JACR: Radiologist-provider relations strained; rads need to get political

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Never before have so many hospitals and their radiology practices parted company, and relationships between radiologists and the healthcare systems that they serve must be improved, according to an American College of Radiology (ACR) Task Force Report published June 1 in the Journal of the American College of Radiology.

The report, which focused on relations between radiologists, hospitals and other healthcare organizations, offered reasons why tensions between radiology groups and hospitals have been increasing and proposed several recommendations that can help improve relationships between radiology groups and healthcare systems.

“In a small percentage of cases, it is the radiology group that initiates the departure; however, in the overwhelming number of instances, it is the hospital that ousts the incumbents and seeks a new radiology group,” wrote lead author Cynthia S. Sherry, MD, chairman of the department of radiology at Texas Health Presbyterian Hospital Dallas.

Noting reasons that could lead to a breakdown in the contract between radiology practices and healthcare systems, Sherry and colleagues offered that there is greater ease in replacing radiology practices in today’s climate of many options for hospitals, and administrators are growing less reluctant to pursue these options due to stricter financial constraints and the growing trends of outsourcing via teleradiology. Another factor citing in the report was “turf issues”- or debate over which group of physicians, radiologists or nonradiologists, should provide particular types of imaging services within hospitals.

Despite these concerns, Sherry and her colleagues wrote that radiologists hold the power to increasing their level of value and can more strongly influence their tenure by building and maintaining relationships.

“Radiologists must be more visible to patients, referring physicians, and the hospital administration,” wrote the authors, explaining that this can be facilitated by radiologists offering expanded hours of on-site coverage, a greater number of available radiologists, more subspecialization and greater opportunities for consultations with referring physicians and their patients, as the article noted that the development of technology, including PACS, have improved productivity while naturally reducing direct personal interactions between the radiologist and hospital medical staff.

The article also made note that radiologists should become involved in the political structure of the health system. “Radiologists should weave themselves into the local medical fabric by regularly attending medical staff meetings, serving on hospital and medical staff committees, and participating in local medical activities such as city, county or state medical societies,” wrote the authors.

The ACR must take a lead role in the education and protection of its members by providing leadership training and support, as well as funding campaigns to “clarify and enhance the role of radiologists and radiology,” according to the report. By extension, Sherry and colleagues wrote that health systems must encourage and support the implementation of programs such as the ACR Accreditation and Appropriateness Criteria programs.

“The challenges that radiology and radiologists will face over the next decade are unprecedented,” the article concluded. “Radiologists must rededicate themselves to the concept of service…[and] the ACR can play a vital role in improving the relationships between radiologists and the healthcare systems that they service.”