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d'Souza RG, Chetan D, Patharateeranart K, Almohizy O, Gill N, Tassos V, Young A, Lam CZ, Seed M, Yoo SJ. Synergistic Learning Models: The Case for Joint Training Programs in Pediatric Cardiac Imaging. Can J Cardiol 2024; 40:358-360. [PMID: 38787746 DOI: 10.1016/j.cjca.2023.10.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 09/21/2023] [Accepted: 10/11/2023] [Indexed: 05/26/2024] Open
Affiliation(s)
- Romina G d'Souza
- Division of Cardiac Imaging, Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
| | - Devin Chetan
- Division of Cardiology, Labatt Family Heart Centre, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Karnkawin Patharateeranart
- Division of Cardiac Imaging, Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
| | - Omar Almohizy
- Division of Cardiology, Labatt Family Heart Centre, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Navjot Gill
- Division of Cardiac Imaging, Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
| | - Vivian Tassos
- Division of Cardiac Imaging, Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
| | - Andrea Young
- Division of Cardiac Imaging, Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
| | - Christopher Z Lam
- Division of Cardiac Imaging, Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
| | - Mike Seed
- Division of Cardiac Imaging, Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada; Division of Cardiology, Labatt Family Heart Centre, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Shi-Joon Yoo
- Division of Cardiac Imaging, Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada.
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Keeping Up with Cardiac CT: A Call to Action for Cardiology Fellowship Training. J Cardiovasc Comput Tomogr 2022; 16:355-357. [DOI: 10.1016/j.jcct.2022.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 03/25/2022] [Accepted: 04/14/2022] [Indexed: 11/22/2022]
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van Hoek J, Huber A, Leichtle A, Härmä K, Hilt D, von Tengg-Kobligk H, Heverhagen J, Poellinger A. A survey on the future of radiology among radiologists, medical students and surgeons: Students and surgeons tend to be more skeptical about artificial intelligence and radiologists may fear that other disciplines take over. Eur J Radiol 2019; 121:108742. [DOI: 10.1016/j.ejrad.2019.108742] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 10/28/2019] [Accepted: 11/06/2019] [Indexed: 02/07/2023]
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Sayyid SK, Mullins ME, Singer AD. Current Trends Among US Diagnostic Radiology Visiting Professor Programs. J Am Coll Radiol 2019; 16:757-761. [DOI: 10.1016/j.jacr.2018.10.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 10/17/2018] [Accepted: 10/30/2018] [Indexed: 10/27/2022]
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Degnan AJ, Yi PH, Kim N, Swietlik J, Huh E, Nguyen JC. Diagnostic and Interventional Imaging Services are Significant Sources of Medicare Revenue for Highly Reimbursed Nonradiologist Providers. Curr Probl Diagn Radiol 2018; 49:17-22. [PMID: 30466795 DOI: 10.1067/j.cpradiol.2018.10.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 10/28/2018] [Accepted: 10/29/2018] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Nonradiologist providers increasingly perform diagnostic imaging examinations and imaging-guided interventions traditionally performed by radiologists, which have raised concerns regarding appropriate utilization and self-referral. The purpose of this study was to assess the contribution of imaging studies to Medicare reimbursements for highly compensated nonradiologist providers in specialties often performing imaging studies. METHODS The Medicare Provider Utilization and Payment Database was queried for provider information regarding overall reimbursement for providers in anesthesiology, cardiology, emergency medicine, neurology, obstetrics and gynecology, orthopedic surgery, neurology, and vascular surgery. Information regarding imaging studies reported and payment amounts were extracted for the 25 highest-reimbursed providers. Data were analyzed for relative contribution of imaging payments to overall medical Medicare payments. RESULTS Significant differences between numbers of imaging studies, types of imaging, and payment amounts were noted based on provider specialty (p < 0.001). Highest-reimbursed cardiologists received the greatest percentage of Medicare payments from imaging (18.3%) followed by vascular surgery (11.6%), obstetrics and gynecology (10.9%), orthopedic surgery (9.6%), emergency medicine (8.7%), neurology (7.8%), and anesthesiology (3.2%) providers. Mean imaging payments amongst highly reimbursed nonradiologists were greatest for cardiology ($578,265), vascular surgery ($363,912), and orthopedic surgery ($113,634). Amongst highly reimbursed specialists, most common nonradiologist imaging payments were from ultrasound (45%) and cardiac nuclear medicine studies (40%). CONCLUSIONS Nonradiologist performed imaging payments comprised substantial proportions of overall Medicare reimbursement for highly reimbursed physicians in several specialties, especially cardiology, vascular surgery, and orthopedic surgery. Further investigation is needed to better understand the wider economic implications of nonradiologist imaging study performance and self-referral beyond the Medicare population.
