The Value of Flexibility

Dr Hardy PhotoThis post was contributed by Seth Hardy, MD, member of the ACR Commission on Economics.

Operations management is the study of organizational sustainability. There are four pillars of operations known as competitive priorities: cost, quality, timeliness and flexibility. Effective management of these competitive priorities is how the organizations in which we work and do business become sustainable. Once you are aware of them, they become quite obvious in our everyday lives. Organizations that neglect all of these priorities typically cease to exist.

In the car rental market, we have Budget and Hertz. They clearly compete with each other using cost vs. quality. Enterprise with their “we’ll pick you up” promise utilizes the timeliness and flexibility dimensions to gain a competitive advantage. As for Rent-A-Wreck, there is a reason you will not find them at any airport you want to fly to.


ACR Maine delegation meets with Sen. Susan Collins (R-ME)

Our College purports that, “Quality is our Image.” Among the medical specialty societies with which we compete, the ACR’s stake in quality serves us very well.  Every Hill Day, Senator Susan Collins (R-ME) is very generous with her time. She has made it clear that she listens to our ideas because they represent quality. The fact that they may bend the cost curve is a bonus. The access, respect and exchanging of concerns is based on an appreciation of quality. An organization that understands and exploits their competitive priority(ies), such as ACR does with its focus on quality, is hard to beat.

While the concepts of cost, quality and timeliness are understood to every child who has run a lemonade stand, flexibility as a priority is less obvious. However, if flexibility is well-understood, it is a very powerful space in which to compete. Certainly, if there were a Transformers car rental agency, I would carry their loyalty card in my wallet and toss the rest.

Charles Darwin tells us, “It is not the strongest of the species that survive, nor the most intelligent, but the one most responsive to change.” As the frequency and amplitude of economic and regulatory change increases, we must be flexible in order to sustain our operations. Listen to Darwin carefully; he is not only claiming that flexibility is the most important competitive priority, he is also linking it to resiliency and survival.

As you work and do business, start to recognize and analyze which competitive priorities are being used, if any at all. If sustainability and resiliency are of value within your practice and life, contemplate which competitive priorities you are going to exploit and remember the value of flexibility.

I invite you to use the comments section below to share examples of where flexibility has helped your practice overcome a challenge.

Jump Start Value-Based Imaging Care

This post was submitted by James V. Rawson, MD, FACR, chair of the ACR Commission on Patient and Family-Centered Care

RawsonHeadshotEmerging health care models are changing the way Radiologists and patients partner together and make care decisions.

ACR Chief Executive Officer William Thorwarth Jr., MD, FACR, recently noted that, “It’s imperative that radiologists be leaders in patient engagement since that collaboration is critical in the redesign of the nation’s health care system.”

Direct interaction between radiologist and patient (and their families) is not always possible, but opportunities to empower patients to make informed health care choices exist. Patients and their families can also be partners in facility renovation, designing patient experiences, improving safety and many other health care areas.

The American College of Radiology (ACR) Commission on Patient and Family-Centered Care works to ensure that radiology incorporates the needs, wants and values of our patients and communities. The College provides an evolving resource list to help practices do this.

The ACR continues to pursue other avenues to make radiology more patient- and family-centered. The College recently announced a collaboration with the Society for Participatory Medicine (SPM), which encourages patients to become responsible drivers of their health care and urges providers to value them as full partners in that process.

At the recent American Medical Association annual meeting, ACR members Marc H. Willis, D.O., and Jacqueline A. Bello, MD, FACR, highlighted how to build collaborations to improve imaging utilization through the Radiology Support, Communication and Alignment Network (R-SCAN). R-SCAN, which focuses on 11 Choosing Wisely® topics, creates a collaborative care team of radiologists and referring clinicians to improve imaging utilization, ensuring patients are at the center of care. ACR is collaborating with the AMA on a co-branded educational activity about clinical decision support under the AMA Steps Forward program, scheduled for release this summer. You can sign up to participate in R-SCAN and take the pledge here. I also encourage you to take a look at your practice and think about other ways to make the care you provide more patient- and family-centered.

So how do you jump start value-based imaging care? Like anything else, one step—and one patient—at a time. What’s your next step?

Virtual Colonoscopy Coverage a Reality (at Last)

The following post was contributed by Judy Yee, MD, FACR, chair of the American College of Radiology Colon Cancer Committee.

Dr. YEEYou may have seen the ACR press release announcing that the United States Preventive Services Task Force (USPSTF) recognized CT colonography among a list of colorectal cancer screening options that received an “A” rating from the government body. Under the Affordable Care Act, this means private insurers are now required to cover CTC and the other USPSTF-recognized screening options.

This is a tremendous victory for patients and the ACR, which has devoted tremendous advocacy and public relations resources to promote CTC and help make this happen.  

At present, CIGNA, UnitedHealthcare, Anthem Blue Cross Blue Shield and some other insurers cover screening virtual colonoscopy. More than 20 states require insurers to cover these exams. This week’s  USPSTF recommendations would now effectively require all private insurers who take part in insurance exchanges to cover beneficiaries for CTC and the other USPSTF-recognized tests.

Now, we are urging Medicare – which is not bound to provide coverage under the ACA – to cover seniors for CT colonography. Those discussions will play out over the coming weeks (and months). In the meantime, I urge you to educate your patients regarding CTC using materials in the CT colonography resources section of the ACR website and at

I also invite you to let us know how those efforts go using the comments section below. We are all in this together.