Connecting With Primary Care on Appropriate Imaging

As a private practice radiologist for over 20 years, I find that one of the greatest sources of job satisfaction is collaborating with other physicians and health care providers in order to provide the best patient care. For many years, I have presented programs on appropriate imaging to primary care physicians and nurse practitioners both at local and statewide meetings. I try to spread the message of the tremendous benefit of appropriate imaging while providing information about the downsides of inappropriate imaging including cost, radiation exposure, false positives, incidentalomas, etc. It is very rewarding to receive positive feedback that these educational programs are useful and enhance our common goal of providing better patient care. As medicine transitions from a volume to a value driven model, I would encourage private practice radiologists to give CME programs in their communities on imaging appropriateness and the value of using ACR Appropriateness Criteria®. The ACR criteria are a great resource for clinicians, but unfortunately, in my experience, most primary care providers are unaware of them or how to access them. By educating our primary care colleagues on ways to ensure appropriate imaging, and by being available to help decide on the appropriate test for the given illness or injury, we will not be seen as gatekeepers, but as part of a health care team trying to obtain the best outcomes for patients. Developing and maintaining strong relationships with our referring physicians will be increasingly important as reimbursements reflect both outcomes and patient satisfaction with our care.

Author – Rob Milman, M.D.
Austin, TX

Radiology’s Team of Advocates

I spent most of last week at the AMA/Specialty Society Relative Value Scale Update Committee (RUC) meeting. For anyone not familiar with it, the RUC makes recommendations for valuation of services to Medicare. With pressure to restrain spending and a relatively fixed pool of money to spend in the Medicare Physician Fee Schedule the discussions can be robust and often challenging to those presenting. I sit on the RUC as the radiology member, but I am required to act as an expert not an advocate. We are lucky, therefore, to have a team of radiologists, known as RUC advisors, who are not only experts, but can also be passionate advocates for the value of what we as radiologists do for our patients. They present the results of surveys that you complete and argue for appropriate valuation. The American College of Radiology’s (ACR) team is led by our Economics Commission Vice Chair, Zeke Silva, M.D., and our team works closely with representatives from the American Society of Neuroradiology; Society of Interventional Radiology; Society of Nuclear Medicine and Molecular Imaging; American Roentgen Ray Society; Association of University Radiologists; Society of Breast Imaging and others to make sure that we advocate for fair reimbursement for the services you all provide.

The days at the RUC are long; 10 hour meetings are not unusual. Radiology has been the busiest specialty there in recent years. Each person representing our profession took at least 3 days away from their practice (and does this 3 times per year) to be there on our behalf. I want to thank our team, including our amazing ACR staff, for their dedication to our specialty and more importantly to our patients.