ACR Bulletin March 2017

Final Read

Sara H. Kim, MDfinal read

Q: How do you create the ideal patient experience in your practice?

Every day, as a radiation oncologist, I witness the stress patients living with a cancer diagnosis go through.

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Fast Jets for RFS

fighter pilot rinzler rfsPrior to residency, I had the privilege to work as a flight surgeon in the United States Air Force.

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Primer on Patient and Family Centered Care


Radiology is changing and not in the way you may think. Advances in imaging technology have always shaped our chosen profession and will continue to do so throughout our training and during our future practice. But it is not a new technology or imaging modality that is bringing change to radiology. Rather, it is a concept that is not new at all: patient- and family-centered care (PFCC).

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Meet the ACR Leadership: William T. Thorwarth, Jr., MD, FACRLeadership

This is an installment of a series titled “Meet the ACR Leadership.” Throughout the series, we interview the ACR Leadership to get insight into their background and involvement in the ACR. For this installment, we talk with William T. Thorwarth, Jr., MD, FACR.

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The Moorefield Fellowship Experiencemoorefield fellowship experience

This past October, I was honored to participate in the American College of Radiology Moorefield Fellowship in Economics and Health Policy.

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Building Momentum

MACRA and QPP are here. Are you ready to drive change, but don't know how or where to start?Building Momentum

With fast-approaching deadlines, the mandate for transformation to value-based radiology is more urgent than ever before. The trouble is many smaller and mid-sized practices are still struggling with implementing the principles and practices of Imaging 3.0®.

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Leading the Field

Recognizing leaders in the imaging community.Leading the Way

Each year, the College awards individuals whose work and dedication advances and strengthens the specialty. Spanning continents and subspecialties, this year's recipients include diverse individuals from across the community of imaging.

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Merge Ahead

Radiology practice mergers proliferate in light of regulatory pressures.merge ahead 1

Several times during their group's 25-year history, the radiologists at La Porte Radiology in La Porte, Ind., considered merging with another practice. But the six-member team never had a compelling reason to follow through — until 2015.

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Tailoring Access to Care

The business case for reducing missed care opportunities.tailoring access to care

Recently, a patient walked away from a meeting that included her primary care physician (PCP) and her radiologist and declared she had just received "a mini lesson in medical evaluation and reasoning."

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Patient Experience and Payment Policy: One and the Same

The Commission on Economics is committed to ensuring opportunities for radiologists contribute to an improved patient experience.Patient Experience

Continually improving patient experience is what we strive for; it is the right thing to do. But if that were not motivation enough, policymakers have made patient experience an integral component of radiology payment policy.

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Balance Billing

How can practices shield their patients from "surprise" bills and insurance coverage gaps?Balancing Billing

Last spring, I had the pleasure of speaking at the Texas Radiological Society annual meeting, where I learned first-hand the struggles some of our states have had in regard to the issues of "balance billing," also referred to as "surprise billing."

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Nominees for 2017 Positions


Look who's running for office.

At ACR 2017, the ACR Council will vote on the following slate of candidates recommended by the College Nominating Committee (CNC).

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March Case of the Month

Access case here.

Authors: Turner K. Fishpaw, MD, PGY1, University of North Dakota, School of Medicine and Health Sciences, Grand Forks, N.D.; Daniel Amirhamzeh, MD, PGY-5, radiology resident, diagnostic radiology, Department of Radiology, Santa Barbara Cottage Hospital, Santa Barbara, Calif.; Laura E. Traube, MD, MPH, attending radiologist, interventional and diagnostic radiology, Department of Radiology; Arthur A. Lee, MD, attending radiologist, vascular and interventional radiology, department of radiology, Santa Barbara Cottage Hospital, Santa Barbara, Calif.; and Bernard Chow, MD, program director, musculoskeletal imaging, Department of Radiology, Santa Barbara Cottage Hospital, Santa Barbara, Calif.

Why did you select this case for submission?

My senior staff steered my attention to this case to illustrate that chest radiographs remain a powerful imaging modality, and to demonstrate how subtle findings and broad differential diagnoses can lead to early identification and treatment of life-threatening pathology.

What should readers learn from this case?

This case should act as a teaching aid for posterior mediastinal masses and as an example of how an aortic aneurysm may present on a chest radiograph.

What did you learn from working on the case?

As my first case submission, the process of selecting representative images and composing a report worth reading was rewarding. Beyond the requisite radiology subject matter, I learned that with enthusiasm, creativity, and willingness to see a project through to completion, even a medical student can coordinate a project that produces an award-worthy case report.

How did guidance from senior staff at your institution impact your learning and case development?

As a visiting medical student at Santa Barbara Cottage Hospital, I was stunned by how supportive and enthusiastic the residents and faculty were when I informed them early in my rotation that I wanted to submit a case report. With no shortage of interesting cases, we quickly identified a case with salient teaching points and subtle, interesting radiological findings. Senior staff experience with academic publication was critical in molding and polishing our final draft.

Why did you choose Case in Point for submission of your case?

All steps of the submission process were streamlined and easy to interpret. I especially appreciate the case suggestion step. Preliminary case approval prior to a full case write-up and submission was crucial, as I had never submitted a case before. Early approval helped confirm that I did indeed have a case worth publishing.

Are you a regular reader of Case in Point? What are your favorite types of cases?

I do read Case in Point regularly. My favorite cases are those that inspire a broad differential diagnosis and effectively keep the reader thinking and second-guessing until close to the end of the case. I also prefer cases that include a variety of imaging modalities.

What else should we know about the case that you would like to share?

I owe the success of this CIP submission to the support and guidance of the incredible faculty and residents at Santa Barbara Cottage Hospital. My rotation with them was an intensive introduction to radiology and they continue to enrich my life as a doctor and a medical learner!