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Table of Contents
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| Letter from the Editor |
The shortest month of the year is here, but the FRS has been quite active nonetheless already! The FRS Winter Board meeting was held virtually on Sat Feb 5th, with active engagement from all the participants in a cordial, efficient meeting. Although wide-ranging topics from the business side of the FRS to the national efforts being undertaken at the ACR were discussed, I will focus on a few here that may be of interest to you. The Florida Radiological Society Annual Meeting (Fri Jul 15 – Sun Jul 17, 2022 at The Ritz-Carlton, Amelia Island near Jacksonville) has been set and there is a terrific slate of speakers. Please Click Here for the schedule. As usual, there will be a research agenda for the meeting with poster presentations from across the state. New this year will be three new award categories — Quality & Safety, Radiation Oncology, and Diversity, Equity & Inclusion – so, if you are a trainee or a mentor to trainees, please disseminate information about the poster sessions and encourage participation. These are also committees within the FRS; so, if you have interest in serving on one of these committees, please do not hesitate to let one of us know. A Council Steering Committee (CSC) sponsored resolution for the ACR Annual Meeting has gained support within the FRS Executive Committee and Board. The Resolution sprang from a workgroup convened to address a previous resolution on the Practice Parameters and Technical Standards (PP&TS) — these are the guidelines/recommendations issued every year by the ACR (and partnering societies) on a range of subjects from renal scintigraphy to preparation of CME. You can see them here. A town hall in December sought to receive member input and helped shape the subsequent resolution. In short, the resolution proposes that the ACR create a new, separate, virtual-only meeting in the springtime devoted solely to PP&TS. All ACR members could participate and offer comments or suggested edits, and then those comments could return to the PP&TS committees for consideration of inclusion. All the duly edited PP&TS would then be presented together as a consent agenda for majority vote at the annual meeting, with the ability for any councilor with majority backing to extract a particular PP&TS from the “bulk consent”. This process should end in more time available at the virtual meeting to discuss and wordsmith PP&TS, more time at the annual meeting to focus on larger “House of Radiology” issues, and a less hurried process at the annual meeting with regard to PP&TS. If the resolution passes the first year, then this could be applied to the PP&TS process would be for the 2024 meeting. Enjoy the rest of the month and the great weather we have during the wintertime!
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Juan Batlle, MD
Secretary, FRS
juancarlos98@gmail.com |
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| Meet Your 2021 – 2022 FRS Executive Committee |
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President
Rajendra Kedar, MD, FACR |
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President Elect
Chintan Desai, MD, FACR
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Treasurer
Laura Vallow, MD |
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Secretary
Juan Batlle, MD |
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| FRS President’s Message |
FRS Winter board meeting: We had an exciting and engaged FRS virtual board meeting on Feb 5, 2022. Although we had planned and were looking forward to an in-person meeting, due to uncertainties related to COVID -19 Omicron variant, it was decided to have it virtual. I thank all board members for a very engaging meeting. We came out with multiple new ideas and concepts too. Some of the highlights to report are: Medical Student Funding Proposal: Thanks to Dr. James Banks who proposed ideas to engage medical student involvement in the FRS. He suggested a breakout session at the annual meeting to engage medical students, offer a residency fair with program directors for all programs in Florida in order to educate the medical student regarding radiology, allow them to submit a poster without a resident author, and offer a medical student stipend to attend the meeting. The board liked all ideas and approved a proposal to offer a stipend to 5 medical students meeting the same criteria as residents do for the stipend. Each one will receive $150 each for presenting at this year’s annual FRS meeting. We will continue to work on engagement with medical students interested in radiology. Adding more awards for Resident’s Poster Session at the Annual Meeting: Apart from 4 awards given out to the residents every year at the annual meeting for the best posters, the EC proposed adding 3 more awards. Additional categories will be Radiation Oncology, Quality & Safety, and Women & Diversity Inclusion. All will also qualify for the best poster award. FRS Member in Focus: In this month’s Ebrief, as part of our Women & Diversity Inclusion drive, we will highlight an FRS member and