The Good, the Bad, and the Inspired

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Finally, some good news for imaging. The eleventh-hour override of the president’s veto in early July saved the day for physicians, if only temporarily. Now, the bad news: The cumulative adjustments in the sustainable growth rate affecting the Medicare Physician Fee Schedule will now come due in a mere 18 months. The 10% reduction scheduled for July 2008 was avoided, but the next adjustment will be something like 20%. Nevertheless, the delay gives the profession some valuable breathing room and time to coalesce around a strategy to avoid further cuts in reimbursement, while at the same time finding ways to unite and speak with one voice on the important economic issues facing medical imaging.

Here is some more good news: Although our profession is currently facing some of its most turbulent times, opinion leaders have rarely been more encouraged by the opportunities that are seemingly cleverly disguised within these troubles.

There is evidence that supports an optimistic view of the future for the profession.

A primary reason is the collective inspiration that I, and nearly 350 other participants, felt at GE Healthcare’s recent conference for outpatient imaging center leaders, held in Washington, DC, at the end of July. Unlike the palpable anxiety that one felt at the same conference two years ago (when the DRA was still only a vague and distant threat), it was clear, this year, that having been subsequently backed into a corner, medical imaging came out swinging. We may be under assault, but the sleeping giant just may have been awakened.

United for a Greater Cause was the banner under which GE gathered luminaries and thought leaders from a wide spectrum of imaging’s brain trust to discuss new ideas, approaches, strategies, and data—all designed to build a unified platform that will, for the first time that I can recall, align the profession’s respective stakeholders. Refreshingly, the theme was not mere rhetoric. Unlike the situation at the end of 2005 that created the opportunity for legislators essentially to divide and conquer medical imaging’s disparate factions, radiology practices, hospitals, IDTFs, manufacturers, lobbyists, and various consulting organizations are now working from a common playbook. It was clear in Washington that these groups have moved from their former balkanized perspectives to form a common team approach, finally telling imaging’s story to those in power.

It is a powerful story that transcends the turf issues associated with the self-referral debate. Yes, self-referral is important, but it is not the right time to dwell on it when we have an 18-month window to get the core imaging story told and delivered to the right people—and to use the new momentum. First, we need to survive to fight another day, and when more defensible data exist, perhaps that particular part of the radiology story can then be resolved.

Just what is the common cause that is finally uniting all of us? Among other things, optimum patient care, a diagnostic profession that saves lives while providing economic benefit for payors (especially in reducing costs for unnecessary interventional procedures), and access to the highest-quality imaging providers in the world. We work in a profession that saves lives each and every day. We should remind ourselves often of that amazing fact. Radiologists need visibility and need to be integral to an integrated patient care system. Most legislators don’t even know what radiologists do.

Organized imaging now has a platform and a plan. The mission has been defined and the resources have been assembled. The ACR, the Medical Imaging & Technology Alliance, the Association for Quality Imaging, and the vast array of stakeholders have responded to this common cause and are ready to speak with the one voice that has been missing. If our common cause has been identified, so has our common enemy: complacency. We cannot afford to be lulled into a sense that the worst is over and that we have weathered the storm. The truth is that we have all been tested, and the model for the future of our business will continue to be defined by waves of similar tests, change, uncertainty, and threats. It is a classic business model faced by many other professions. The days of the low-hanging fruit are over, yet this new structure will make us better. It will be better for our customers and it will be better for those who learn to thrive in the new era.

The conference was inspirational in many ways,