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Affiliation(s)
- Andrew J Degnan
- Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA.; Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.
| | - Paul H Yi
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Nathan Kim
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - John Swietlik
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Eric Huh
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Jie C Nguyen
- Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA.; Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
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Day of Week, Site of Service, and Patient Complexity Disparities in Musculoskeletal MRI Interpretations by Radiologists Versus Nonradiologists. AJR Am J Roentgenol 2018; 211:827-830. [PMID: 30063370 DOI: 10.2214/ajr.17.19438] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Although most musculoskeletal MRI examinations are interpreted by radiologists, some nonradiologists provide interpretations as well. We aimed to study day of week (weekday vs weekend), site of service, and patient complexity differences between radiologists and nonradiologists interpreting lower extremity MRI examinations on Medicare beneficiaries. MATERIALS AND METHODS Using fee-for-service carrier claims for a 5% sample of Medicare beneficiaries nationally from 2012 through 2014, we identified all lower extremity joint MRI examinations. Services were classified by physician specialty, day of week, and site of service. Charlson comorbidity index (CCI) values were calculated for all patients. Chi-square statistical testing was performed. RESULTS Of all 125,800 billed lower extremity joint MRI examinations, 118,295 (94.0%) were performed on weekdays and 7505 (6.0%) on weekends. Of the weekday examinations, radiologists interpreted 85,991 (83.3%) and nonradiologists 17,260 (16.7%). Of the weekend examinations, radiologists interpreted 6212 (92.8%) and nonradiologists 485 (7.2%). Of examinations performed in inpatient hospital and emergency department settings, radiologists interpreted 6499 (99.2%) and nonradiologists 51 (0.8%). Of the examinations on the most clinically complex patients (CCI ≥ 3), radiologists interpreted 4228 (90.2%) and nonradiologists 461 (9.8%). All interspecialty differences were statistically significant (p < 0.001). CONCLUSION In the Medicare population, radiologists interpret most lower extremity joint MRI examinations. Compared with nonradiologists, radiologists disproportionately provide services on weekends, in the highest acuity settings, and on the most clinically complex patients. To promote patient access and minimize disparities, future pay-for-performance metrics should consider temporal, acuity, and complexity parameters.
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Chen J, Fazel R, Ross JS, McNamara RL, Einstein AJ, Al-Mallah M, Krumholz HM, Nallamothu BK. Do imaging studies performed in physician offices increase downstream utilization?: an empiric analysis of cardiac stress testing with imaging. JACC Cardiovasc Imaging 2011; 4:630-7. [PMID: 21679898 PMCID: PMC3319749 DOI: 10.1016/j.jcmg.2011.04.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2010] [Revised: 04/04/2011] [Accepted: 04/11/2011] [Indexed: 11/19/2022]
Abstract
OBJECTIVES The goal of this study was to compare patterns of downstream testing and procedures after stress testing with imaging performed at physician offices versus at hospital-outpatient facilities BACKGROUND Stress testing with imaging has grown dramatically in recent years, but whether the location of where the test is performed correlates with different patterns for subsequent cardiac testing and procedures is unknown METHODS We identified 82,178 adults with private health insurance from 2005 to 2007 who underwent ambulatory myocardial perfusion imaging (MPI) or stress echocardiography (SE). Subsequent MPI, SE, cardiac catheterization or revascularization within 6 months was compared between physician office and hospital outpatient settings. RESULTS Overall, 85.1% of MPI and 84.9% of SE were performed in physician offices. The proportion of patients who underwent subsequent MPI, SE, or cardiac catheterization was not statistically different between physician office and hospital outpatient settings for MPI (14.2% vs. 13.9%, p=0.44) or SE (7.9% vs. 8.6%, p=0.21). However, patients with physician office imaging had slightly higher rates of repeat MPI within 6 months compared with hospital-outpatient imaging for both index MPI (3.5% vs. 2.0%, p<0.001) and SE (3.4% vs. 2.1%, p<0.001), and slightly lower rates of cardiac catheterization after index MPI (11.4% vs. 12.2%, p=0.04) and SE (4.5% vs. 7.0%, p<0.001). Differences in 6-month utilization were observed across the 5 healthcare markets after index MPI but not after index SE CONCLUSIONS: Physician office imaging is associated with slightly higher repeat MPI and fewer cardiac catheterizations than hospital outpatient imaging, but no overall difference in the proportion of patients undergoing additional further testing or procedures. Although regional variation exists, especially for MPI, the relationship between physician office location of stress testing with imaging and greater downstream resource utilization appears modest.
