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Table of Contents
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Letter from the Editor |
The 2022 ACR Meeting came to a close this past week, the first in-person meeting for the College since 2019. As always, an enthusiastic Florida delegation was heavily involved in the meeting, representing our state, our radiologists, and our patients. We would like to congratulate the new Fellows of the ACR from Florida: Guilherme Dabus, MD, Gary Felsberg, MD, Doug Hornsby, MD, Robin Osborne, DO, Jeffrey Peterson, MD, and Robert Pooley, MD. We would also like to celebrate our own David Epstein, MD, for receiving ACR Global Humanitarian Award for his work across the globe in helping patients in need, including Honduras, Panama, and Iraq. Please click here for more information on Dr. Epstein’s wor k Click Here. Congratulations David!
The ACR meeting as usual focused on economics and advocacy. The Board discussed the joint lawsuit of the ACR and the societies for emergency medicine and anesthesia against the federal government over the No Surprises Act. In short, the Act aims to curb bills to patients from out-of-network providers and legislated a dispute resolution process including arbitration when an out-of-network provider had a dispute over how much the insurer should pay. When agencies implemented the Act, however, they made that arbitration secondary to a Qualified Payment Amount (median in-network payment) as a central way to determine the ultimate rate that was paid. This decision is seen as contrary to what the Act itself demanded and as detrimental to physicians. The QPA may be significantly lower than what the physician would usually be paid, and the system incentivizes insurers to *want* physicians and groups to be out-of-network so they can pay the low QPA rate. See here for more information Click Here. The Texas Medical Association successfully sued to have a stay placed on the Act, and the federal government recently (Fri Apr 22) appealed that stay. So, the court battle is ongoing. A recent legislative win for the ACR was in December 2021 with the “Protecting Medicare and American Farmers from Sequester Cuts Act”, which staved off significant cuts from Medicare reimbursements to radiology. So, it is not all doom and gloom on the reimbursement front, but it is clear that we have to stay vigilant and involved. For the first time in AMA history, a radiologist, Zeke Silva from Texas, will chair the RUC committee of the AMA, a crucial role in the system that determines Medicare payments and ensures our work is valued properly. See Click Here. Elections for the College were held and the BOC and CSC results are below. Several resolutions were considered and the following resolutions PASSED: neutral position on MARCA, new practice parameters virtual meeting, climate change, partnership track considerations at change of business, family and medical leave, and economic credentialing and exclusive contracts. At the meeting itself Florida played its usual hospitable role — we hosted residents and students, helped lead the Southern States caucus in discussing resolutions and policy, and met to break bread at the Old Ebbitt Grill for our Florida state dinner. We all look forward to the same hospitality at our state annual meeting in July. We hope to see you there! ACR Council Elections Results for the 2022 Annual Meeting President, ACR One-year term. Howard B. Fleishon, MD, MMM, FACR Vice President, ACR One-year term. Frank J. Lexa, MD, MBA, FACR ACR Board of Chancellors Member – Commission on General, Small, Emergency and Rural Practices First three-year term. Mark D. Alson, MD, FACR ACR Board of Chancellors Member – Commission on Radiation Oncology Second three-year term. William Small Jr., MD, FACR ACR Board of Chancellors Member – Commission for Women and Diversity Second three-year term. Johnson B. Lightfoote, MD, FACR ACR Board of Chancellors – Member At-Large Second three-year term. Timothy L. Swan, MD, FACR ACR Board of Chancellors – YPS Position Two-year term. Taj Kattapuram, MD ACR Council Steering Committee New or Renewed Two-year term. Rachel Gerson, MD Nolan J. Kagetsu, MD, FACR Andrew K. Moriarity, MD Derrick Siebert, MD ACR College Nominating Committee Two-year term. Betsy Jacobs, MD, FACR Neil U. Lall, MD Christopher R. McAdams, MD
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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 |
The ACR meeting in Washington DC The FRS had a strong presence at this annual meeting. Our 31 delegates included: councilors, alternate councilors, members, new fellows, residents and medical students. The FRS and the FRS Educational Foundation had sponsored 7 residents and 2 medical students from multiple radiology and radiation oncology programs. Below are FRS members that were awarded the FACR award at this year’s convocation: Gary Joesph Felsberg, MD Douglas Neal Hornsby, MD Robin E Osborn, MD Jeffrey James Peterson, MD Robert lan Pooley, PhD Congratulations to all of the newest ACR fellows from the FRS chapter. The 2022 FACR application cycle is open and the deadline for the Florida chapter is May 31. Some of the important resolutions that were passed with little alterations at the ACR annual meeting are: Family leave: The American College of Radiology (ACR) recommends that diagnostic radiology, interventional radiology, radiation oncology and nuclear 64 medicine practices, departments and training programs strive to provide 12 weeks of paid family/medical leave in a 12-month period for its attending and trainee physicians as needed. Partnership-track Associates at time of business change: The ACR recommends that partnership track associates should receive at least some proportional monetary compensation and should be included in discussions related to substantial changes in practice structure or ownership as legally permissible. ACR Elections: Unfortunately, the FRS did not have any candidates in fray. Hopefully, we will have some next year. Hope to see an even stronger presence of the FRS chapter in next year’s ACR meeting.
