Magazine

In 1994, Rosabeth Moss Kanter coined the phrase “collaborative leadership” in Harvard Business Review to describe the leadership skills and attributes needed to successfully develop and manage interorganizational strategic alliances.1 The authors of a 2014 book, New Leadership for Today’s Health Care Professionals, also explored this concept, explaining that collaborative leadership requires a leader who can achieve success by motivating individuals in multiple organizations while bringing together and aligning the goals of many stakeholders.2

Radiology has been intertwined with information technology in a generally enthusiastic, if occasionally uneasy, embrace for the better part of four decades. What does this mean for radiologists right now and going forward? To hash out that question, we assembled a panel of four practicing radiologists with leadership-level expertise in IT and informatics:

When Verlon Salley, MHA, CRA, arrived six years ago as executive director of radiology at UPMC’s Presbyterian and Shadyside Hospitals in Pittsburgh, he vowed to give his staff a more powerful voice. It was more than mere lip service. Consider: he sat down with a patient care aide who had 40 years with the organization and asked for her candid thoughts on how to improve personnel engagement.

Large Outpatient Providers Are Adapting, but Can Smaller Businesses Survive?

Earlier this year, a bill known as HB 1036 passed in the Texas House of Representatives and the Texas Senate and was subsequently signed into law by Texas Governor Greg Abbott. Sponsored by Texas Rep. Senfronia Thompson (D-Houston), the law requires all commercial insurance providers in Texas to cover the cost of digital breast tomosynthesis (DBT, also known as 3D mammography) for all patients.

I still vividly remember the protocol for a CT scan of the abdomen and pelvis from 1993. “Give two cups of barium to drink one hour prior to scanning, two cups 30 minutes prior to scanning and one cup on the table just before scanning,” it read. “Parameters included 5-mm scans with a 1.5-mm pitch helically, from domes of the diaphragm to the iliac crest with axial images through the pelvis.” These were the notes handwritten by our chief radiologist for each and every patient requiring the protocol. There were never any shortcuts taken or shorthand used; each protocol was painstakingly written.

In the not-too-distant past, patients seldom, if ever, had an opportunity to meet face-to-face with a radiologist or access their own imaging reports. In addition, providers rarely asked for feedback or considered the patient’s perspective when implementing new policies. But in the age of patient satisfaction, times are changing as radiology practices and hospital radiology departments are implementing patient-centered strategies intended to improve patient care and, in turn, support an increased level of patient satisfaction.

I visited the great city of Chicago back in April for RBMA’s PaRADigm annual meeting. It was a terrific conference overall, but one moment in particular stands out.

As a collectively key component of the Affordable Care Act, accountable care organizations (ACOs) entered the present decade looking poised to enjoy a long and dominant run in the driver’s seat of U.S. healthcare economics. Many providers—not just primary-care “gatekeeper” docs but specialists too—had the sense they’d better join, align with or otherwise befriend an ACO if they wanted to remain enduringly relevant and maximally reimbursable. Today, the buzz is centered on CMS’s Quality Payment Program (QPP), with its MACRA and MIPS alphabet soup hogging the spotlight.

Over the last 10 to 15 years, awareness of the risks of radiation exposure in medical imaging and efforts to reduce dose have escalated exponentially. Imaging equipment vendors have answered the call with dose-reducing strategies that include more sensitive image receptors, better image reconstruction techniques, dose alerts and post-processing software. Radiologists, technologists and physicists have been hard at work as well, edging down dose without compromising image quality. So where do we stand? Are we as low as we can go or is there more that can be done?

For nearly 30 years, gadolinium-based contrast agents (GBCAs) have been used to aid diagnosis in clinical MRIs and have been considered safe for patients without severe renal insufficiency. Recent studies have shown that traces of gadolinium may be retained in a patient’s brain after use, however, sparking a firestorm of passionate debate.

I have experienced medical imaging from a perspective that is a bit out of the ordinary, spending my Sundays working on NFL sidelines. The fast-paced, physical world of professional football has taught me a great deal over the years, and I like knowing that I am making a difference in the lives of these athletes.

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