ACR Bulletin

Covering topics relevant to the practice of radiology

Physicians First

A long-time radiology advocate has always seen the value in connecting with patients.
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While the problems that face underserved areas aren’t unique to radiologists, we need to be physicians first and radiologists second.

October 01, 2019

Many radiologists are faced with being more isolated and more disengaged with patient care.” This is a reality that shouldn’t be ignored — and one the ACR is working to change, says Raymond K. Tu, MD, MS, FACR, who was recently recognized by the Council of the District of Columbia for his work on healthcare disparities and the underserved. 

Tu, an active member of the ACR, councilor for its Washington, D.C. chapter, and president of the Medical Society of the District of Columbia, was appointed by Mayor Muriel E. Bowser of Washington, D.C. to represent nearly 12,500 physicians on the District’s Commission on Healthcare Systems Transformation. Tu is also the new chief medical officer at United Medical Center (UMC) — the first radiologist to serve as its physician executive. The Bulletin recently had an opportunity to learn more about Tu’s patient-centered philosophy. 

What has been some of your work in the underserved areas of Washington, D.C.?

The recognition I’ve received has been for the work I and other stakeholders, such as the Ward 8 Health Council and the Rodham Institute, provide our communities east of the Anacostia River. For example: several years ago, my medical staff peers at UMC, a safety net hospital that largely serves Medicaid and Medicare patients, recognized my unwavering pledge to provide the best care possible to all. The Council of the District of Columbia and DC Health are steadfast in their commitment to the health and protection of the public. UMC serves a community with many challenges, such as poverty, illicit drug use, behavioral health issues, obesity, asthma, cancer, stroke, and other conditions that are prevalent at the east end of the nation’s capital.

What does it mean to you, as a radiologist, that your work has not gone unnoticed?

While the problems that face underserved areas aren’t unique to radiologists, we need to be physicians first and radiologists second. Being involved locally and regionally with state medical societies, radiology organizations, and boards of medicine are all stairs available to us to climb. In the beginning, being the chair of radiology for three hospitals in the most underserved regions of Washington, D.C. was not in my comfort zone. I gained invaluable experience as a radiologist, physician, and patient advocate. The greatest personal honor I have each year is hooding a medical student (many of whom have chosen radiology) from The George Washington University’s School of Medicine and Health Sciences at its annual commencement ceremony. 

What are some of the challenges facing radiologists who want to be more patient-centric?

As reimbursements decline, so will margins. And with no margin, there is no mission — as mentioned at the ACR 2019 Economics Forum organized by Economics Commission Chair Ezequiel Silva III, MD, FACR. Some radiology groups have responded to decreased margins by putting more emphasis on volume over value, which will sideline the future of the specialty and interest in physician engagement. All organizations must embrace radiologists who have the skill and expertise to represent our specialty, build our brand, and maintain our value. 

What is the value of fighting for payment integrity?

When your radiology team of volunteers participates at the Current Procedural Terminology editorial panel and AMA/Specialty Society Relative Value Scale Update Committee, their effort to argue on behalf of payment integrity is their personal sacrifice of time from their practices — and all radiologists benefit. Physician volunteers are grateful to the ACR for the resources, and dedicated staff time, provided to us. 

Do you think radiology may be undervalued or overlooked as a specialty? 

Radiology is both an interpretative and non-interpretative specialty. Some current value calculators measure the “worth” of a radiologist with a case/shift formula. A misapplied ruler to achieve a preconceived result is perilous. Non-interpretive expertise not accurately measured will create physician demoralization and burnout. 

How can radiologists make a difference in patients’ lives? 

It might come down to a handshake, really. You need to introduce yourself, provide content and resources, and get your radiology group to embrace patient-focused thinking. For my part, reading cases and communicating critical results with a physician and patient are essential priorities. 

What are things radiologists can do outside the office?

A passion and willingness to speak in your community and specialty societies is a start. I accept every invitation to speak on television, radio, at churches, community centers and senior centers. The ACR provides several resources for volunteer opportunities. We should be looking for ways to connect with patients, peers, and students. Be the radiologist who says, “yes!” Begin with opportunities in your comfort zone, such as your local ACR state chapter. Seek opportunities to meet with other physicians in your medical office building or hospital. Engage your local state insurance programs to educate their staff; you may be invited to be a medical reviewer for them. Get to know your state Medicaid medical director. Speak at patient focus groups. Many patients are beneficiaries of the excellent radiology care they have received from you — and the emotions that arise from meeting “that doctor” who impacted their lives cannot be measured.