Radiology Lifetime Achievement 2016: Richard Duszak, Jr, MD

For the Top People in Radiology 2016 contest, Diagnostic Imaging (DI) honors a career radiologist for his or her contributions to the advancement of radiology and how those activities have improved the industry.

This year, the Lifetime Achievement Award went to Richard Duszak, Jr., MD, vice chair for health policy and practice at Emory University School of Medicine. Here, DI talked with Duszak about his career and plans for the future.

DI: What is your greatest accomplishment?

Duszak: Launching the Neiman Health Policy Institute, serving initially as its inaugural CEO and, then, later as its CMO. Outside of the primary care arena, it’s the first-ever specialty society-supported policy research “think tank,” and I’m extremely fortunate to have had the ACR’s leaders’ and our members’ confidence in getting this initiative off the ground. Although I recently stepped down as CMO to pursue some new opportunities at Emory, I remain highly engaged with the team and am so proud that we’ve been able to accomplish so much, including more publications each year than many academic departments three times our size, in such a short period of time. The awareness of the importance of policy-focused research in the radiology community has increased dramatically over those four years. For me, personally, it also very nicely catalyzed my transition from private to academic practice, where my soapbox has expanded my outreach and impact even further.[[{"type":"media","view_mode":"media_crop","fid":"55272","attributes":{"alt":"Richard Duszak, Jr., MD","class":"media-image media-image-right","id":"media_crop_3299190452792","media_crop_h":"0","media_crop_image_style":"-1","media_crop_instance":"6916","media_crop_rotate":"0","media_crop_scale_h":"0","media_crop_scale_w":"0","media_crop_w":"0","media_crop_x":"0","media_crop_y":"0","style":"height: 255px; width: 170px; float: right;","title":"Richard Duszak, Jr., MD","typeof":"foaf:Image"}}]]

DI: What’s been your biggest challenge?

Duszak: Continuing to message the value and potential value of radiology and the need for the profession to change as our health care delivery and payment systems change. Some policymakers have targeted radiology as a driver of unnecessary health care spending, and in doing so, ignore so many of our advancements, such as the many patients saved from massive bleeding with interventional procedures or all of the exploratory laparotomies avoided because of CT. Unfortunately, while the culture is slowly changing, there are still far too many radiologists who are complacent with the past, content just waiting for the work to show up, and doing what they want and when they want. This doesn’t help us at all in messaging our value. Unfortunately, for them, they put themselves at risk as digital imaging and nascent artificial intelligence technology rapidly change how radiology is practiced. Dinosaurs need to evolve – and rapidly – lest they go extinct. 

The best messaging to external audiences will also come from engaging internal audiences to make sure we’re all speaking the same thing. It’s one thing to believe collectively that we’re the best thing since sliced bread – thinking it is different from articulating it and getting people to understand it. That’s not necessarily unique to radiology, but it’s in medicine as a whole. We are vulnerable because we are less patient-facing and are remote from the patient.

DI: What’s an existing goal you have?

Duszak: To foster a deeper and broader understanding of health policy and health services research within the radiology community. Not everyone needs to be an expert in this space, but we do need everyone to understand its importance as our health care delivery and payment systems go through rapid change. Much of my Neiman HPI work focuses on mentorship and outreach – trying to rapidly build a “farm team” of future investigators and thought leaders who will allow this work to go viral. I joke around a lot – but there’s definitely some truth in it – that as one of the few people active in this space, my job will be done when there are so many people doing what I do that no one will need me anymore.

DI: What would you like to see change in radiology in the next 10 years?

Duszak: Perhaps I watched the movie “Back to the Future” too many times, but I’d very much like to see radiologists return to the old days where we interacted with patients and referring physicians a lot more. I’m not saying we should go back to doing barium enemas on a regular basis, but back then, we interacted with patients regularly. Those were the days when we talked regularly with our referring physicians because they had to come to our reading rooms. It’s convenient for many of us to work in dark rooms without interruptions, but those are critical conversations. They remind people who we are and what we do, reassure patients and manage expectations, and convey nuances of our interpretations far better than those communicated through text reporting. This is where we really add value to the health care system. Stakeholders are increasingly demanding this from us, and radiologists who don’t like that change will find that they like irrelevance even less.