A year to forget: Radiology Business’ biggest stories of 2020

COVID-19 dominated the headlines in 2020, but this year had no shortage of big stories outside of the pandemic realm.

Those included publicly traded Mednax announcing plans to exit radiology, only to sell its slew of imaging practices to an even larger player. And when they weren’t grappling with safety concerns or declines in patient visits, many radiologists spent time writing to members of Congress, asking them to address millions in Medicare cuts coming down the pipeline in 2021.

Lawmakers obliged this week, approving a massive year-end spending bill, injected with $3 billion to help smooth over these concerns.

Beyond Mednax, other big names made their way into our most-read stories of the year, ranging from Walmart to Cigna, the American Board of Radiology and even action star Chuck Norris. Here’s a look at Radiology Business’ most-read stories of 2020.

12) Pennsylvania radiologist, hospital must pay $10.8M over allergic reaction to gadolinium, jury rules

Malpractice settlements are nothing out of the ordinary in imaging, but this one likely caught eyes for the hefty amount. Back in August, a Pennsylvania jury ordered supervising radiologist Kelly Biggs and Tyrone Hospital to pay nearly $11 million in damages. The judgment came after 45-year-old Christopher Carey Miller suffered an allergic reaction to gadolinium during an MRI exam. A delay in receiving epinephrine caused severe brain damage to the patient, and the payout was slated to help with his around-the-clock care.

11) Walmart continues its push into imaging, primary care with new clinic

Retail giant Walmart caught radiology’s attention back in February when it announced plans to open a brand new health clinic in Georgia, complete with x-ray imaging and other diagnostic services. Finding early success with the new business segment, the Arkansas-based company said it has “bold ambitions” to rapidly expand the model with several health hubs in the near future. As part of that push, Walmart also recently hired cardiologist Cheryl Pegus as its new executive VP of health and wellness.

10) Decorated neuroradiologists express ‘concerns’ over peer Scott Atlas’ White House guidance during pandemic

Neuroradiologist and Stanford fellow Scott Atlas, MD, came onto the COVID-19 scene in August, tapped by the president as an advisor, despite having no background in infectious disease. From there, he was a source of controversy, promoting a “herd immunity” approach to the pandemic, and urging Michigan residents to “rise up” against lockdowns. Colleagues at Stanford criticized Atlas’ tenure at the White House, as did a group of decorated neuroradiologists. He resigned from his post on Nov. 30.

9) Board certification brouhaha: Rads cry foul over ABR’s ways and means

Years of simmering tensions between physicians and the American Board of Radiology seemed to come to a head this year. Radiology Business Journal documented some of the history back in April, noting widespread unrest among the industry, accusing ABR of being opaque and monopolistic. Some of those strains bubbled over during the summer as the field implored ABR to offer online test taking amid the pandemic. The board heeded those calls in June, with virtual exams on tap for 2021.

8) Humana curtails coverage for PET/CT, drawing 'adamant' disagreement from imaging advocates

Two major commercial insurers made our most-read list this year for implementing payment policies that restrict patients’ access to imaging care. Cigna came first, announcing in February that it would stop covering most hospital-based CT and MR imaging, steering patients, instead, to cheaper outpatient options. The Connecticut-based payer briefly delayed implementation, due to the pandemic, but moved forward in August. Meanwhile, Humana drew ire in November for its plans to restrict PET/CT coverage because of the modality’s “experimental” nature.

7) $2M settlement after subpoena of radiologist’s keystrokes finds lax CT reading

A new malpractice concern emerged in 2020, after attorneys extracted a $2 million settlement from Tenet Healthcare. They had claimed physician Steven Fuhr was lax in his duties for failing to spot brain bleeding on one patient’s CT images, leading to his eventual death. Attorneys subpoenaed records from the hospital and found “smoking gun” evidence that Fuhr spent six and a half minutes interpreting 700 images. In a recent analysis, one expert urged rads to be aware of this “novel allegation,” and prepared to answer questions about how the profession works.

