Feature | April 26, 2013 | Greg Freiherr

Whip Radiology’s Decline Now

streamline workflow, Synapse RIS 6.2, FujiFilm

Increasing procedure volume, brought on by pending healthcare reforms, may put a premium on software that can automate and streamline workflow. (Screenshot of Synapse RIS 6.2 courtesy of FujiFilm Medical Systems)

In the 1970s when I studied at the University of Wisconsin-Madison, the UW had a reputation for being a hotbed of insurrection. I did my part in 1975 by wearing Gerald Ford’s WIN button upside down. It was a tacit repudiation of the idea that a public relations campaign could spawn a grassroots movement to “Whip Inflation Now” and an implied statement that there are “No Immediate Miracles.”

Forty years later, there is a consensus in the radiology community that government efforts cannot produce miracles, at least anytime soon. At November’s RSNA meeting, executives of major equipment vendors told me they had all but given up hope that the current recession would soon end. Over the next 18 to 24 months, the new normal for the imaging community, they said, would be comprised of sporadic gusts of purchasing followed by long periods of little upbeat activity.

Regents Health Resources, a national consulting firm specializing in medical imaging business intelligence, suggests otherwise. 

Regents estimates that the Patient Protection and Affordable Care Act (PPACA) will lead providers to perform millions more imaging exams. Californians alone could undergo almost 9 million additional imaging exams per year. Across the country, imaging procedures are forecast to rise an average 13.6 percent. This would translate into 61 million more such procedures annually. 

You might say, “Hallelujah, brother  … and pass the mustard.” But hold on. As with my diminution of President Ford’s attack on inflation, we would all do well to don our NIM buttons. There are no immediate miracles! 

The radiology climate is not likely to turn suddenly from Ice Age to Jurassic. Considering, however, that a government program designed to substantially broaden insurance coverage has the potential to change, over time, the healthcare landscape, the imaging community might consider how this landscape could change if healthcare reform exerts a cumulative influence over the coming years.

If procedure volumes rise, as Regents predicts, it would eventually absorb the over-capacity that now exists in some imaging operations. This would lead some facilities to extend their hours of service to handle the increased load in the short-term, as they plan changes
in technologies and staff management to foster
long-term fixes.

Meanwhile, there would likely be a growing cry from budgeteers. Regents forecasts that additional procedures will add $4 billion to Medicare and Medicaid expenses in just the six states experiencing the biggest surge in demand — California, Florida, Massachusetts, New York, Tennessee and Texas. The rest of the country would add to that, undoing years of reduced expenditures in medical imaging orchestrated by last decade’s Deficit Reduction Act.

If this happens, radiology could again be vilified for adding cost to healthcare. The real risk to radiology, however, might come from short-term answers
inappropriately applied by referring physicians who order the wrong exams and the docs who do their own imaging. Low-cost substitutes may be wedged into places where higher cost, premium performance technologies belong, resulting in misdiagnoses and substandard care that could smear medical imaging.

To date, organized radiology has failed to get across to the general public the value that imaging brings to patient management. In the months and years ahead, we would be well served to find a way to do so or the imaging community could be seriously harmed, especially if radiology stages a miraculous comeback over the coming years.

To put this likelihood in perspective, look back to when President Ford declared that inflation was “public enemy No. 1” in a speech to Congress titled “Whip Inflation Now.” At the time, the United States was struggling with annual inflation of 11.3 percent, according to the Bureau of Labor Statistics. Two years later, that rate had dropped to 5.8 percent.

While miracles did not immediately happen, one did indeed happen. In that context, it would be wise for us to not write off the imaging industry, but rather to prepare for the best. Because unless we are careful, the best could all too easily turn into the worst.

Greg Freiherr has reported on developments in radiology since 1983. He runs the consulting service, The Freiherr Group. Read more of his views on his blog at www.itnonline.com.

Related Content

Houston Methodist Hospital Enters Multi-Year Technology and Research Agreement With Siemens Healthineers
News | Imaging | August 17, 2017
Houston Methodist Hospital and Siemens Healthineers have entered into a multi-year agreement to bring cutting-edge...
Patient Complexity, Subspecialization Impact List Prices for Radiologists' Services
News | Business | August 15, 2017
A new study by the Harvey L. Neiman Health Policy Institute finds that patient condition complexity and...
Upcoming radiology conferences, meetings and events.
News | August 14, 2017
ITN maintains a comprehensive listing of radiology specialty meetings on its website at ...
ACR Establishes Education Committee for Patient- and Family-Centered Care
News | Patient Engagement | August 09, 2017
Members of the new Education Committee of the American College of Radiology (ACR) Commission on Patient- and Family-...
ACR Annual Conference on Quality and Safety Offers Strategies for Radiology Practices
News | Business | August 08, 2017
The American College of Radiology (ACR) Annual Conference on Quality and Safety, scheduled for Oct. 13-14 in Boston,...
Sponsored Content | Videos | Business | July 28, 2017
Angelic McDonald, MSRS, CRA, FAHRA, regional director of imaging, Baylor Scott & White Health and the president-e
Radiation dose tracking in medical imaging is helping increase patient safety by lower X-ray doses.
Feature | Radiation Dose Management | July 26, 2017 | Dave Fornell
Patient X-ray radiation exposure from medical imaging has been a hot topic in radiology the past few years and has pr
Radiologists Seek Greater Involvement in Patient Care
News | Patient Engagement | July 20, 2017
Despite time and workload constraints, radiologists are looking for ways to become more directly involved in the care...
ACR Updates Radiation Oncology and Medical Physics Guidance With ASTRO and AAPM
News | Radiation Dose Management | July 19, 2017
July 19, 2017 — The American College of Radiology (ACR) recently collaborated with professional medical societies to
Overlay Init