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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, FACR
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FRBMA President’s Message |
Why is healthcare lagging behind in the implementation of artificial intelligence? Geoffrey Hinton, early AI researcher wrote, “We should stop training radiologists now. It’s just completely obvious that within five years, deep learning is going to do better than radiologists”. That was written in 2016, six years ago. So, why has there been so little advancement in AI?
In the Radiology Business Edition in March 14, 2022, there was a brief mention about a research paper from Brookings Institute regarding healthcare’s slow adoption of AI. There was a link to the Brookings research, which I am providing here: Click Here. The report was published March 8, 2022 and this month’s article provides a high-level summary of their findings.
Who is the Brookings Institute? Brookings Institute is a think tank located in Washington, DC that is often quoted by media and politicians. They describe themselves as independent and non-political. There have been studies that show their research, when used by politicians, is used almost equally by both sides of the aisle: 53% that used their research were left leaning and 47% who used their research were right leaning. They were founded in 1916 and the most recent data I could find showed that in 2020 they had revenues of $86 million and expenses of $93 million. Their foundation has over $500 million in assets. They’re funded primarily through individual donations and government funded research grants. In 2020 they received grants from 21 countries. They receive donations from hundreds of individuals and foundations each year. The largest donors in 2020 were: BHP foundation, Federal Republic of Germany, Bill and Melinda Gates foundation, Robert Wood Johnson foundation, Alfred P Sloan foundation, and the Andrew H. and Ann R. Tisch foundation. Brookings has won “Think Tank of the Year” and “Top Think Tank in the World” every year since 2008.
Brookings hypothesis is that healthcare is not getting investment in this early stage of AI development. They looked at job postings across all industries and found that healthcare is hiring the second lowest level of AI capable employees as compared to other industries. Healthcare AI capable job postings amount to one AI capable job posting for every 1,850 job postings of non-AI related skill set. On the other end of the spectrum is the Information industry which is running the most job postings; one AI related job posting for every 71 non-AI postings. That seems a bit obvious. But third from the top was Finance industry which had one AI related job posting for every 175 non-AI job postings. So, why so little investment in healthcare especially when you consider that healthcare showed so much “early” AI promise?
Brookings Institute listed five main factors that are slowing the advancement of AI in healthcare.
Barriers to Adoption Healthcare organizations use numerous systems to provide care and there is a lack of complimentary innovations in these systems that would simplify the integration of AI. In other words, the technologies and the manufacturers of those technologies are not actively working on the adaptation and/or integration into the AI space. This can be true in other industries as well; but, the scale and variety of systems that must be integrated within healthcare is significantly more complex than that of other industries.
Algorithmic Limitations The actual function of AI is a black box and once released it may encounter not previously considered scenarios. The system may need additional tweaking as it gets into real world application. The stakes are different in healthcare and a more proven and reliable system is needed in a healthcare AI implementation.
Data Access Limitations You need mountains of data to develop an AI model. Cooperation from the healthcare industry is less welcoming than other industries. Just the nature of healthcare makes it’s more difficult to collect. Then there is the complexity of pooling the data across numerous providers. Finally, the data itself could have different labeling, formatting and other attributes based on the hardware software, and workflow differences from one provider to another.
Regulatory Barriers There are three regulatory issues that hamper adoption. (1) Privacy issues with patient data. (2) FDA approval for any medical technology which can be a very lengthy and uncertain process. (3) Liability risk concerns for AI developers related to negative outcomes that could, at least partially, be attributed to the AI product.
Misaligned Incentives For the most part, physicians are not aligned with AI developers. A couple years ago, an AI developer approached our group and offered to read all of our plain films for $6 per study. The catch was that we had to give them access to our historical data and we had to sign a 5 year exclusive contract (non-stats). The business plan was to initially use radiologists to read the studies; but, also have the AI learn how to interpret studies by working side-by-side with the radiologists. We said “no” because we were not aligned with their end goal.