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Affiliation(s)
- Jersey Chen
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut 06520, USA.
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Minocha J, Yaghmai V, Hammond N, Pyrros AT, Nikolaidis P. Cardiac imaging training in radiology residency programs: a survey of radiology chief residents. Acad Radiol 2010; 17:795-8. [PMID: 20457420 DOI: 10.1016/j.acra.2010.02.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2009] [Revised: 02/04/2010] [Accepted: 02/06/2010] [Indexed: 10/19/2022]
Abstract
RATIONALE AND OBJECTIVES Comprehensive training in cardiac imaging during radiology residency is imperative if radiologists are to maintain a significant role in this rapidly growing field. In this study, radiology chief residents were surveyed to assess the current status of cardiac imaging training in radiology residency programs. The responses to this survey may be helpful in understanding current trends in cardiac imaging training and how such training can be improved in the future. MATERIALS AND METHODS Chief residents at accredited radiology residency programs were sent an e-mail with a link to a 17-question Web-based survey. The survey assessed the organization of cardiac imaging training in each residency program, imaging modalities incorporated into cardiac imaging training, the role of residents on cardiac imaging rotations, and attitudes of residents about their cardiac imaging training and the future of cardiac imaging. RESULTS Responses were obtained from 52 of 112 (46%) programs. Seventy-one percent had at least one dedicated cardiac imaging rotation during their residencies. Fifty-two percent and 62% of respondents reported <5 hours of cardiac imaging-related case conferences and didactic lectures per year, respectively. Most had cardiac computed tomography or magnetic resonance imaging incorporated into their cardiac imaging training. Although 92% felt that cardiac imaging training is important, only 17% felt that they currently received adequate training in cardiac imaging. CONCLUSIONS The majority of residency programs represented in this survey had at least one dedicated cardiac imaging rotation for their residents. Most of these programs had few cardiac imaging-related conferences and lectures per year. Although most chief residents believed that cardiac imaging training is important, only a minority felt that they currently received adequate training in cardiac imaging.
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Gunderman RB, Weinreb JC, Borgstede JP, Hilman BJ, Neiman HL. The 2006 ACR Forum: Cardiovascular Imaging: Learning From the Past, Strategies for the Future. J Am Coll Radiol 2007; 4:24-31. [PMID: 17412221 DOI: 10.1016/j.jacr.2006.08.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2006] [Indexed: 11/15/2022]
Abstract
This paper summarizes the 2006 ACR Forum, which explored the history of the relationship between radiology and cardiovascular imaging and sought to explore strategies by which radiology could cope with similar challenges in the future. Key topics include: competition between radiology and other medical specialties, the importance of cardiac imaging, the relative merits of cardiologists and radiologists as cardiovascular imagers, and specific recommendations for radiology leaders in the areas of education, research, clinical practice, and policy.
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Levin DC. Re: “Radiologists and Cardiologists Should Work Together on Advanced Cardiac Imaging”. J Am Coll Radiol 2006. [DOI: 10.1016/j.jacr.2005.12.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Levin DC. The Statements by the American College of Cardiology on In-Office Cardiac Imaging Performed by Cardiologists. J Am Coll Radiol 2006; 3:6-8. [PMID: 17411996 DOI: 10.1016/j.jacr.2005.11.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2005] [Indexed: 10/25/2022]
Affiliation(s)
- David C Levin
- Thomas Jefferson University Hospital, Department of Radiology, Philadelphia, PA 19107, USA.
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