6) Radiologists urged to reschedule all nonurgent imaging in wake of COVID-19’s spread

As the severity of the pandemic grew clear, the American College of Radiology in March began urging physicians to reschedule nonurgent, outpatient imaging visits where possible. ACR’s guidance mirrored recommendations from the CDC, as health officials sought to keep care workers away from harm and preserve scarce protective equipment at the time. Several stories on COVID safety made the most-read list, top of which was this piece on steps to safeguard practices. Multiple members of the imaging community lost their lives to the virus, including an Ohio department director, a longtime Indiana interventional radiologist, and a Florida rad tech.

5) Mednax to sell its $550M Radiology Solutions business line, change name back to Pediatrix

Amid those summer slowdowns, Mednax announced plans to exit radiology back in June after also abandoning anesthesiology in May. Leaders of the Florida physician firm, however, said their decision had nothing to do with COVID. Rather, it was a strategic choice to focus on caring for mothers and children (with Mednax changing its name to Pediatrix). El Segundo, California-based Radiology Partners ended up buying the firm’s imaging business line for $885 million, closing the deal Dec. 15.

4) How radiology practices can prepare for the ‘surge’ once routine cancer screenings resume

After radiology providers shook off the initial shock shutting things down in April, leaders began plotting for the upcoming “surge” once routine screenings resumed. Experts from Michigan Medicine and RSNA detailed some of their recommendations for this ramp up, including extending hours, shortening imaging protocols, and reconfiguring traffic patterns. Several studies this year detailed COVID’s profound impact on imaging, with some experiencing outpatient visit decreases north of 80%. Amid the industrywide slowdown, the U.S. FDA halted in-person inspections and granted regulatory flexibilities as imaging facilities were forced to temporarily close.

3) Ultrasound useful for detecting COVID-19 pneumonia, emergency medicine providers say

With much of the literature focused on x-ray and CT back in March, a group of Italian providers shined a light on ultrasound’s utility during the early days of the pandemic. Publishing their work in Radiology, a team of researchers noted that computed tomography is not always available in busy emergency rooms. Lung US, meanwhile, is recommended for acute respiratory failure and had proven as a useful alternative, members of the Department of Emergency Medicine at Ospedale Guglielmo da Saliceto in Piacenza, Italy, wrote. Subsequent analyses on COVID and US went on to label the modality as the new stethoscope, and a first-line tool for assessing the disease.  

2) ACR asks Congress to protect radiology practices from double-whammy of COVID-19, costly policy change

As the pandemic took hold in March, the American College of Radiology also turned its attention to upcoming Medicare cuts, slated to hit physician specialists in 2021. The college implored Congress to address an estimated $450 million in payment reductions, noting the financial strain practices were already facing from COVID. This set off months of fierce lobbying from imaging industry advocates. One survey out of the Radiology Business Management Association estimated that 50% of rad practices planned to reduce staff, if lawmakers did not act. Months later, Congress finally came through, injecting $3 billion into the physician fee schedule to help offset the payment reductions.

1) CT should not be used as first-line tool against coronavirus, ACR warns following pandemic declaration

March 11 is likely a day many of us will remember, with the World Health Organization officially declaring the COVID-19 outbreak a pandemic. On that same day, ACR made its own declaration, urging physicians not to use CT as a first-line test to diagnose the disease. The college noted that chest imaging lacked specificity, with overlapping findings for infections such as H1N1 and SARS, and presented infection control challenges. The news came as a shock for some after weeks of studies out of China, touting CT’s usefulness in diagnosing the disease.

Numerous analyses questioned chest imaging’s COVID usefulness in the week’s that followed, including this one out of Hong Kong, published March 27 in Radiology. Meanwhile, others such as the Fleischner Society suggested a broader set of circumstances in which imaging should be used to assess patients with the virus. Dutch experts later introduced their COVID-19 Reporting and Data System, or CO-RADS, offering physicians an established process for assessing pulmonary involvement in CT scans.

Honorable mentions

Here are a few more of our most-read stories from 2020 in no particular order: