Facility Management

Proposed new credentialing requirements could make it more difficult for hospitals to contract with teleradiologists to provide night and weekend call, a legal analysis concludes.

All across the country high-tech imaging volumes are flat or declining compared with last year.

Until we broke down the numbers, we didn’t realize that our practice’s overnight call coverage cost had increased by 200% in just three years. We had to take a close look at the root causes before we could agree on the solution.

Medical acronyms are intended to boost efficiency. The advantages of brevity should be weighed against the possibility of crypticness (making the communication harder for others to understand) and ambiguity (having more than one possible interpretation). In other words, a smart communicator uses good shortcuts but makes sure that other people will understand what he or she means.

Because of all the attention currently focused on radiation dose, a California imaging bill addressing radiation exposure has the potential to spread like wildfire to other states. California is a state that doesn’t wait for others to address a problem, so it’s possible similar bills could pop up around the country. The bill has passed the California senate and is now in the California Assembly Appropriations Committee with a hearing set for Aug. 4. Sen. Alex Padilla (D-Pacoima) is lead sponsor of the bill.

From the hospital's perspective, a radiology group's quality is measured by quality assurance reporting, working well with others, participating on medical staff committees, and other administrative duties. Still, a highly competent radiology practice, one with "quality" radiologists, can lose a contract over basic service issues, nonphysician interpersonal relationships, or other common administrative expectations.

Most radiologists have fundamentally the same concerns: How do I maintain a good income? How do I balance the increasing demands of time/speed with my overall workload? Am I increasing my potential clinical risk? Wwhat is going to change next?

New supervision requirements for diagnostic services provided to hospital outpatients could threaten the ability of many hospitals to meet Medicare requirements for outpatient tests. The rules took effect July 1.

In a previous radiology lifetime (not so long ago), geography was the friend of the radiology group with an exclusive hospital professional services agreement. Life was tidier then, with turf carved out in a relatively collegial fashion among radiology practices who maintained a gentleman’s agreement not to compete across certain lines. Geographic distribution and a “moat” of agreed-upon boundaries provided a level of strength so groups could also exhibit an adversarial stance when dealing with hospital administration. And they frequently did. They also tolerated bad behavior among members of the group and, in some cases, seemed to view their contracts as entitlements.

Physicians can improve coding decisions by better understanding needle-based and catheter-based thoracentesis techniques.

Recruitment for radiologists has shifted from private radiology groups to hospitals and big teleradiology groups, according to national physician search firm Merritt Hawkins, an AMN Healthcare Company.

Not even two months have passed since a private equity firm snagged teleradiology provider Virtual Radiologic, but in that time the imaging industry has played host to several other such deals. The most recent was a bid by Hologic, announced earlier this week, to acquire privately held Sentinelle Medical. Others are Sonosite’s purchase of a different Canadian company, VisualSonics of Toronto, completed just a few days ago, and Covidien’s pending acquisition of ev3, a maker of interventional devices.

In a case that goes to the heart of privileging issues, six interventional radiologists associated with Radiological Associates of Sacramento have filed lawsuits against Sutter Health for refusing to allow them to perform procedures at Sutter facilities.

Virtual Radiologic, already a major player in the teleradiology field, aims to become a major player in the radiology IT space as well with the launch of a new suite of image management products.

Radiology groups pan call for FDA regulation of imaging dose; author defends position and urges more action by the specialty

Not everyone is convinced cumulative radiation dose exists, or even that repeat CT scans cause cancer.

Awareness can be a powerful tool. When 50 centers performing coronary CTA compared protocols, they found that some were exposing patients to 10 times the radiation dose others were.

Radiologists must get used to the idea of competing with nontraditional companies such as teleradiology provider Radisphere if they hope to survive, according to a radiology practice expert. In particular they must provide subspecialty coverage, otherwise it’s all too easy to replace them.

Assuming our hypothetical radiology practice reached consensus regarding a baseline compensation package, what would be the financial implications to physicians in the group? We begin with a practice profile.

A physician, who at the time was the principal doctor of a major medical clinic, once approached me about radiation dose issues and asked me to compare a chest x-ray to a chest and abdomen CT scan. I was prepared, having dealt with similar concerns expressed by other medical practitioners, and explained briefly how it can vary greatly and how the potential health hazards are weighed against the benefits. It was not the first time I had an inquiry about dose-saving techniques from the medical community or from patients. I started realizing how more and more the general public is being affected by media coverage and how the medical community should be able to react.

A new initiative by the American College of Radiology addresses growing tensions between hospitals and their contracted radiology groups, some of which have caused the relationship to end in a bitter breakup.

The first article in this series discussed why productivity-based compensation is controversial based on the various production levels in the group: the racehorses, plowhorses, and plodders. Once productivity-based compensation has passed the conceptual stage, the real work begins. And this phase, due to its potential complexity and the reality of potential salary adjustments, often represents the point at which the wheels fall off.

How would you feel if legislators in your state approved a law requiring a specific statement in certain types of radiology reports?

From Mike Graham, healthcare territory manager for Anthro, a vendor of digital workstation furniture:

A recent study from Massachusetts General Hospital finding that radiologists suffer from poor ergonomics in the reading room put a spotlight on a relatively common problem in radiology.

In response to a dramatic increase in the volume and cost of diagnostic imaging and other ancillary services furnished to Medicare patients in referring physicians’ offices, the Medicare Patient Advisory Commission is considering ways to rein in both.

A dramatic shift in R&D toward patient safety has taken place in the CT industry, a shift most clearly seen in efforts to reduce patient radiation dose. Iterative reconstruction algorithms are a prominent fixture at the ISCT meeting this year, as they and their future development are increasingly seen as providing the means to cut dose, while maintaining or even boosting image quality.

Fears that revenues last year from the sale of new CTs in the U.S. would slide to levels not seen in a long time proved to be well founded, as the industry suffered its worst year in more than a decade.

Much is known about dose reduction and adult patients, but what about kids? The literature is scant, but that doesn’t mean solutions don’t exist, according to a presenter at the International Society for Computed Tomography conference May 21.

Virtual Radiologic, one of the nation’s two publicly traded teleradiology companies, has agreed to be acquired by Providence Equity Partners, a private equity firm, for $17.25 per share in cash, the companies announced Tuesday.