Safeguarding the Future of Radiology

Dayal_AnupriyaAnupriya Dayal, MD, radiation oncologist at Temple Health-Fox Chase Cancer Center and Pennsylvania delegate, American Medical Association Resident and Fellow Section House of Delegates, contributed this post.

As a member of the American Medical Association (AMA)’s Resident and Fellow Section House of Delegates (HOD), I recently attended the AMA Interim Meeting to help represent the views and perspective of radiation oncologists like myself. The HOD is the AMA’s policy-making body and is made up of a diverse group of physicians, medical students and residents representing every state and medical field. We work together in a democratic process to create and implement policy on various health care conflicts to ensure safe, high-quality and efficient care for patients and communities around the country. Our recent meeting focused on the protection of residents and fellows displaced by unexpected hospital closures and radiation oncology safety measures.

The Hahnemann hospital closure earlier this year was an unexpected event that disrupted the training of 960 resident and fellow physicians. There were no safeguards in place to protect affected residents and fellows. As a result, trainees were left unsure of the future of their careers. On top of that, the incurred relocation costs – added to an average debt of around $200,000 – have left many in an unexpected financial strain.

The AMA, along with the AMA Resident and Fellow Section coauthors, intervened to help find a solution for these residents and fellows. Our new policy allows us to partner with interested parties to identify viable options to secure malpractice tail-end insurance for residents and fellows impacted by the Hahnemann closure and for those impacted by any future teaching hospital closures, at no cost to those who are displaced. We’ve also committed to working with the Centers for Medicare and Medicaid Services to establish regulations that will help protect residents and fellows affected by training program closures.

Additionally, we discussed the recently released CMS Hospital Outpatient Prospective Payment System final rule, which includes a provision to change all radiation therapy services from “direct supervision” to “general supervision.” This rule is supported by the misguided notion that radiation therapy can be administered without the presence of an MD and is a glaring safety and scope of practice issue.

Radiation oncologists are the only medical professionals trained in reviewing toxicity of treatment, daily patient setup variability, real-time imaging interpretation for accurate radiation guidance and other clinical parameters which determine the safety of further radiation treatment administration. Our role is critical to ensuring safety in delivering high doses of radiation that may otherwise be fatal without supervision. As such, the AMA provided convincing testimony to encourage reconsideration by CMS.

As physicians, we are compelled to be advocates for not only our profession but also – and more importantly – for our patients. As radiologists, we provide expertise not only to other health care professionals, but also specialty-specific health policymaking. Membership in the American College of Radiology and the AMA help ensure that we have a seat at the table of health policy discussions that impact both our daily work and the future of medicine.

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