Burton P. Drayer, MD

CHICAGO—Burton P. Drayer, MD, president of the Radiological Society of North America (RSNA), met with Health Imaging prior to the RSNA annual conference to discuss the shifting paradigm for radiologists in clinical practice, and how they can better prove their worth in today’s clinical practice.

HI: This year’s theme of the annual meeting is 'Celebrate the Image.’ Why is that important right now?
Drayer: It is important that radiologists understand and recognize that they have been part of a revolution within healthcare. Medical imaging has been directly responsible for a change in the way medicine has been practiced globally. Sometimes, the importance of images in the patient care continuum gets taken for granted. This week, we’re going to celebrate how truly integral imaging really is, and direct our attention to the positive accomplishments of radiology within preventive care, diagnosis and treatment. 

Because of the pervasive economic uncertainties and the reduction in reimbursements for medical imaging, radiologists are feeling underappreciated. We, at the RSNA, thought it would be a good time to recognize what the field has accomplished.

HI: How will the conference specifically address these accomplishments?
Drayer: While the meeting will address the advancements of imaging techniques, this year, in particular, we are addressing how these techniques have been applied more wisely in recent years and how we have made advances in reducing radiation dose. In fact, there are quite a few presentations on dose reduction techniques and safer imaging for patients at this year’s meeting. The radiologist is in the center of this decision making, in order to make further dose reduction a possibility when they are performing a mammogram or a CT scan. The radiologists are working within their provider settings, as well as with industry, to ensure the lowest possible dose. 

The RSNA meeting provides a forum for a discussion for how we can make the images better with higher resolution and greater accuracy—regardless of modality. However, MRI and hybrid imaging are definitely taking center stage. One of our main sessions is focusing on the possibilities with hybrid imaging, such as its potential to identify vulnerable plaque with atheroscelorotic patients.

HI: In today’s clinical practice, how can radiologists increase and assert their role in the patient care continuum and in the clinical decision making process?
Drayer: Whenever a diagnosis is required—whether for orthopedics or various cancers—the radiologist is the one who reads those images and makes a decision for patients. However, that is not always recognized. Therefore, we need to make sure that patients, referring physicians and other caregivers understand the critical nature of our roles. These same people need to realize our role in dose reduction. Since patients often don’t see radiologists in the care setting, they are not always aware of the care that they provide. Radiologists need to be better advocates for themselves and their profession. 

In addition to our clinical role, we also have a role in proving the cost-effectiveness of our decisions. We are integrally involved with capital equipment purchases in the hospital setting. We need to evaluate which equipment is necessary or not.

HI: How has radiology’s close association with informatics and IT moved the field forward?
Drayer: The best way to decrease dose is to only conduct or order a study that is indicated. We can accomplish this task through the use of clinical decision support systems. Due to our early utilization of PACS, radiologists are very comfortable with the integration of IT with their daily activities. While we need to continue to be on the forefront of dose reduction, better decision making with test ordering also will prove our worth—whether that means recommending a different modality or not ordering the test at all. Finally, image sharing will be the new wave of dose reduction strategies, so we can ensure that images are not reordered regardless of where they were first taken.

In addition to his position at RSNA, Dr. Drayer is executive vice president for risk at the Mount Sinai Medical Center in New York City, and since 1995, has served as chair of the department of radiology at the Mount Sinai School of Medicine.