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 »

I read this question and reply on CNN.com.  A mother emailed a question to CNN asking whether she had “put her son at risk” for cancer because of a series of CT and MRI scans as well as x-rays the 3-year-old underwent after a traumatic head injury as an infant. CNN correspondent pediatrician Jennifer Shu, MD, pursued an answer from neuroradiologist Rick Woodcock, MD. As you’ll see in the linked article, Woodcock provided an excellent description of radiation risk and risk/benefit analyis for imaging exams. Shu ran Woodcock’s explanation it in her response.

This question and answer seems to related to a common charge leveled at imaging reports—that they too often don’t help the physician making decisions. In this case, the mother asked the pediatrician a question. The pediatrician consulted a radiologist and relayed that information to the patient. But I don’t think the pediatrician’s response answered the patient’s question. Read the rest of this entry »

New Congressional Budget Office (CBO) research suggests that medical malpractice reform could save $54 billion in the coming decade, according to an article published in the Washington Post. The CBO calculation was based on a $250,000 cap on pain and suggering awards, a $500, 000 cap on punitive damages, a one-year deadline for adults to file suit and three-year deadline for minors.

“These numbers show that this problem deserves more than lip service from policy-makers,” Utah Republican senator Orin Hatch said in a written statement. “Unfortunately, up to now, that has been all the president and his Democratic allies in Congress have been willing to provide.”

Any healthcare reform that passes will be a compromise, so I’m not convinced the above assumptions should become law, but Hatch is correct that the left hasn’t provided anything more than lip service on malpractice reform. And while our legislative system has been at near complete ideological loggerheads since the Clinton administration, keeping the hot spotlights of public attention still seems like the best way to break the stalemate.

If a picture is worth a thousand words, an image with a little narration is worth much more—especially to your referrers. Last year at RSNA, Greg Rose, MD, President and CEO of NightRays teleradiology service, excitedly showed me an easy-to-use tool that combines a PACS workstation’s diagnostic images, the cursor movement and the radiologist’s dictation into an mpeg file for referring physicians and their patients. Check out Rose’s intro to VidRay and the first VidRays archived on the Radiology Today Web site.

If you read the letter James Thrall, MD, sent the White House and the five Senate and House committees involved with healthcare reform, you’ll see something everyone in radiology can get behind. Malpractice tort reform needs to be part of healthcare reform (or follow shortly thereafter if politics dictate).

Incredibly, the White House says it “hasn’t heard from physicians” on the issue. Change that.

Eduard Michel, MD, PhD, is chief medical officer and co-founder of telerad provider Virtual Radiologic Corporation (VRC). Besides providing quality interpretation, VRC’s success depends on radiologist efficiency. The company has developed its own systems and procedures for improving workflow efficiency. Michel discussed eight pitfalls to workflow efficiency in a digital radiology environment Tuesday at the AHRA annual meeting. Smaller groups and facilities might not have the resources and expertise at their immediate disposal to implement all of Michel’s suggestions, but his pitfalls list still represents eight areas to investigate for organizations seeking to improve their workflow. Here’s Michel’s list of pitfalls to reading efficiency: Read the rest of this entry »