Rads + responsibility

As adults, most of us understand responsibility can be a heavy burden. It’s also a privilege that can be lost. Some days it’s downright unpleasant to take responsibility, but those who shirk it often ultimately wind up paying a high price. That may be why physicians' responses to the survey about “major responsibility” for healthcare costs published in the July 24/31 edition of JAMA seemed so frustrating.

The survey of 2,556 U.S. physicians indicated a pervasive lack of ownership for spiraling healthcare costs. The majority of respondents named trial lawyers, health insurance companies, hospitals and health systems and pharmaceutical and device manufacturers as bearing major responsibility for reducing healthcare costs.

Physicians did figure into the picture but as relatively minor players, according to the results. However, healthcare costs are a collective problem that requires a collective solution.

Surveyed physicians expressed minimal support for emerging payment reforms such as eliminating fee-for-service payments and implementing Medicare payment cuts.

Few of us truly welcome major change, especially those that seem to threaten our livelihoods. But bending the cost curve will require adjustments from all stakeholders—physicians, patients, payers and pharma.

Where does this leave radiologists? They can lead the way or drag their feet.

The opportunities for the specialty are expansive. This week’s top stories underscore a few possibilities.

A study published in the July issue of Academic Emergency Medicine estimated the national annual costs in the U.S. for patients presenting to the emergency department with dizziness at $4 billion. CT imaging, which is often ineffective and overused in these cases, accounted for $360 million in costs in 2011. Radiologists could take a leadership role in curbing unnecessary advanced imaging and cutting costs.

Meanwhile, a study published July 22 in Pediatrics revealed a relatively low rate of incidental findings on pediatric CT exams for blunt head trauma. The authors explored the challenges of dealing with incidental findings, and how ethical and medicolegal perspectives on how to proceed could conflict with each other. They noted the value of the American College of Radiology’s position papers on “incidentalomas” as an example. Given the anticipated ongoing nature of the incidentalomas issue, more leadership is essential.

Taking responsibility and helping to address these challenges will pay off for radiologists. They can have a seat at the decision making table and a voice in the future role of the specialty. Or they can abdicate responsibility and have decisions made for them.

How is your practice approaching responsibility? Let us know.

Lisa Fratt, editor