The Brookings article pointed out similar misalignment issues. However, they also noted that in large organizations non-physician business leaders are more prevalent and they do not have the same alignment issues as physicians. They are, in fact, incented to reduce costs through adoption of AI. However, physician leadership can be heavily ingrained in these healthcare organizations as members of the board of directors and in executive level positions. Conflict and disagreements on AI strategies can develop from the comingling of business professional leadership and physician leadership.
Brookings View on Policy Implications Brookings believes there is great potential for AI in the healthcare space. However, given the lack of advancement, there is at least some possibility that AI is not a good fit for healthcare. That said, here are the things that could help spur development:
- Improve the regulatory approval process. Make it more transparent and clear to the developers.
- Address the liability issues and provide clarity as to who is legally accountable on AI related negative outcomes.
- Develop policies for data sharing mechanics that are efficient and don’t violate patient privacy.
- Brookings sees misaligned incentives issue as difficult as long as “physicians have a seat at the table”.
Final Thoughts The first three policy implications listed above will eventually be addressed. However, these policy observations by Brookings are not obvious enough that it will drive legislative change by our lawmakers without a strong lobbying effort by AI developers. Misaligned incentives is a more difficult issue to solve. The combination of corporate radiology and an increase in the hospital-based physician employment model has reduced the influence of the radiologist, at least in these models. To the extent that corporate radiology groups and employment model hospital providers adopt AI that provides them a competitive advantage, private practices may need to move in the same direction. |
John Detelich, CPA, MBA, CEO President, FRBMA jdetelich@radassociates.com |
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Legislative Update |
Since my last Ebrief, we have had our first special session and the new congressional maps were passed and sent to the Governor and have been signed into law.
Also, included in the call, was an act relating to special districts which dissolved the Reedy Creek special district along with four other special districts. The bill sunsets the districts in a year which will allow the legislature to pass legislation modifying how these districts are set up, if need be.
The Governor has called another special session for May 23-27th and plans to address property insurance. There are rumors that he will also take up consumer data privacy legislation.
There may be a third special session to address: open carry of firearms and how union dues are collected.
Needless to say, this is making it difficult for members to fundraise as they are prohibited to raise campaign funds during session.
Campaign season is well underway and lots of our friends are fundraising.
Please contact me if you have any questions on your local candidates.
Wishing everyone well. |
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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 2-night hotel accommodations and tax 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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Available Positions
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FRS Member In Focus |
I grew up in south Florida and attended college and medical school at the University of Miami. While I left for five years to complete my training, I knew that I wanted to return to the sunshine state to practice. After completing my fellowship, I was fortunate to be offered that opportunity to return.
I met several radiologists from our home state during my training who had warmly mentored me into exploring career opportunities in Florida. One of those people, so generous with their time and effort, was Kurt Scherer M.D. We crossed paths when we were both training at the University of Washington – he as a fellow, me as a resident. Kurt volunteered small group board reviews and, in between his case sessions, shared how important early career legislative action in the FRS was for him. His energy, enthusiasm, and genuine caring for our profession was contagious!
Since then, I have had the chance to meet many more passionate Florida radiologists and that “genuine caring” spirit always shines through. To be able to put into practice that caring spirit was the driving factor for me to pursue residency leadership as a part of my early career.
Mentoring and sponsoring trainees is an excellent way to be involved in our future, develop as an educator, and network with colleagues across our state. There is great satisfaction in being given the opportunity to make an impact on the future of our specialty, and to watch many trainees serve as FRS officers during residency or go on to be legislative leaders in their community, as well as nationally, early in their careers. My trainees have expressed to me the sense of fellowship, valuable early career sponsorship, and a voice that the FRS gives them. They look forward to the annual FRS meeting as an accessible and warm place to network as they prepare for the next stage in their careers.
I am proud to be a part of a chapter that has impactful grassroots efforts and involves members at all stages of their career. This engagement is even more paramount to me as a woman in radiology because I have been mentored by both women and men leaders at the FRS. True to the grassroots and genuine caring spirit, they are equally actionable in providing an opportunity for scholarship and service to women medical students, trainees, and early career women faculty. To see many of our women FRS members carry the torch to national level leadership with the ACR, serving as chairperson and vice chairs, and grow and lead dynamic practice groups across our state is validation of the success of this effort by the FRS.
As I continue into the next chapter of my career, I hope to keep mentoring medical students and train women to boldly venture into leadership and build friendships in our society. You never know which FRS member is going to inspire and guide you into the next joyous chapter of your career!
Nupur Verma, MD |
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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