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Edition: November 2020 |
Table of Contents |
Letter from the Editor | FRS President’s Message | FRBMA President’s Message Legislative Update | FRS Educational Foundation | Job Board | Job Posting Opportunities Become a PAC Member |
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Letter from the Editor |
ACR Advocacy Update Centers for Medicare and Medicaid Services (CMS) released the Radiation Oncology (RO) Model Final Rule on Sept 18, 2020. Click Here to review the RO Model Final Rule The ACR, ASTRO, AMA and other stakeholders urged CMS to reverse course and delay implementation of the model from Jan.1, 2021. On Oct. 21, 2020, CMS announced that in response to feedback from the radiation oncology community, they will delay the RO Model start date to July 1, 2021. We will continue to follow the response of the CMS and highlight the ACR and ASTRO stakeholder communications. Other CMS news for the radiation oncology community includes recently posted Recovery Audit Contractor (RAC) proposed audit topics now included Intensity Modulated Radiotherapy (IMRT) Plan: Unbundling as a proposed topic. ACR joined 60 health care organizations in signing a letter to thank Rep. Michael Burgess, MD (R-TX) and Rep. Bobby Rush (D-IL) for introducing H.R. 8505, a bill to prevent the significant payment cuts included in the CMS 2021 Medicare Physician Fee Schedule. Click Here to view H.R.8505 If passed this bill would waive budget neutrality requirements in the finalized evaluation and management code proposal. On Oct. 19, 2020, a letter from congressional leaders and 221 cosigners urged house leaders to avert the impending healthcare crisis caused by Medicare evaluation and management payment changes scheduled for implementation on Jan 1, 2021. Click Here to view letter This recognizes the importance of a legislative solution to support primary care provider pay increases while avoiding corresponding cuts for specialist providers who infrequently bill Medicare codes. This call to advance legislation helps providers already suffering from the COVID-19 pandemic to remain open and preserve health care access for millions of Americans. “The 40,000-member ACR looks forward to working with Congress, the Centers for Medicare & Medicaid Services and other medical societies to make necessary Medicare adjustments that preserve access to care for America’s seniors. We thank these congressional leaders for advancing this crucial effort,” said Howard Fleishon, MD, MMM, FACR, Chair of the American College of Radiology Board of Chancellors. The US Nuclear Regulatory Commission (NRC) and Food and Drug Administration (FDA) convened a public workshop on Oct. 14, 2020 title “Enhancing the Development of Emerging Technologies”. ACR and ASTRO representatives participated on the organizing committee for the virtual event. This workshop explored the regulatory pathways prior to use of new radiopharmaceuticals, medical devices and sealed sources. The ACR Commission on Medical Physics and Government Relations Committee chair, Ralph Lieto, moderated the panel on radiological devices, such as yttrium-90 microsphere brachytherapy and stereotactic radiosurgery units. The agencies will use the proceedings to reexamine the clinical study requirements for radiopharmaceuticals. The ACR will remain active in any pertinent regulatory policy initiatives. The FRS will continue to keep members apprised of changes and developments.
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Laura Vallow, M.D. Secretary, FRS Vallow.Laura@mayo.edu |
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Meet Your 2020 – 2021 FRS Executive Committee |
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President Douglas Hornsby, MD |
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President-Elect Rajendra Kedar, MD, FACR |
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Treasurer Chintan Desai, MD |
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Secretary Laura Vallow, MD |
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FRS President’s Message |
Are you tired of hearing about it or do you feel it?
I keep reading about physician burnout and COVID-19. I was less concerned about it until the forced isolation from COVID-19 made matters worse. The Journal of Internal Medicine describes the burnout as chronic stress associated with emotional intense work demands with depersonalization, emotional exhaustion, and feelings of loss of accomplishments and effectiveness in helping patients with their problems and lack of value from our work-related activities.
In Medscape’s latest survey on burnout released radiology burnout was rated as 45%, which was somewhere in the middle of specialties. The survey was performed in January of 2020 prior to the pandemic. In a journal from Diagnostic Imaging, Mina Makary, M.D. notes since COVID-19, the pandemic has increased strain to the healthcare systems and radiology burnout.
Dr. Makary states there is marked increase in radiology residency burnout, which has the worst rates of burnout of all fields at nearly 85% of trainees experiencing some effects.
