July 2022 Ebrief

Odds and Ends and Final Thoughts

My two-year term as FRBMA President concludes at the end of the July FRS/FRMBA conference. Consequently, this will be my last article. Rather than just selecting one topic, I decided to write about the things that are most on my mind.

FRS/FRBMA Meeting July 15

In prior articles I have provided a full overview of the upcoming conference. Because I am including several topics in this article, I am only highlighting the session “Radiology Practices Interactive Session” which I feel will be very unique and interesting session. This session compares and contrasts the typical work and career experience a radiologist based on the type of company that they join. The session focuses on the three most common business structures:  Academic, Corporate and Private Practice.  Six organizations (two from each business model) were invited to provide a presentation. Each organization has received three topical categories that they must address. The exciting part of this session is that each of the selected organizations will be sending a representative from their senior leadership team. The format allows each presenter ten minutes to address the topics proposed by FRS/FRBMA planning committee.  Following their presentation all of the presenters will participate in a 25-minute open question and answer panel discussion.  This is just one session of a terrific program.  I look forward to seeing you at the meeting.

Things I worry about most:

1. Cyber risk. Insurers that are willing to cover cyber risk is shrinking. Vendors that are in this space have been imposing minimum requirements to qualify for this insurance coverage. The requirements required are workflow design and processes, training, and software applications that essentially will reduce the likelihood of a cyber-event. I expect the compliance requirement will increase to keep pace with the expanding threats. The impacts to our groups will be: (1) significantly higher annual IT annual expenditure growth rates and (2) cybersecurity premiums will far exceed inflation rates. Even if you have high-tech cyber solutions and you’re insured, you could still have a cyber-event which will significantly disrupt your organization
2. Labor force shortages. US birth rate has dropped 50% from 1950 (24 per 1,000) to 2021 (12 per 1,000). US population growth rate has declined by 50% over the last 25 years.  Participation in the US work force has still not reached pre pandemic levels. An increasing number of employees are selecting jobs that allow work from home and other have left the work force altogether. All industries will need to plan for these trends. We need to begin discussions in our groups to strategize how will address these trends.
3. Healthcare costs.   2022 is likely to result in the largest annual employee health insurance premium increase in history. Brown and Brown shared with our group that the 2022 health insurance renewals are running just under 18%. Our previous high for a premium increase was in 2019 at 11% and our average over the last 20 years gas been 6%. Increases of 18% are unsustainable. Higher deductibles and implementation of HSA plans with mandatory employee match contributions could slow the upward trajectory.
4. Future Leadership in FRBMA.  One of the things I love about the semi-annual FRMBA conferences are that you develop relationships with practice leaders across the state. Each meeting you get gather with your colleagues that you have worked with most of your career. And that’s really the point. I see a lot of the same faces every year. In fact, most of the attendees are the same people that attend every year.  And here is the problem.  Many of us are late-stage career and if you have not been to one of these meeting you do not understand their value.  We all must make a concerted effort to include more of our staff in the two FRBMA conferences.

Things that make me wish I wasn’t retiring in 3 – 4 years

1. Working with some of the most talented people in the country. The radiologist and business colleagues that I have worked with have added so much value to not only my career but also my life.
2. The excitement of seeing where AI is going and how it will change our practice. The opportunity to change the delivery of medicine is at our door step and the changes could be profound.
3. Seeing who will be the victor in the corporate vs private practice model.  I believe it will be the decisions and strategies that each model deploys in the next ten years that will determine the end result.

Things I must do but never liked

1. MIPS. I am not sure that any healthcare outcome was actually improved.
2. AUC design.  Although not yet implemented this is something I have spent many hours on and unless congress changes the law, I will be working with this for all of my remaining years. Awful program design that I believe will have limited impact on costs or quality.
3. The ever-increasing government regulation over business and healthcare
4. Too many 14-hour days and not taking all my vacation.

I would like to let you all know how much I enjoyed the last two years. I have always felt that my company deserved all my attention so I never sought a leadership opportunity with FRBMA. But reflecting back I find this to have been a worthwhile experience.  It has also given me an appreciation for those that freely give their time to the FRS and FRBMA.

Finally, I’d like to give special thanks to Barbara Rubel and Jeff Younger for all their guidance and help during my term.  And an extra special thanks to Lorraine Roger for all that she does to support the FRBMA and FRS.

Florida qualifying for all statewide candidates and Congressional members has been finalized. It is a reapportionment year; so, many members have been drawn into new districts.

Several Candidates are unopposed including the incoming Senate President Kathleen Passidomo-R Naples.

Other Senators who were elected without opposition are Republican Senators: Jennifer Bradley, Gayle Harrell, Ana María-Rodriguez, Ben Albritten (Senate President designated after Sen Passidomo) and Debbie Mayfield. Democratic Senators elected without opposition are: Senators Jason Pizzo, Bobby Powell, and Rosalind Osgood.

Three Republican House members who were running for Senate seats were all elected without opposition:  Clay Yarborough (Aaron Bean’s seat), Erin Grall (newly created treasure coast seat), and Bryan Avila (Sen Manny Diaz’s seat). Also new to the process is Republican Jonathan Martin who won’t have opposition for Senate District 33 which was Sen Ray Rodrigues’s seat.

More than 20 House Candidates will be re-elected without opposition. I will go into more details on the House during the FRS summer conference.

Of note – We have two radiologist’s wives running for election to the Florida House. Robyn Hattaway is running in a newly created Daytona/Space Coast seat and Karen Pittman is running in the open seat created by Rep Jackie Toledo leaving to run for a newly created Congressional seat.  

Governor DeSantis drew no primary opposition and will face the winner of the Democratic primary which most likely will be Charlie Crist. Current polling shows the Governor winning against Crist – 54% to 42%. The same poll shows a three-seat loss for the Democrats in Congress.

I look forward to seeing everyone at the summer conference in Amelia Island. Please feel free to contact me if you have any questions regarding the upcoming elections.

All my best,
Alison Dudley

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Dr Brittany Fowler Rea

Dr Brittany Fowler Rea is a 3rd year diagnostic radiology resident at the University of South Florida. She is a St Petersburg, Florida native and the daughter of a Cuban immigrant. She was the first person in her family to seek higher education as she completed her undergraduate degree at University of Miami. After a brief time away from Florida for medical school at New York Medical College and intern year at Green Hospital with Yale New Haven Health, she chose to return home for residency where she plans to live and practice after training. She plans to apply to Neuroradiology fellowship this upcoming fall. Dr Rea recently attended the ACR conference in Washington, DC as one of the FRS scholarship recipients and was also recently named the recipient of the FRS Dr. Martin Northup Resident Leadership Award. She also intends to become actively involved in the RFS chapter this year. She currently lives in St. Petersburg where she bought a home with her husband Joseph and her Rottweiler Kya. In her free time, she can be found on the beaches, exploring the Florida springs, listening to live music in downtown St. Pete, watching the Tampa Bay Lightning, or catching a live local comedy show.