their work in this column. If you know someone whom we can feature in this column, let us know, and we will recognize them. Florida State Capitol visit: I visited Tallahassee with residents sponsored by the FRS Educational Foundation – Parker Freels (DR, UFL Jax), Crystal Seldon (RO, Jackson Memorial), and Lucas Rindy (DR, Aventura Hospital). Alison Dudley, our lobbyist for the FRS, did an excellent job hosting us. We met around 25 representatives including majority leader Mike Grant, as well as, attended live sessions. We had very productive conversations with each of them and appraised them as to what it takes to become a radiologist, what we do, and how we help our patients and doctors. We also educated them about difficulties we face and regarding the mammography bill which we did not favor. With our successful campaign with Alison’s contacts and work by our FRS breast Imaging Committee, the bill will not be heard. Alison will give more updates on it. FRS PAC: We are running very low on our PAC and need donations to survive in order to do what we do for Florida radiologists. Without funds, our lobbyist cannot protect radiology interests. Please donate at: https://flradpac.org/. I also appeal to all board members to participate 100%. Congratulations 2022 FRS Gold medal recipient: Dr. Nicholas Hatton, MD, past president, will be honored at the Gold Medal reception this year during the Annual Meeting. Congratulations to FACR Fellows approved for 2022: Gary Feisberg, MD; Douglas Hornsby, MD; Robin Osborn, DO; Jeffrey Peterson, MD; Robert Pooley, PhD. Some of the other topics that were discussed were the annual meeting program by Dr. Edem Chen, meeting apps by Dr. Juan Batlle, ACR resolutions, also by Dr. Batlle, and the FRS Education Foundation by Dr. Jeffrey Stone.
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Very Respectfully,
Raj Kedar, MD, FACR
President, Florida Radiological Society
Professor of Radiology, University of South Florida – Morsani College of Medicine
Director- Body Imaging Education and Fellowship
Chief -Dept of Radiology, Tampa General Hospital |
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Past President
Douglas Hornsby, MD
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| FRBMA President’s Message |
FRBMA Winter Conference
We held our FRBMA winter conference on January 28th in Orlando at the Swan Hotel in Disney. This is a one-day conference with a great deal of content. We expected 30 attendees; but, had several last-minute cancelations due to Covid. I think we ended up with 25 attendees. I know a lot of our membership would have not only enjoyed; but, also would have benefited from this conference. I certainly hope we see more members next year. I am going to recap the Healthcare Consolidation presentation this E-Brief and two other presentations in next month’s article.
Healthcare Consolidation
Jeff Younger presented an in-depth overview of healthcare consolidation. This topic covered both Florida and nationwide and looked at radiology, as well as, other parts of healthcare economy. Mr. Younger’s career in healthcare spans 41 years which includes 15 years as a hospital executive, 18 years with SDI Radiology in Tampa and 8 years as the CEO of Preferred Radiology Alliance (PRA). Having almost ½ of his career split between a hospital setting and private practice, Mr. younger was able to provide a perspective that few of us have. My group is a shareholder in PRA, and I know that Mr. Younger stays very current on this topic.
Hospitals and Health Systems have been very active in the acquisition and merging in an effort to expand their footprint. The trend is that the bigger and more successful Hospitals and Health Systems are strategically expanding while the less successful are unable to participate in this strategy. This has resulted a consolidation whereby 10 systems now control 25% of the hospitals. Although Mr. Younger noted that 2021 was one of the slowest years for mergers and acquisitions, he believes this trend will continue to the point nearly 50% of all hospitals will be part of a national health system.
The healthcare space outside of health systems transactions is also very active. Mr. Younger noted there were over 500 major transactions in 2021. This included Siemens buying Varian, Microsoft buying Nuance, United Health buying Change healthcare, just to name a few. What does all this mean? Well as Mr. Younger put it the consolidators see healthcare as an untapped mountain of gold. I think what we can all hope for is that this significant influx of capital into the healthcare segment will lead to an acceleration of innovation.
So, what has been going on in radiology? RadPartners is the biggest consolidator and they have said that they now have 2,769 radiologists operating in 34 states and have 3,259 sites where they provide services. One of their biggest acquisitions was Mednax which included VRad tele-radiology. They also acquired Mori, Bean and Brooks in Jacksonville and Radiology Associates of Florida (Tower) which primarily operates in the Tampa market. Along the way they have accumulated 3.4 billion or roughly 1,156,000 per radiologist currently working for them.
