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By: Cullen Ruff, MD

Saying, “I want it anyway,” the ICU physician insisted that his patient with breast cancer should get an MRI exam to look for lung metastases. My years of experience as a radiologist did not dissuade him; such a test would be a poor way to evaluate his patient’s lungs, even under ideal circumstances (which hers were not). She was on a ventilator, incoherent, and unable to hold her breath, rendering the study a useless waste of time and money. More important, her lungs, just days earlier, had been clear on a chest CT exam—the gold standard for detecting lung nodules. We already knew that she had no lung metastases. Repeating, “I want it anyway,” the ICU physician became emphatic and slightly frantic, desperate for information on why his patient was doing poorly. Unfortunately, that...

Features
By: Cheryl Proval
Welcome to the results of the sixth annual radiology-group survey. Recently, I had lunch (at a conference on health care’s future) with the former CEO of a large teleradiology company, and he asked...
Features
By: Cynthia Keen
As citizens and the media debate the cost and growing pains associated with the Patient Protection and Affordable Care Act (PPACA), Cuckler et al¹ (at the CMS Office of the Actuary) predict that...
Features
By: George Wiley
What policymakers and payors want from radiology departments is not volume, but value. If radiologists can help hospitals contain costs, improve quality, and increase market share, then these...
Features
By: Cat Vasko
It’s the assumption at the core of GE, IKEA, and Unilever’s strategies; its presence, or lack thereof, guides the investments of billionaire Warren Buffett, among others. Sustainable competitive...
Features
By: Ben Lauing
If someone asked you to define quality in radiology, what would you say? The precise definition of quality is certainly nebulous, but it has never mattered too much—until now.
Features
By: RIchard Heller III, MD, MBA
Efficiency can be thought of as the volume of work done over a period of time. In diagnostic radiology, that has been interpreted to mean RVUs per radiologist per unit of time. With decreasing per-...
Features
By: Galen Kilroy; Paul Francaviglia; Aditi Vakil; and David S. Mendelson, MD, FACR
There has long been interest in clinical decision support, especially at the time of order entry, but a lack of systems (and credentialed guidelines) has limited clinical use.
Features
By: Cheryl Proval
Eight years ago, I sent an email to Barry Pressman, MD, FACR, radiology chair at Cedars-Sinai Medical Center (West Hollywood, California). My 75–year-old mother, a lifelong nonsmoker whose primary-...
Features
By: Kris Kyes
On September 9, 2013, Cheryl Proval, editor, Radiology Business Journal, moderated “The Boston Experience: Radiology’s Value Proposition in the New Health-care Paradigm,” a panel discussion held in...