties facing the specialty, it’s more important than ever to bring associations together to speak to what unites us and what we need to work on further.

—Angelisa M. Paladin, MD, MS

Using One Voice

Advocacy is another area where society collaboration excels. “Radiology groups have allied with each other to tackle all sorts of issues affecting the specialty — from giving opinions on payment policies to providing subject matter experts that help inform public policy at all levels of government,” says Jordan. Paladin adds, “Without working together to check our voices and goals in advocacy, many societies would be replicating efforts that would be much stronger when done in partnership.” She explains how recently, the specialty was concerned about the upcoming ABR Core Exam dates — as well as the possibility of making tests virtual to protect residents during the COVID-19 pandemic. “At first, a lot of different people were communicating various concerns ad hoc to the ABR,” says Paladin. “There were lots of different constituents with different concerns. Therefore, society leadership worked together to have one meeting with the ABR that resulted in a policy that covered the ABR’s concerns as well as residents’ and radiologists’ concerns.” That outcome wouldn’t have been possible without established good relations between the various parties, she says.

Although important work has been done through intersociety collaboration, Jordan believes that there is still a lot of ground to cover. “COVID-19 has highlighted many of the unjust structural inefficiencies of our healthcare system when it comes to vulnerable groups,” says Jordan. “We have to solve this problem. However, to be most effective, we need to be united in our voice.”

Mahadevappa Mahesh, PhD, FACR, chair of the ACR Commission on Medical Physics, agrees. According to Mahesh, social media is acting as a bridge to help physicians learn more about the marginalized communities they serve — as well as opening up possibilities for interspecialty and intersociety collaboration. “Prior to the pandemic, I wasn’t even aware that some of my colleagues were members of the LGBTQIA+ community,” says Mahesh. “I know it now because of our professional interactions on social media — probably because these colleagues feel safer speaking about this part of their identity online, rather than in physical professional spaces. A lot of conversations that my physics colleagues would normally have in private, pre-pandemic, are now taking place publicly on Twitter. This has resulted in physicians from other specialties taking notice and inviting
us to collaborate on care issues that intersect all of our specialties.”

Paladin is hopeful that despite the profession facing new adversities, the different radiology societies will continue to work together to provide the highest quality care for patients and families. “Rather than silo ourselves based on our different subspecialties or affiliations, we need to draw on the unique strengths that our different societies offer,” she says. “That way we will be stronger together.”


1. 1. Patti JA. Planning for the Future Through Intersociety Collaboration. J Am Coll Radiol.
2011; 8:595.
2. Naeger DM. “The ACR Intersociety Committee: History, Activities, and Membership.” J
Am Coll Radiol
. 2013; 10:341–344.

Author Meghan Edwards and Laura Sirtonski, freelance writers, ACR Press