Envision, another large national radiology consolidator, has not recently been participating in acquisitions. They have about 900 radiologists and are 2 billion in debt. They had been contemplating bankruptcy back in 2000. Mr. Younger feels they are more financially healthy due to the influx of cash from the PPP loans.
Mr. Younger also went into some detail with other national groups like Radnet, Akumin Outpatient Centers, Rayus Outpatient Centers and SimonMed. All of these are newer entrants to the consolidation wave and are currently active.
Mr. Younger speculated on why groups are selling and what we might see in the future. Generally, when radiologist become partners in a radiology practice, they pay a fraction of what their shares are really worth. They also receive just that same fraction of what they’re worth when they leave. However, if they sell to a consolidator then the partners will receive the true market value for their shares. This could easily be 10-20 time more than what they would get if they just retired. It’s a tempting proposition and depending on the group’s demographics (majority of partners are radiologists close to retirement for example) it can be hard to pass up. Couple the money factor with radiologist burnout, a lack of succession plan and a group can be an ideal candidate for a transaction. Mr. Younger feels that most that fit this criteria have already sold to one of the consolidators and therefore the transaction pace might slow. He also pointed out that the lack of a viable succession plan or the inability to replace organization leadership could lead to a new wave of transactions down the road.
Mr. Younger said that not all transactions go smoothly. Getting on a common PACS across the whole organization is a difficult hurdle. Culture of the acquired group and push back for the non-partner radiologists could lead to tensions within the group.
Mr. Younger has been working as a consultant for a non-radiology medical group transaction and learned firsthand the work needed for the selling group to complete a transaction. He discussed the significant cost and significant complexity of putting these deals together. It could run into the millions for the larger practices in legal, accounting and consulting fees. That money is at risk if the transaction never closes.
Given all this activity you would think these consolidators are well on the way to controlling a majority of radiology groups. Mr. Younger pointed out that’s way off the mark and estimates that it is in the range of just 15%, plus the pace of transactions are slowing.
What’s the end game? Mr. Younger feels that most of these consolidators are likely to sell either into the public market or to a bigger consolidator. The end game is not likely to be just the love of running a radiology business.
What’s my take away? Well, if your group is not interested then you’re currently in the majority. Could that change? Sure, but I believe that Mr. Younger is correct that the groups that most appreciated this opportunity have already sold. Also, the amount consolidators are willing to pay has also dropped. You must also remember the consolidators control the radiology group not the hospitals. Hospitals are free to contract with anyone they choose to. What happens a decade from now when the only ones left in the radiology group are the employed physicians that did not participate in the cash buyout. No one knows the answer to that but it is something to think about.
I touched on about 50% of what Mr. Younger discussed on this topic. It was a terrific presentation. Next month, I will discuss the highlights of the HR presentation and the Surprise Billing presentation. |
John Detelich, CPA, MBA, CEO
President, FRBMA
jdetelich@radassociates.com |
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| Legislative Update |
Greetings from the Florida Capitol. We are almost through week four of the legislative session and the House and Senate are starting to unveil their respective budget proposals. The state is experiencing a record high of recurring and non-recurring dollars which should make the budget easier to negotiate and finalize. Both bodies are hard at work on reapportionment and the maps have been released and are being heard on the House floor this week. The Governor proposed his own maps for the Congressional seats, which is unusual, and he requested that the Supreme Court review them. It will be quite interesting to see which maps are chosen.
The Telehealth controlled substance prescribing bill, supported by the FMA, is poised to pass both houses. To date, most of the scope expansion bills have either not been filed or heard which is excellent news for the House of medicine. We still have not reached the halfway point; so, it is too soon to celebrate by any means.
Thanks to Dr. Raj Kedar and the following residents- Dr. Parker Freels, Dr. Crystal Seldon, and Dr. Luke Rindy for making the trip to Tallahassee and spending time with me in the Capitol. They were wonderful stepping up and helping me work issues on behalf of the FRS.
Special thanks to Dr. Williams and his lovely wife Pat and Leader Mike Grant for welcoming Dr. Kedar and the residents to Tallahassee. It was an extra special dinner as Leader Grant presented Dr. Williams with a resolution from the House of Representatives honoring Dr. Williams and his life time of accomplishments. Well deserved!
