Father-and-son Radiology

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Curtis Kauffman-PickelleI have written in this column and spoken around the country about the perfect storm that the radiology profession is experiencing these days, and at the time of this writing, the storm clouds continue to gather. A call, last week, from industry veteran and colleague Tim Stampp, MBA, of Medical Imaging Specialists, capped another tumultuous month of reimbursement headwinds. Stampp alerted us to the fact that it seems that the CMS practice-expense RVU reimbursement assault has not been sufficiently addressed, nor have radiology groups sufficiently prepared to fight yet another cut at the margins—one that CMS hopes will go unnoticed, or at least be taken merely as a minor adjustment (nothing to see here, folks—keep moving along).

The CMS strategy on reimbursement, these days, seems to focus on smaller, moderate cuts that, added together, have a cumulative impact on the practice’s revenue and profitability in far more significant ways than might seem to be the case at first glance. It is death by a thousand paper cuts. We have a lot of work yet to do to tell the profession’s unique story and to have that story understood at the highest levels of the regulatory bureaucracy.

This started me thinking about the impact that the November election could have on our profession. Don’t worry; I am neither starting a PAC nor developing any partisan talking points—we are a business publication, not a political one.

Having said that, I was intrigued by the fact that one of W. Mitt Romney’s five sons is a radiology resident at the University of Utah School of Medicine. Ben Romney is an internist who earned his medical degree at Tufts University and has set his course for a career in this beloved specialty. One can only imagine the scene of this future radiologist poking around the various vendor exhibits at RSNA, Secret Service in tow.

Think of the upside, though. Family gatherings of a future first family might include a spirited discussion between dad and radiologist son related to bureaucrats second-guessing the ordering of high-tech imaging studies or those pesky nonstop reimbursement cuts—or, perhaps, even some wonderful philosophical discussions about how beneficial radiology is to the continuum of care; how early diagnosis saves lives; and how science and art combine to push the limits of our understanding of anatomy, biology, physics, molecular structure, and so on. This is not to mention the fact that radiology is leading the way in informatics, analytics, interoperability, electronic health records, and other progressive health-care IT solutions.

Yikes! Wait a minute. I just thought of another discussion between Ben and Mitt that might not be as helpful, should the elder find himself in a policymaking position. That discussion would be likely to focus on why Ben probably chose radiology over internal medicine in the first place, and it would bring high-level attention to what a great gig radiology continues to be, even in an era of the perfect storm. Finding out how many weeks of vacation Ben’s radiology group gets each year could also be an eye opener of sorts—not necessarily one quite as easily understood by the uninitiated.

Nonetheless, the truth of the matter is that should this fall’s election end up with Romney in the White House, radiology will, at the very least, have someone close to the center of power and authority who understands and can explain what radiologists do, why they are critically important to the future of health care, how the profession needs to be supported (not assaulted), and why it is in the very forefront of health-care innovation.

As the father of six, I can attest to the fact that lobbying from one’s children is very effective in shaping parental attitudes and behavior, especially when fledgling careers are involved.

Curtis Kauffman-Pickelle is publisher of ImagingBiz.com and Radiology Business Journal, and is a 25-year veteran of the medical-imaging industry. He welcomes your comments at ckp@imagingbiz.com.