In a medical education system, we are conditioned to not express emotion, be a superhero and may be in a workaholic setting. To paraphrase Mike Drummond for American Practice Management, the prime directive is: “The patient comes first” As a consequence, we ignore our mortality and emotional wellbeing. The second prime directive although unspoken is we never show weakness.” |
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Past President Patricia Mergo, MD, FACR |
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Legal Counsel Michael M. Raskin, M.D., J.D., FACR |
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The extended work hours and limited personal interaction with other specialties and social isolation in general that the COVID-19 pandemic has presumably increases the severity of burnout symptoms.
There is a description of MDs and health care workers is healthcare heroes. In radiology we may feel this is unwarranted since we are not in direct patient care.
For example, going into only my 5th day outside of my dark cave of the imaging suite since early March, I walked in to get a haircut in my mask and scrub suit and everyone applauded. They said, “we applaud all our healthcare heroes.” I had to demur saying that I live in a dark cave and interpret images and that I am certainly not a healthcare hero, but I work in the company of heroes.
For those of you who read tele-radiographically, the isolation is probably more severe. The encouragement and participation of colleagues is a great source of reassurance and emotional support. The sense of isolation and inadequacy concerning difficult cases in the absence of being able to consult colleagues is an additional stressor.
My guess, it is most likely worse in small practices where there is no relief from workload, and the stress of continuing a functioning practice in the midst of absence of ancillary staff and the financial burdens that COVID-19 has brought.
For most of us, recharging our batteries seems to be limited to our isolated department setting and our cave-like existence at home with our families.
To paraphrase Dr. Drummond, how often when someone asks you if you are ok, do you automatically say, “I am fine” and present a stiff upper lip and keep marching. Do we seek help? Unfortunately, our training as physicians and radiologists have taught us to keep going and not express emotion.
In this setting, it is imperative that we reach out to our friends and family and other radiologists both inside and outside of our practice and especially our colleagues in the FRS for reinforcement and the joy of discussions of common problems and opportunities and a refreshing renewal of friendships.
Radiology residents and Fellows have an extreme work burnout potential and should be counseled individually and as a group even when no symptoms are apparent. I encourage talking to all residents you know in training programs knowing in advanced that most of the reactions are going to be “Do not worry about me. I am fine” or “More stress, I didn’t notice.”
For me, I will be calling you, because it is reassuring to hear voices of new and long-time friends and even hear the complaints and worry about legislature or the politics of our specialty. It is a normal part of my responsibilities as an officer of FRS, to call all the residency programs and encourage participation by the residents and fellows. Even if we do not know them individually, we still see most of the residents at our meeting on an annual basis. They may be need us more now and need to know their lives will improve. I look forward to the comfort of talking to someone who is young and looking for encouragement from someone who has gone down a similar road.
Let me know what you think. I would love to hear from you.
Thank you, |
Doug Hornsby, MD President, FRS doughornsby@msn.com |
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FRBMA President’s Message |
It’s not all about Work
As a CEO we know we are evaluated on how well our company is performing. We use a wide variety of business and financial measure like growth rate, productivity, bad debt etc. For a radiology business I think you need to bring another element into this equation. The added element is a management style that we use for our supervisors.
My premise is that employees are not just doing a job, but they are a critical piece to building and maintaining our reputation in the medical community. I discussed this in last month’s article. Also, many of our employees have skills that are not specific to radiology or even healthcare. We need not only an emphasis on hiring quality staff but also retaining them. Retaining staff is tied to job satisfaction and I believe job satisfaction is tied to the relationship between the employee and the supervisor. The company emphasis on the relationship between the employee and the supervisor to retaining our staff is what I’m calling a culture of “it’s not all about work”.
The question we had to answer is what changes we should make to reduce turnover. What we have found is that turnover most often occurs when an employee dislikes their supervisor. That’s our experience but I think it is also not a surprise. We began coaching our supervisors to develop closer relationships with their employees. This objective requires supervisors to cultivate relationships of trust, recognition and most importantly the development of a personal relationship between the supervisor and employee. This is of equal importance to each supervisor’s goal of ensuring the quality of the employee’s work function.
I don’t think the elements of the “it’s not all about work culture” are new or innovative but the elevating of the importance is a significant change. Not every supervisor will fit in a model structured this way. We find that the supervisors that best implement this methodology have the lowest turnover and the highest employee satisfaction. It’s hard to point out the specifics of how this is accomplished because each supervisor has developed their own approach. This is still a work in progress but most of our supervisors have successfully made this transition.
The same culture that I am trying to develop in our supervisors was one of the things I did when I came to this company 16 years ago. When I got here, I started something called, “Lunch with the Practice Administrator”. Once per month I would have lunch with the non-supervisory employees that were having their birthday that month. Lunch was away from the office. By using birthdays, it resulted in relative random group from across the business. We spent the whole lunch learning about everyone. It took three years before all the employees had attended this lunch and I feel it really helped me in building the relationship I wanted to have with our employees.