Dr. Luke Rindy, House Leader, Representative Mike Grant, Dr. Crystal Seldon,
Alison Dudley, Dr. Charles Williams, President, Dr. Raj Kedar, Dr. Parker Freels, and Mrs. Pat Williams
Thanks to all for their help and support. |
Thanks, and stay well.
Alison Dudley, FRS Lobbyist
AlisonDudley@dudleyandassociates.com |
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| Martin Northup Resident Leadership Award |
H. Martin Northup Resident Leadership Award – A scholarship opportunity for Florida Diagnostic Radiology, Radiation Oncology and Medical Physicist 2nd year Residents or graduate students.
Martin Northup was very committed to radiology resident education and advancement. To eternally honor and remember him, the board of the FRS Foundation has established a special award bearing his name, the “H Martin Northup Resident Leadership Award.” Each year, this award will be given to a 2nd year Florida radiology resident who will be a 3rd year at the time of the fellowship to support the cost of accommodations for attending the FRS annual summer meeting. The resident will have an officer mentor and will attend all functions including the board meeting. The goal is to develop future leaders in Radiology and develop promising residents to assume greater roles in the society, such as President of the Resident and Fellow’s Section. The award recipient will be chosen for the 2022 Annual Meeting in Amelia Island, Florida, July 15-17, 2022 by the Scholarships and Grants committee based on a competitive application process.
Please click here to download an application. Return your completed application to lroger@edusymp.com by May 16, 2022 in order to be considered for this award.
Thank you,
Jeffrey Stone, M.D., FACR
President, FRS Educational Foundation |
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| 2022 Annual Meeting of the FRS & FRBMA |
Please join the Florida Radiological Society and the Florida Radiology Business Management Association for the 2022 Annual Meeting at The Ritz-Carlton Amelia in Amelia Island, Florida July 15-17, 2022. The meeting will focus on “The Evolution of Radiology: Then, Now, and the Future” and will feature lectures by faculty who are leaders in the practice of radiology. We look forward to seeing you in July.
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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.
Phone: (813) 806-1070
Fax: (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 |
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Available Positions
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| FRS Member In Focus |
I am a radiation oncologist who specializes in the treatment of breast cancer. I was born and raised in Chicago where I also completed my medical training and residency. I joined Mayo Clinic Jacksonville in 2001 and have had the great fortune of being involved in medical education as Program Director since 2015. As a Program Director I recognize the importance of diversity and inclusion in training programs. We know the fields of radiation oncology and radiology have a lower proportion of women and under-represented minorities, and I am involved at the local and national level in programs to mentor and sponsor these individuals. It has been one of the most rewarding aspects of my career to help develop the younger generations and to watch their careers unfold.
Attending the 2021 FRS Annual Meeting
Left to right: Tim Malouff, MD; Omran Saifi, MD; Jennifer Peterson, MD; Laura Vallow, MD; Dee Seneviratne, MD; Aaron Bush, MD
In 2021, I transitioned to Department Chair, replacing Dr. Steven Buskirk. It was Dr. Buskirk who led to my involvement with the FRS, when he asked for my involvement in the Annual Meeting. I attended the first year at his request and haven’t missed a meeting since! When I became involved with the FRS, the members were so welcoming and supportive, I knew I wanted to increase my engagement in the society. I now have the honor of serving on the executive committee. The FRS Annual Meeting is one of my most anticipated events and I look forward to it every year.
On a personal note, I love Florida and love being outdoors. I am always planning some adventure with my husband and our 4 kids. We enjoy boating, camping and the beach. Music is also an important part of my life. I am a music devotee and always on the hunt for new and interesting music across a wide span of genres. I find the diversity of music, like people, enriches my life.
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Laura Vallow, MD
Treasurer, Florida Radiological Society
Vallow.Laura@mayo.edu
To promote Diversity, inclusion, and representation, we will feature one FRS member in the “Member in Focus” column in the monthly Ebrief. Please let us know if you know of someone for this column.
Raj Kedar, MD, FACR
President, FRS |
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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: Dr. Mergo
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
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| 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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