An International Survey of Quality and Safety Programs in Radiology.

PURPOSE: The aim of this study was to determine the status of radiology quality improvement programs in a variety of selected nations worldwide. METHODS: A survey was developed by select members of the International Economics Committee of the American College of Radiology on quality programs and was distributed to committee members. Members responded on behalf of their country. The 51-question survey asked about 12 different quality initiatives which were grouped into 4 themes: departments, users, equipment, and outcomes. Respondents reported whether a designated type of quality initiative was used in their country and answered subsequent questions further characterizing it. RESULTS: The response rate was 100% and represented Australia, Canada, China, England, France, Germany, India, Israel, Japan, the Netherlands, Russia, and the United States. The most frequently reported quality initiatives were imaging appropriateness (91.7%) and disease registries (91.7%), followed by key performance indicators (83.3%) and morbidity and mortality rounds (83.3%). Peer review, equipment accreditation, radiation dose monitoring, and structured reporting were reported by 75.0% of respondents, followed by 58.3% of respondents for quality audits and critical incident reporting. The least frequently reported initiatives included Lean/Kaizen exercises and physician performance assessments, implemented by 25.0% of respondents. CONCLUSION: There is considerable diversity in the quality programs used throughout the world, despite some influence by national and international organizations, from whom further guidance could increase uniformity and optimize patient care in radiology.

Venture Capital in US Medicine: A Briefing for Radiologists.

In recent years, there has a been a rapid and significant drop in the number of private practices in US radiology. Many factors have driven this change. One of the most important has been the corporatization of practices. In many cases, this involves third-party financing, one type of which is venture capital. This article will provide an introduction to the venture capital investment model for medical professionals.

Disrupting the old order of imaging.

OBJECTIVE: The purpose of this article is to expand on the economic concepts of creative destruction and disruptive innovation to imagine scenarios in which diagnostic imaging modalities and certain imaging paradigms can be rendered obsolete. CONCLUSION: Potential disrupters of imaging are novel drugs, clinical trials, accurate biomarkers, and government regulations. A taxonomic schema can be used to better predict the decline of certain imaging modalities.

Leadership: Causing and Curing Burnout in Radiology.

Burnout in US radiology has reached crisis proportions. Leaders play critical roles in both causing and preventing burnout. This article will review the current state of the crisis and how leaders can work to stop causing burnout as well as developing proactive strategies for preventing and mitigating burnout.

Practice Resources to Address Radiologist Burnout.

This special focus issue article provides a large number of contemporary and seminal resources developed to improve well-being and discusses specific challenges and proposed strategies to mitigate burnout through the Veterans Health Administration, a large private academic practice, and academic medical centers.

Summary of the 2022 ACR Intersociety Meeting.

The ACR Intersociety Committee meeting of 2022 (ISC-2022) was convened around the theme of "Recovering From The Great Resignation, Moral Injury and Other Stressors: Rebuilding Radiology for a Robust Future." Representatives from 29 radiology organizations, including all radiology subspecialties, radiation oncology, and medical physics, as well as academic and private practice radiologists, met for 3 days in early August in Park City, Utah, to search for solutions to the most pressing problems facing the specialty of radiology in 2022. Of these, the mismatch between the clinical workload and the available radiologist workforce was foremost-as many other identifiable problems flowed downstream from this, including high job turnover, lack of time for teaching and research, radiologist burnout, and moral injury.

Burnout and work-work imbalance in radiology- wicked problems on a global scale. A baseline pre-COVID-19 survey of US neuroradiologists compared to international radiologists and adjacent staff.

PURPOSE: Worldwide, radiologists are experiencing increasing clinical workloads with associated increased burnout. This paper will review burnout definitions, prevalence, and causes. We will also share data from a survey of US neuroradiologists as an example of the impact of work-work imbalances from clinical overload. This article examines the impact on several key job indicators and upon the quality of the neuroradiology work environment in one nation. Finally, we will review proposals for ameliorating and preventing radiologist burnout. METHOD: A survey was sent to members of the American Society of Neuroradiology (ASNR) practicing in the US. Selected measures included workhours and volume, burnout symptoms, subjectively reported errors, participation in non-clinical activities, perceived interpretation quality, results communication, and consideration of early retirement. RESULTS: Survey respondents (n = 412) included 57.5% with teaching responsibilities. Cutbacks in teaching, mentoring, research and/or practice building were reported by 86.2% of respondents. Subjective errors were reported as occurring sometimes or more frequently in the majority of respondents (56.9%) and were increased with faster than optimal speeds of interpretation (P < 0.001) and signing (P < 0.001). At least one burnout measure was reported by 85.2% of respondents. CONCLUSIONS: Increasing clinical demands in conjunction with a more challenging work environment impacts the ability of radiologists to perform core non-interpretive duties that are critical for success in both private and academic practice and is associated with burnout symptoms and adverse effects on quality. While this survey does not prove causation, the trends and findings are concerning and warrant both close monitoring and appropriate intervention.

Just ask: a proposal to hone the indications for sophisticated radiology examinations.

AIthough MRI and CT have revolutionized healthcare, the growth in their utilization comes with a commensurate and unsustainable growth in spending. The cost of sophisticated radiology tests goes beyond the cost of the technology itself because the tests can be so sensitive, they can lead to excessive treatments when incidental findings are not labeled as such. Thus to improve utilization for its own sake, but more importantly to limit spending on unnecessary treatments, we propose that requests for MRI and CT studies must be accompanied by a clinical question, and all reports offering interpretations must include a direct answer. This approach should increase the effective specificity of the tests that are performed, and in turn decrease provocation for unnecessary treatments. This question/answer policy can be implemented by new Medicare payment guidelines that echo the Medicare reimbursement rules for standard medical consultations.

Medical Leadership: A Manifesto for Radiologists.

Leadership is much discussed but also often misunderstood. For radiologists, leadership may seem irrelevant or, even worse, an onerous addition to their busy careers. It is important that radiologists understand the relevance and importance of good leadership for the success of departments and groups. There are many obstacles to radiologists becoming effective leaders, including personal resistance that is due to myths and misunderstandings, the time and effort (and money) required to learn to lead well, as well as others including the shift in perspective that comes from focusing on organizational success rather than individual career success. This manifesto will explore the what, the why, and the how of becoming a leader in radiology and why it is critical for individuals, their organizations, academic departments, private practice groups, and others, as well as the larger house of radiology.