Another way I build these connections is by meeting every candidate before hiring. This serves a similar purpose as the lunches because I don’t talk about their specific job qualifications. It is more of a get to know each other talk. We talk about the kind of things you might discuss whenever you meet someone new. I want to know them better and I want them to know me better.
I have always applied this element to my management style because to it just shouldn’t be all about work.
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John Detelich, CPA, MBA, CEO President, FRBMA jdetelich@radassociates.com |
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Legislative Update |
Tuesday November 3rd is Election Day, and I hope everyone had a chance to exercise their right to vote. Hopefully, the election will go smoothly and election results will be known quickly.
Florida’s Organizational Session has been set for Tuesday November 17th. This is when all newly elected members are sworn into their respective bodies. Also the Senate President elect, Wilton Simpson will be officially voted in as President of the Senate. In the House, Speaker elect Chris Sprowls be officially elected as Speaker. The Capitol is still closed to the public and the protocol on how the public will be allowed in the building is still being worked on due to Covid. Early indications are the public will not be allowed in the Capitol for the Organizational session.
To date, no legislation has been filed. There has been quite a bit of discussion behind the scenes of introducing legislation to provide tort protection from Covid suits.
I hope everyone is staying safe and well! |
Thanks, Alison Dudley, FRS Lobbyist AlisonDudley@dudleyandassociates.com |
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FRS Educational Foundation |
Qualified Charitable Contributions
As fall approaches, keep in mind the FRS foundation still values and relies on your charitable support of Florida’s Radiology and Radiation Oncology residents as part of our ongoing educational mission. As many of you may be aware, the CARES Act was passed by Congress in response to the pandemic and waives the required minimum distributions (RMDs) for all types of retirement plans for 2020.
Many of our members have previously used Qualified Charitable Distributions (QCD) as a means to donate to the FRS Foundation and this remains an option for 2020 despite the waiver for RMD and still holds tax advantages even if one takes a standard deduction. The QCD allows IRA owners over age 70 ½ to directly transfer up to $100,000 annually from an IRA to a qualified charity tax free, is excluded from income and allows you to get a tax break even if you are claiming the standard deduction. Individual circumstances may obviously vary and we advise you check with your accountant to explore individual benefits of using a QCD for your charitable contribution.
We hope that you will consider the benefits of a QCD and help the FRS Foundation continue to grow and prosper through your generous contributions. |
Jeffrey Stone, M.D., FACR President, FRS Educational Foundation |
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Job Board |
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Available Positions
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Job Posting Opportunities |
Florida Radiological Society is pleased to introduce the opportunity for interested parties to advertise for potential jobs in our monthly FRS Ebrief bulletin.
Advertisement pricing is as follows:
Ebrief Job Posting pricing: 3 months ($100 monthly) 6 months ($90 monthly) 12 months ($80 monthly)
Please contact Lorraine Roger, our Society Administrator for further information on how to advertise in our monthly publication.
ph (813) 806-1070 fx (813) 806-1071 email lroger@flrad.org
We feel that this will provide a valuable service to both our members and our Florida community of Radiology.
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Thank you for your interest! Patricia Mergo, MD, FACR |
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Become a PAC Member Today |
Attention FRBMA Members! Please support the cause. We encourage you to be PAC members and supporters; you do not have to belong to the FRS. Donations can be made online through our PAC website www.FLRADPAC.org. Thank you for your donation.
It is critical that we support both our Florida PAC and RADPAC in order to bolster our voice in Tallahassee and Washington, respectively. Please join FRS lobbyist Alison Dudley in her special appeal for all Florida radiologists to become Florida PAC members. If you would like to help FRS defend radiology against untoward legislation and introduce bills that have a positive impact on our practices, we need your financial support to re-elect our friends in the state House and Senate. The FRS can also show you simplified ways on how to sign up your radiology group. Contact Lorraine Roger at lroger@flrad.org or contact Alison Dudley at alisondudley@dudleyandassociates.com for more information.
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Telephone (813) 806-1070 • Fax (813) 806-1071 5620 W. Sligh Avenue • Tampa, Florida 33634 |
The E-Brief is an exclusive member benefit of Florida Radiological Society, delivering monthly member, chapter and industry news. Please do not reply to this automatic e-mail. For comments or questions about the E-Brief, please contact lroger@flrad.org. |
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