Why Should You Implement Core Privileging?

Philip S. Cook, MD, FACR, FSIR, Chair, American College of Radiology® (ACR®) Interventional Radiology Core Privileges Oversight Committee, and Alan H. Matsumoto, MD, FACR, FSIR, Chair, ACR Commission on Interventional and Cardiovascular Radiology, contributed this post.

Philip S. Cook, MD, FACR, FSIR

The ACR Interventional Credentials Overview Committee was created in June 2017 to address the desire of radiologists to use the core privileging process for image-guided procedures.

Since 2019, the ACR has advocated for and supports the use of the core privileging process. More specifically, the ACR encourages the use of the core privileging process by diagnostic and interventional radiologists for image-guided procedures rather than having to document the volume and specific numbers of procedures to obtain privileges for multiple, different but related, procedures. The American College of Obstetricians and Gynecologists, American College of Emergency Physicians and Society for Vascular Surgery currently advocate for core privileges for their respective specialties.

Alan H. Matsumoto, MD, FACR, FSIR

Privileges are granted by hospitals or healthcare systems to providers who are appropriately credentialed, a process that is variable from institution to institution. To facilitate core privileging, the ACR Commission on Interventional and Cardiovascular Radiology created the Core Privileging Library as a tool to help institutions and diagnostic and interventional radiologists implement an image-guided core privileging process. The library includes useful background information, and importantly, core privileging templates from several large, urban university practices, a multi-specialty clinic and a small community/rural referral hospital as examples of documents that may be repurposed as needed.

The core privileging process has several advantages. First and foremost, it simplifies and streamlines the privileging process for both the physician and medical staff office, especially given the growing number of facilities at which a single provider must obtain privileges. Second, the process uses a rigorous method for privileging to ensure patient safety while not limiting patient access to needed image guided procedures. Lastly, core privileging recognizes the translational nature of a physician’s skill set, training and expertise. 

We hope that this resource will help diagnostic and interventional radiologists with the privileging and re-privileging process for image-guided procedures.

  • Visit acr.org to learn more about the Core Privileging Library and to access an introductory guide and other useful resources to assist with implementation.

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A Special Tribute to Our Nation’s Military Radiologists

Mohammad Naeem, MD, FACR, and Jennifer Nathan, MD, Co-Chairs of the American College of Radiology® (ACR®) General, Small, Emergency and/or Rural Practice (GSER) Network Military Subcommittee, contributed this piece.

Mohammad Naeem, MD, FACR

The opinions and assertions herein are the private views of the authors and are not to be construed as official or reflecting the views of the Uniformed Services University, or Departments of the Army, Navy, Air Force or Defense.

This Veterans Day, we are honored to reflect on the evolution of the ACR GSER Network Military Subcommittee. Our efforts began in January 2017, when the ACR expressed interest in strengthening their relationship with military radiologists.

To encourage ACR military member participation, the GSER Network Military Working Group sought to devise a process for nomination for Fellowship of the American College of Radiology (FACR). Frequent transfers and military assignments prevent many military radiologists from being involved with state chapters long enough to obtain FACR nominations, so in March 2018, the Military-unique pathway to FACR was approved. Later that year, the Military Working Group became the ACR GSER Network Military Subcommittee, which now includes 25 diverse members. Some of the Subcommittee’s other notable achievements include the addition of a military-unique CME session during the ACR 2019 meeting and the creation of a dedicated military section on acr.org in 2020.

Jennifer Nathan, MD

The Subcommittee also strives to create opportunities for military radiologists to participate in various ACR educational, operational and leadership activities. In addition, the ACR is proud to offer discounts on annual membership, educational products and CME-bearing activities for military radiologists.

The Subcommittee is dedicated to protecting, promoting and projecting military radiology’s interests and image at the national level while simultaneously increasing awareness and recognition of the unique value created by these military radiologists.

The specialized training and leadership experience of military radiologists allows them to offer a unique perspective to their civilian counterparts, especially on working in austere environments with limited resources and particularly in unprecedented times such as the COVID-19 pandemic. The day-to-day non-medical responsibilities of active duty radiologists require critical thinking, effective communication skills and the ability to adapt and overcome unpredictable circumstances on short notice. These unique skill sets coupled with the military decision-making process can be applied across the healthcare system to improve care for our patients.

