President’s Message

August 2019

Dear colleague,

Thank you for your membership in the Massachusetts Radiological Society (MRS), our chapter of the American College of Radiology. I am privileged to serve as your President for the 2019-2020 session and it gives me the chance to address you this summer. I want to report on the exciting things we have done together over the past year. I also want to share my take on the challenges and opportunities ahead. Even so I realize that we’re all super busy so I’ve organized things so you can get the bits you care most about. Just don’t skip the last two paragraphs.

THE MRS AND THE ACR

The MRS is funded by your dues. You see a bill for $1095 each year, $900 for the ACR and $195 for the MRS. The MRS Executive Committee meets regularly during the year and is committed to spending those dollars wisely for the benefit of our profession and our patients. I’ve seen how it works from the inside, and I recognize that from a member’s perspective, you are putting your faith in someone else. That’s why this year I was very relieved and proud to listen to a report this year from ACR Secretary-Treasurer James Rawson, MD, FACR. Dr. Rawson gave a fairly detailed presentation explaining the ACR’s annual income and expenses. I won’t repeat those details here, but I feel comfortable saying that it is worth it — and that we should keep holding our national leadership accountable to make sure it stays worth it.

Each year at the ACR annual meeting many of the ACR Practice Parameters and Technical Standards are updated. Massachusetts radiologists volunteered on committees revising the standards or participated in a formal process to vet proposed changes. Often language that we offered or concerns we raised made a difference in the final decision. This matters! In 2019 when you perform a brain MRI, should a DWI sequence be standard? If there is a positive finding on a study, when should you be obligated to use “non-routine” communication to make sure the provider gets the result? Are there some ways of practicing radiology that have gotten outdated and need to be retired? Pediatric radiology, neuroradiology, and radiation oncology standards were among those reviewed. The real benefit will come when we as members review the updates and bring them into our own practices.

GOVERNMENT RELATIONS STATE AND NATIONAL

I choose to believe that elected officials want to make things better. They may be tethered to the groups that helped them get elected, but they work with a broad range of legislation that is not connected directly to one group. They also pass laws on areas that are complicated. There can be unintended consequences that can arise from a single word choice. At the state level, hundreds of new bills are introduced each year. The MRS tries to keep an eye on the process and provide testimony at the state house when needed. Our leadership team also tries to alert you about issues when appropriate.

Last year Question 1 received a lot of attention. It was the initiative that would expand mandatory nurse staffing ratios from the ICU to more hospital settings. At one point during polling, a majority of Massachusetts residents supported passage. Ultimately, the question was defeated by large margins. The take away is not a victory lap that “we defeated question 1.” It is instead that volunteers in the MRS painstakingly studied the issue and the likely effect of passage. They concluded that as written, the initiative was going to create more problems than it would solve. Then President, Mary Ellen Sun, MD sent you a 3 page, single spaced letter detailing the pros and cons. It included references and links for more information so you could reach your own conclusion. I’m proud that we went beyond simple tribal politics to address that issue.

This year the legislature wants to address surprise billing in its various forms. The typical scenario is that a patient has a very narrow insurance plan that includes a hospital but not all of the providers. The patient receives care at the hospital at a negotiated low rate, but receives bills from the doctors at the published charge rate that almost no one ever pays. The providers look bad and the legislature wants to fix it. But just like question 1, it is not that simple. One legislative proposal would automatically set payment at the Medicare rate whenever a patient’s insurance didn’t pay. This might have an unintended consequence of encouraging insurance companies to avoid including any providers in their plans. This is because Medicare is usually the lowest rate. Hopefully the legislature will adopt a policy that protects patients without creating incentives that destabilize the health insurance market. The federal government may weigh in.

There will continue to be issues of concern and they may come up quickly. To quote TV host Soledad Obrien, “We’re paying attention even if you’re too busy.” Your support and your opinions matter. They allow us to represent our profession when the decisions are being made.

GOALS FOR THE YEAR

We have always been at our best when we place our patients as our first priority and look next to our profession. Our support of diversity initiatives is a way of doing both. We serve individual patients who come from populations with many different backgrounds. By maintaining inclusive environments, we make sure that all of Massachusetts’ citizens can access our services. We can also make sure that qualified individuals are attracted to our specialty. Just as with Question 1, we must be guided by both our own experiences and careful study of the issues. At a conference, a practice leader was asked, “Does your practice have any diversity initiatives?” He responded that the leadership wanted the most qualified people and did not want to lower any standards. I think the response was not intended to offend, but belied an unconscious assumption that attracting women and minorities means passing over better qualified applicants. Instead we should be conscious that there are many qualified women and under-represented minorities at every stage of our profession. As leaders, our actions can influence their progress to the next stage — hopefully never as a hindrance. Some practices and some regions of our country do a better job of developing and attracting a diverse workforce. Others do not do as well and have changed little over the past 20 years.

Earlier this summer the Massachusetts General Hospital Radiology Department’s Diversity & Inclusion Committee and Women in Radiology Group invited Dr. Katarzyna Macura to speak on diversity issues. Dr. Macura serves as the Chair of the ACR’s Commission for Women and Diversity. One of our EC members, Dr. Anand Kumar Narayan brought this event to the attention of the MRS and we were happy to provide encouragement and support. Many individuals in our sister organizations and in our academic medical centers are doing very good work. We have much to learn from each other and I hope to further that process during the year.

When exploring diversity, we can also consider the diversity of our professional practices. We are academic and private practice radiologists, radiation oncologists, and physicists. We work in community hospitals, tertiary medical centers, outpatient imaging centers, and teleradiology practices. We work in practices from Cape Cod to Pittsfield. Our profession does well when those experiences are represented. To that end, we are experimenting this year. We have reserved meeting space for our annual meeting on a Saturday, making it easier for members from the western part of the state to attend. I realize that will mean giving up a precious day of the weekend. We hope that the format will allow an exchange of ideas and foster participation. We will continue to leverage remote conferencing tools to make it easier for members who live further away to participate.

I’ll close this letter with the thought that radiology is not a pie to be sliced up, but rather a pie to be expanded and made more delightful. Please enjoy your summer and reach out to us with your ideas during the year.

Sincerely,

Rodrick Williams, MD
MRS President 2019-2020