This post was contributed by Gunjan Malhotra, MD, radiology resident, University of Michigan Class of 2021 and newly elected vice chair of the American Medical Association Residents and Fellows Section.

My introduction to, and passion for, advocacy and organized medicine began during my first year of medical school in Detroit, where the Wayne State University School of Medicine’s curriculum specifically aimed to expose medical students like myself to medical advocacy. It was through that curriculum, and organized advocacy days at our capitol in Lansing, MI, that I realized the importance of policy and legislation to the practice of medicine.

It was also during my first year of medical school that I attended my first American Medical Association (AMA) meeting, where physicians and physicians in training from all over the country – representing more than 130 national medical societies, military service groups and professional interest medical associations – came  together to discuss policy pertinent to our practice and patients.

My involvement with the AMA revitalizes my passion for medicine every year. I have found lifelong friends and mentors from across the country, and have been able to collaborate on a number of resolutions over the years on topics related to patient care and physician practice.

My experiences also led me to find the American College of Radiology (ACR) delegation as a fourth year medical student, which has now become my home within the AMA as a resident. The ACR delegation has shown me the power of working together with physicians from other specialties as a united physician organization. In the end, we all share the common goal of providing the highest quality care for our patients.

Through the support of my fellow resident and fellow colleagues in the AMA, the ACR and the Michigan State Medical Society, I was recently elected vice chair of the AMA residents and fellows section for 2018-2019. I look forward to representing the radiology community, my state society and the residents and fellows in this role.

As radiologists continue to support clinical decision tools, advance the use of appropriateness criteria to determine the most appropriate imaging or treatment decision and lead the way with AI, we will show our physician colleagues the true value radiology brings to medicine. 

• When were you first introduced to the importance of medical advocacy in radiology and across specialties?
• How are you collaborating with other physician colleagues to deliver the best care for your patients?

 Please share your thoughts in the comments section below and join the discussion on Engage (login required).

This post was contributed by Arl Van Moore, Jr., MD, chair of the ACR Delegation to the AMA House of Delegates.

At the American Medical Association (AMA) Annual Meeting in Chicago earlier this week, Scott Ferguson, MD, founder of Outpatient Radiology Clinic in West Memphis, Arkansas, was elected to the AMA’s Board of Trustees. I am proud to announce that radiology now has a voice not only on the Board of Trustees, but also on four of the six AMA Councils.

Other members of the AMA Radiology caucus have taken on the following leadership roles after being elected at the A-18 AMA meeting:

• Kevin Reilly, MD (KY) – Council on Constitution and Bylaws
• Sheila Rege, MD (WA) – Council on Medical Service
• Gunjan Malhotra, MD (MI) – AMA RFS Vice-Chair

And two radiologists already serving on AMA councils are:

• Jacqueline Bello, MD (NY) – Council on Medical Education
• Alex Ding, MD (CA) – Council on Science and Public Health

The American College of Radiology (ACR), the AMA and these elected leaders each recognize the importance of collaboration across specialties with respect to improving the delivery of patient care. As health care in the United States moves increasingly toward value based, patient- and family-centered care, radiologists have unique opportunities to improve the patient experience, reduce and eliminate unnecessary procedures and maximize value. We are leveraging the ACR Appropriateness Criteria to help referring physicians make the most appropriate decisions for specific clinical conditions. We’re learning from case studies like this recent example in suburban Philadelphia, where radiologists and emergency department physicians used the Radiology Support, Communication and Alignment Network (R-SCAN)™ to achieve a 45 percent improvement in appropriate CT ordering for pulmonary embolism.

Both the AMA and the ACR are also increasing efforts to engage with medical students and better prepare the next generation of doctors for the opportunities and challenges they will face. Nearly every hospital patient will undergo some type of radiological exam, yet undergraduate medical education curricula often don’t include comprehensive instruction on appropriate imaging. This results in some patients experiencing unnecessary imaging, radiation and costs. The web-based program Radiology-TEACHES uses case vignettes in ACR’s CORTEX integrated with the CareSelect™ clinical decision support (CDS) tool to simulate the image ordering process and educate learners about appropriate imaging.

No matter where we as radiologists fall on the continuum of an individual patient’s care, we possess a unique opportunity to break down silos and enhance collaboration that leads to better outcomes. This is true not only within radiology but also across specialty lines as we work with colleagues in different referral specialties. It will require good leadership within our specialty as well as a commitment to teamwork to help bridge these gaps and develop these teams. This representation at the AMA will help us accomplish that!

• How are you working to collaborate across specialties and build health teams to achieve better outcomes for your patients?

Please provide your thoughts the comments section below or on the Engage discussion board (login required).

This post was contributed by Geraldine B. McGinty, MD, MBA, FACR, chair of the American College of Radiology Board of Chancellors.

When it comes to shaping health care’s move from volume to value-based care, “if you are not at the table, you are on the menu.”

As I stated in my recent presentation at the American Society of Neuroradiology (ASNR) Annual Meeting, value-based payment is not going anywhere. Despite recent slowdowns in the implementation of the MACRA legislation we must remain engaged.

One of the primary challenges that ACR is addressing is developing metrics that accurately apply to our work. It is challenging to develop “metrics that matter.” Several ACR commissions and scores of College volunteers and staff are doing so.

We are also in dialogue with the Centers for Medicare & Medicaid Services (CMS) to help ensure that these metrics are what will be applied to radiology as Medicare’s Quality Payment Program moves forward (and not those made up for us by others).

Imaging clinical decision support (CDS) is a unique opportunity for radiologists to demonstrate their value as stewards of appropriate imaging. Starting Jan. 1, 2020, Medicare will require referring providers to consult these appropriateness-criteria based systems prior to ordering advanced imaging for Medicare patients.

The Radiology Support Communication and Alignment Network (R-SCAN™) is a great (free) way for you and your referring providers to get started with CDS now.

You can build your role as “steward” and gain continuing medical education credit and American Board of Radiology maintenance of certification Part 4 credit.

Both radiologists and referring provider practices can fulfill their improvement activity credit requirement under MIPS by completing an R-SCAN project.

Value-based care is here. ACR is at the table.

• What is your experience participating in the ACR’s value-based care initiatives
• What other value-based care initiatives do you think would be helpful for the ACR to support?
• What barriers have you experienced and what recommendations do you have for overcoming or avoiding?

Please share your thoughts in the comments section below and join the discussion on Engage (login required).