For example, civilian radiology practices weren’t used to taking portable X-ray machines outside the confines of the hospital at the outset of the corona virus pandemic – but their military radiology colleagues were quite adept at this, from their deployments to overseas conflict zones in the past two decades. Consequently, military radiologists were able to advise the ACR on establishing ‘radiology facilities in field hospitals,’ as well as participating in ongoing conversations on disaster response.

The evolution of the modern-day battlefield and battlefield imaging has been intertwined with personal sacrifice, unwavering dedication and professional excellence since the beginning of the profession of radiology 125 years ago. American military radiologists have been vital force multipliers in every conflict this nation has faced including the Spanish-American War, World War I, World War II, The Korean War, The Vietnam War, Desert Shield, Desert Storm, Operation Iraqi Freedom, Operation Enduring Freedom, Operation Inherent Resolve, and now, response to the emerging asymmetric national security threats such as the COVID-19 pandemic. On this Veterans Day as our colleagues are packing their bags to deploy overseas, once again we reaffirm our oath to, “support and defend the Constitution of the United States against all enemies, foreign and domestic” and stand ready with pride, dignity and honor to answer the call of duty whenever and wherever needed.

  • Learn more about the ACR GSER Network Military Subcommittee, and find out how you can get involved at acr.org/military.

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Bridging the Gap: Saving Lives Through Lung Cancer Screening

Ashley Prosper, MD, Assistant Clinical Professor of Radiology at UCLA Health and Chair of the California Radiological Society Committee on Diversity and Inclusion, contributed this piece.

This week marks the start of Lung Cancer Awareness Month. Though we may recognize Lung Cancer Awareness Month in a much different way than before – due to COVID-19 – we remain focused on achieving equitable care for all by expanding access to and utilization of lung cancer screening.

This lifesaving tool enables providers to detect more early-stage, treatable cancers. Low-dose computed tomography (LDCT) screening is estimated to reduce mortality by 20% relative to chest radiography, and depending on a patient’s sex, can reduce mortality by 24 to 33% as opposed to not screening at all. Despite these excellent numbers, however, the utilization of lung screening with LDCT by eligible patients is woefully low, hovering at or below 5 percent.

What’s more, Black people are disproportionately affected by lung cancer. Black men, despite relatively lower rates of tobacco use, are affected by lung cancer more than any other group. Though this population is at a higher risk, data from the National Lung Cancer Screening trial suggests that Black participants who were screened had the greatest reduction in both lung cancer mortality and all-cause mortality. This data is a testament to the power of lung cancer screenings.

How can we take action to affect change? As members of the healthcare community, we have the capability to directly increase access and utilization across all communities. We must do all that we can to ensure that our patients can get the care they need, regardless of demographics, socioeconomic or other factors. Recognizing that lung screening is a process, it is imperative that LDCT screening programs are welcoming to all participants and foster a relationship of trust, encouraging patients to return for annual screening exams and seek treatment, if cancer is found.

The approach to affect change involves a multi-faceted, collaborative approach between academic institutions, public health specialists, and community and government leaders. This ideology is built on the foundation of population health, which is defined by the Centers for Disease Control and Prevention as, “an interdisciplinary, customizable approach that allows health departments to connect practice to policy for change to happen locally.”

The American College of Radiology® Lung Cancer Screening 2.0 Steering Committee has created several resources to help you get started. Recognizing that screening exams were paused early in the COVID-19 pandemic, tools include a Lung Cancer Screening Resumption of Screening Toolkit to help patients and physicians safely #ReturnToCare. These resources have been developed by leaders in lung cancer screening from across the country who are passionate about increasing access for patients. Aware that the screening process is ever evolving, these resources are regularly evaluated and updated by the LCS Committee.

We have an incredible opportunity to directly improve care for our patients through lung cancer screening. Let’s save lives together by supporting and growing lung cancer screening programs in our communities.

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