An interesting article in California’s Hanford Sentinel fairly details the story of Adventist Health Central Valley Network replacing its local radiology group with the national teleradiology-driven radiology group Radisphere—the group formerly known as Franklin & Seidelmann. Radisphere took over reading duties for Adventist Health Central Valley Network early this year.

“The decision to go with Radisphere was made because of dissatisfaction with the previous system, where radiologists were employed from a network of local providers,” Sentinel reporter Seth Nidever wrote.

I don’t know the specifics of the “dissatisfaction” that caused the problem, but the solution may have been aimed at a different target. Read the rest of this entry »

Concern about growing imaging costs and widespread awareness of radiation exposure issues has drawn unwanted attention to radiology. Don’t expect that to change soon.

Given those facts, the American College of Radiology’s recent statement about an article on CT scan safety published recently in the New England Journal of Medicine outlines how ACR is trying to exert some influence over the situation by offering a solution that they’ve developed instead of waiting to see what outsiders might devise. That idea is at the core of all lobbying efforts. For example, Wall Street banks could have chosen to fight directly against finance reform, instead they quietly got busy lobbying the people crafting the law and regulations so the end result is Read the rest of this entry »

Six Interventional Radiologists are suing Sutter Medical Center Sacramento over access to procedure suites, according to this article from the Sacramento Business Journal. Sutter Medical Center replaced the IR’s radiology group earlier this year, so it wouldn’t be surprising to see legal action happen as fallout from terminating a long-standing relationship.

This situation seems like one of an increasing number of conflicts between hosptial organizations and radiology groups. What are your thoughts on the relationships between hospitals and radiology groups?

The House of Representative passed the Senate’s six-month “SGR fix” and the Sustainable Growth Rate dance continues. Physicians will receive a 2.2% increase instead of the 21% cut mandated by the law that ties Medicare rate growth to  growth in domestic product. Stay tuned for the next short-term fix in about 5 1/2 months.

Congress once again showed its all-to-common inability to make a tough decision. Does all thing make you worry how Congress will manage implementing healthcare reform?

Often there is an uncomfortable gap between questioning whether a drug or medical device is safe and having proof that it is unsafe. The radiology community has been navigating in that space with gadolinium-based contrast agents. The new version of the ACR’s Manual on Contrast Media recognizes and addresses that issue: “While various factors may have influenced the number of cases reported with each of these agents, investigators believe that intrinsic properties of these three agents increase the relative likelihood of NSF developing following exposure in at-risk patient.”

While MR contrast experts aren’t don’t have sufficient data to report exactly what factors make using Magnevist, Omniscan, or Optimark too risky in patients at high risk for developing nephrogenic systemic fibrosis (NSF), the ACR clearly believes that risk is real—and greater in some gadolinium-based agents than others. The new ACR manual reflects that position and gives patients the benefit of the doubt. The new Manual on Contrast Media categorizes the three MR contrast agents as Group I agents and recommend that they not be used in patients at high risk for NSF. Here is the complete list from the new manual:

Group I: Agents associated with the greatest number of NSF cases:
Gadodiamide (Omniscan® – GE Healthcare)
Gadopentetate dimeglumine (Magnevist® – Bayer HealthCare Pharmaceuticals)
Gadoversetamide (OptiMARK® – Covidien)

Gadobenate dimeglumine (MultiHance® – Bracco Diagnostics)
Gadoteridol (ProHance® – Bracco Diagnostics)
Gadoteric acid (Dotarem® – Guerbet)*
Gadobutrol (Gadovist® – Bayer HealthCare Pharmaceuticals)*

*Not FDA-approved for use in the United States.

Can breast surgeons be taught to read mammograms as well as radiologists do? One study certainly thinks so.

South African research presented at the annual meeting of the American Society of Breast Surgeons earlier this month suggests that surgeons can be trained to read mammograms as well as radiologists. A prospective study of 10,020 mammograms found that “the diagnostic accuracy of the breast surgical team was similar to that of specially trained, dedicated breast radiologists in national European and Australian screening programs. The surgeons’ accuracy was higher than that of typical U.S. radiologists reading mammograms,” according to a press release announcing the study.

It’s not difficult to envision training breast surgeons to interpret mammograms. While one study does change work patterns, when you consider how unpopular reading mammograms among radiologists—as well as the shortage of breast imaging specialists in some areas—carving out the work seems to have merit. While many radiologists don’t want the work, they should cautiously consider encouraging such competition. If radiology turns mammography over to breast surgeons, hands over plain films to the emergency docs, leaves obstetrical ultrasound to Ob/Gyns, and so on, where does it end? Read the rest of this entry »

Radiology Benefits Manager (RBM) MedSolutions and Blue Cross/Blue Shield of Delaware are under scrutiny in Delaware for the RBM’s denial pattern for nuclear stress tests, according to a report from CBS affiliate KYW TV in Philadelphia. The story focuses on repeated denials of nuclear stress testing for a Delaware man Mike Fields, who when admitted to the hospital by  his cardiologist was found to have four blockages and required bypass surgery.

According to the report, Blue Cross/Blue Shield has told the company to stop denying the stress tests while it invests the matter.

“It’s just a big scam to save money,” Fields told the station.