The crisis facing radiology is no secret. However, crisis need not turn into catastrophe, according to an online opinion piece in the March issue of Journal of the American College of Radiology. The expert authors offered 10 strategies for radiology practices to consider to ensure a vibrant and profitable future. The second five are outlined below, and the first five were profiled on March 18.
Each of the 10 steps is important, according to authors David C. Levin, MD, and Vijay M. Rao, MD, both from the Center for Research on Utilization of Imaging Services at Thomas Jefferson University, in Philadelphia, and Jonathan Berlin, MD, MBA, from NorthShore University Health System in Chicago.
The second five steps are:
6. Consider becoming affiliated with or employed by a hospital. “[The] model of the totally independent radiology group may no longer be viable,” cautioned the authors, who advised radiologists to ponder employment. Employed radiologists or those affiliated with accountable care organizations are more likely to receive referrals than those who remain independent.
7. Support and participate actively in utilization management. A host of stakeholders have taken note of the plethora of potentially unnecessary imaging, and diagnostic imaging secured a prominent place on the American Board of Internal Medicine Foundation’s Choosing Wisely list of commonly overused tests. “Now it is up to individual radiologists and their groups to follow through,” wrote the authors. They suggested use of the American College of Radiology (ACR) Appropriateness Criteria, radiology benefits management and computerized order entry with decision support.
8. Do more to publicize the ACR Appropriateness Criteria. Not enough physicians know about or use ACR Appropriateness Criteria, according to the authors, who focused on professional specialty journals as the primary avenue for promulgation.
9. Prepare for a probable era of lower reimbursements. Radiologists may want to set the stage for potential future negotiations regarding hospital employment. Another tough subject to broach is lower charges by the hospital for advanced imaging. Doing so may combat steerage by payers to lower-cost imaging providers.
10. Demonstrate to your hospital how an onsite radiology group adds value. “At every possible opportunity, onsite radiologists need to emphasize to their hospital and physician colleagues how much value they add to the care of patients and the operation of the hospital, value that is often ‘below the radar screen’ but that is real and should not be overlooked when contracts come up for renewal,” wrote the authors. Examples of value-added services include availability to answer patient questions, provision of in-service education to technologists and evaluation of appropriateness of requests for advanced imaging.
The researchers concluded by hinting of a bright future … if radiologists take all of their recommended steps.