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Opinion |
1 Emory University Hospital, 1364 Clifton Rd., N.E., Ste. E118, Atlanta, GA 30322.
Received December 13, 2000;
accepted after revision January 24, 2001.
Summation statement of the annual summer conference of the Intersociety
Commission of the American College of Radiology, July 2000.
Introduction
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The first plenary session dealt with the image and history of radiologists. M. Paul Capp, executive director of the American Board of Radiology, gave a history of the profession, including portraits of many of the first practitioners. He issued a challenge as to whether we would continue as Porsches or become Fords over the ensuing years.
David Guss, chair of the Department of Emergency Medicine at the University of California at San Diego, then presented his view of what radiologists do rightand wrongin their practices. His remarks were primarily addressed to emergency radiologists and covered such topics as 24/7 coverage, sonography in the emergency department, and the need for the complete evaluation of emergency patients under Emergency Medicine Treatment and Active Labor Act regulations. However, his comments were certainly applicable to all our interactions with clinicians.
The afternoon plenary session dealt with issues pertaining to subspecialties that have special issues related to patient care. Michael Pentecost, chair of Diagnostic Radiology at Georgetown University and chair of the Interventional and Cardiovascular Commission of the American College of Radiology, spoke of the multisocietal cardiovascular initiative. The aim of this group is to increase the expertise of diagnostic radiologists in cardiovascular imaging and includes educational symposia for residents and practitioners and production of Web-based and print materials. Jeffrey Weinreb, professor of radiology at New York University and chair of the Standards and Accreditation Commission of the American College of Radiology (ACR), spoke of the process and progress of accreditation of magnetic resonance units. Ed Grant, professor of radiology at University of California at Los Angeles and chief of the imaging department at the Greater Los Angeles Veterans Administration Hospital, then discussed many of the issues confronting ultrasound, including sonography in the emergency department, obstetric sonography, and sonography credentialing.
Saturday morning, George Leopold, member of the Radiology Residency Review Committee, discussed the makeup of the committee and charge and process in the evaluation of residency programs. Robert Hattery, president of the American Board of Radiology, then discussed newer board initiatives, including opportunities for more individualized residency training, such as the Holman Research Pathway and the Interventional Pathway, and challenged the participants to endorse the process of change. Robert Bree, chair at the University of Missouri, discussed supply and demand issues related to radiology, including the size of the radiology workforce and the number of imaging examinations requested.
Friday morning, Friday afternoon, and Saturday morning, participants met in smaller work groups. Discussions in these groups centered on workforce issues; the image of radiologists held by the public, patients, and other clinicians; the importance of research to the future of radiology; and issues regarding training. Recommendations from the work groups and action items follow.
During meals speakers updated participants on ACR issues. Speakers included W. Max Cloud, past chairman of the ACR Board of Chancellors; Harvey Neiman, chairman of the ACR Board of Chancellors; Steve Amis, chair of the ACR Committee on Patient Safety; and William Hendee, vice-chairman of the Board of Chancellors, who spoke about the Institute of Medicine report "To Err Is Human"; and C. Douglas Maynard, president of the Academy of Radiology Research.
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Work Force Issues
Short term.Because of an acute shortage of imaging
professionals, the ACR Professional Bureau is encouraged to add a section on
part-time and retired radiologists so that matches could be made between
practices needing additional help and those radiologists who would be willing
to work on a less-than-full-time basis (ACR).
Intermediate term.Ask the new Task Force for Private Practice Fellowships, chaired by Neil Messinger, to report to the ACR Council in 2001 on ways to encourage funding of fellowship trainees and residents by private practice groups (ACTION 2001 Council).
Intermediate term.Add "Tip of the Day" to the Web page and the ACR Bulletin, in which creative ideas to increase efficiency and ways to partner between private practice and academic departments could be discussed (ACRsolicit members of the Intersociety Commission for ideas).
Long term.Resolution no. 1: Task Force on Medical Workforce Shortage was passed as Resolution 52 at the 2000 ACR Council Meeting and the task force was formed (Appendix 1).
Image
Short term.Continue to enhance the ACR/Radiological Society
of North America Web site (www.radiologyinfo.org) (ACR, Radiological Society
of North America).
Intermediate term.Participants endorsed the ACR resolution regarding 24/7 coverage, which was subsequently passed at the 2000 Council Meeting, and encouraged the ACR to develop programs to help practices implement the resolution (ACR).
Long term.Increase interaction with medical students earlier in their curriculum. This would include teaching correlation of radiology and anatomy in anatomy courses and joining curriculum committees (Association of University Radiologists, Society of Chiefs of Academic Radiology Departments, Association of Medical Student Educators in Radiology).
Long term.Resolution no. 2: Direct Patient Communication was passed as Resolution 51, an amended resolution, at the 2000 ACR Council meeting (Appendix 2).
Research
Short term.Encourage ACR Imaging Network to develop ways to
enable and encourage private practices to participate in the imaging network
(ACR).
Short term.ACR is asked to communicate directly with all its members to encourage a letter-writing or phone campaign to congressional representatives and senators regarding the Institute for Biomedical Imaging and Bioengineering. A sample letter could be included (ACR).
Note that the law establishing this institute was signed by President Clinton December 29, 2000.
Intermediate term.Ask the Academy of Radiology Research to form a task force and develop a short-term plan and strategies to encourage research by residents (Academy of Radiology Research).
Training
Long term.Encourage Association of Program Directors in
Radiology and Society of Chiefs in Academic Radiology Departments to exploit
the flexibility in the training requirements for residents including
concentrated electives and minifellowships to encourage diversification in
training (Society of Chiefs of Academic Radiology Departments, Association of
Program Directors in Radiology, American Association of Academic Chief
Residents in Radiology).
Long term.Encourage development of consultative, management, and communication skills in radiology residents, and test these skills on the oral and written board examinations (Association of Program Directors in Radiology, American Board of Radiology).
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