But James Borgstede, MD, vice chairman of the Department of Radiology at the University of Colorado, Denver, and past president of the ACR, still sees a shortage of US radiologists.
"We need more radiologists, and we're trying to increase training programs and attract the best and brightest medical students into our radiology specialties," noted Borgstede
...James Borgstede, MD, Vice Chairman, Department of Radiology, University of Colorado, Denver
"We need to get beyond the concept that one specialty owns imaging exclusively," said Borgstede
"People still see the technical component as lucrative," said Borgstede
."Meanwhile, the government is much more aware of problems with increased expenditure on imaging.The government doesn't want to spend the money, and then you've got other people continuing to inappropriately utilize."Borgstede
sees this issue as a major challenge facing radiology today, particularly in light of the growing prevalence of radiology benefit managers (RBMs), which automatically review physicians' imaging study referrals for prior authorization before allowing coverage.Sounds helpful, but Borgstede
warns that RBMs are primed for abuse by payors.
"It's very easy for these utilization management firms to ratchet down authorization to create the savings the payor wants," he
There's bad news and there's good news for the radiology industry, according to Borgstede
."We're in the DRA landscape," he
said."Things have changed rather dramatically because the technical component has decreased."And so far there has been no relief in the form of legislation—in both 2006 and 2007, the congressional year ended without a vote on either year's version of the Access to Medicare Act.
"The President has made it clear that he
intends to cut hospital reimbursement, and that links to the Medicare fee schedule technical component," said Borgstede
But it's not all gloom and doom, Borgstede
says, as we move into a landscape of heightened utilization scrutiny."Radiologists know how to operate in an appropriateness realm," he