It’s Time to Get Behind CARE

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It’s the latest in a series of disturbing stories about radiation dose—and it’s about babies, our most vulnerable patients. In a February 27 article entitled “X-rays and Unshielded Infants Raise Alarms,” the NYT reports that in 2007 a Brooklyn hospital mistakenly irradiated several infants from head to toe, without any shielding, in cases where only a chest x-ray was called for.

The article doesn’t demand radiology’s head on a stake; this time, it’s going after techs, or at least the way techs are trained. Of course, none of this is news to those actually in the imaging field—the ASRT has been advocating for better educational and certification requirements for techs for quite a while. Their CARE bill has been around for 12 years without passing. As ASRT government relations VP Christine Lung points out in the article, there are states that currently have stricter regulations for massage therapists and hair stylists.

But here’s my question. How is it that an obviously necessary, totally uncontroversial piece of legislation like the CARE bill can’t seem to scrape together any Congressional support, but a group like AMIC can rack up sponsors left and right for its DRA-cut-fighting legislation?

The answer, which anyone else who read Freakonomics cover-to-cover eight times could tell you, is economic incentives. Radiologists nationwide aren’t seeing payment reductions because some techs sometimes make mistakes in some places, and so they’re not rallying together like they did following the passage of the DRA. What will it take for the imaging community to throw their weight behind the CARE bill—another reimbursement smackdown like the one that suddenly got us interested in patient access? That’s not who we are . . . is it?

If the splashy, fear-mongering articles in big national newspapers keep up, this could go from a hypothetical situation to a real one in no time. Let’s get out in front of a legislative issue for once—demand the right thing before we’re punished for waiting. Everybody has a role to play in dose reduction, but techs are the front line. They deserve at least as much training and credibility as we afford our hairdressers.