WSRS President’s Viewbox: December 2020

Dear WSRS members,

Thank you for the opportunity to serve as your WSRS President. I am grateful and honored for the opportunity to represent you and the other radiologists of Washington State. I am equally thankful for the chance to work with the other dedicated officers of WSRS, all of whom volunteer many hours serving our ACR state chapter. We owe many, many thanks to Ruben Krishnananthan, who pivoted quickly this past year with the COVID-19 crisis during his term as President. Ruben made sure that members were informed of CMS and ACR initiatives and communicated radiology’s interests to WSMA. I look forward to his sage advice as he transitions to Immediate Past-President.

Jenny Favinger is our new Vice-President. Jenny began her involvement with WSRS as a resident, and I will greatly value her perspective as we further the mission of WSRS. Ed Kim has also volunteered at WSRS for many years and now serves as our Treasurer. Ed is a radiation oncologist, and I am happy to see representation from throughout the “House of Radiology.” Rachel Gerson was elected as our new Secretary, and is also the Chair of our Women and Diversity Committee. Rachel is working on several initiatives to increase inclusion in our society, and radiology in general. Should any of you have any ideas, please don’t hesitate to reach out to Rachel or me.

Few of us have seen such a complete disruption to our lives that COVID-19 has wrought. Our practices, our hobbies, our families, and our health have all been adversely affected. Vaccines are now just coming on board, so we can begin to see a glimmer of hope. However, this is going to be a tough holiday, as we will not be gathering with extended family and friends. Hopefully, this will be the last winter we need to maintain our social restrictions.

As many of you know, on top of the precipitous drop in exam volumes we saw this year, CMS is hitting radiologists with the plummet in the Medicare Conversion Factor in the New Year. [Late breaking news: The ACR-led effort has resulted in mitigation of the drop by half. This is part of the $900 billion “Pandemic Relief Package” on the President’s desk.] Yes, it seems like our specialty is always under threat; if it isn’t coming from one side, it’s coming from another, then another. However, we can celebrate a few small victories. As part of my work as the Chair of the ACR CAC Network, we have managed to get coverage for CT cerebral perfusion from Noridian in the setting of acute stroke management. For an exam that has increased significantly in volumes in the last few years, getting reimbursed is a welcome change. This just took effect earlier this month. True, this is only a small drop compared to what is about to occur on January 1, but it is a small light amongst all the darkness.

As our officers and Board members volunteer their time for the specialty, we also ask you for your help. Continue the quality of your work, as that is what defines our specialty and is the basis for our reimbursement. Renewing your ACR & WSRS membership helps us take on the challenges to our profession. Consider volunteering some of your time to WSRS; even if you are not able to commit long-term, we have small short-term projects that could use our members’ help.

Please feel free to contact me or our Executive Director Emily Jones (emily@wsrs.org) if you are interested in the activities of WSRS or if you have any questions. Enjoy your holidays in a unique 2020 fashion, stay well, and may 2021 bring a happier, more “normal” life.

Sammy Chu, MD, FRCPC, FACR
samchu.rad@gmail.com
@SammyChuMD1

Welcome the New WSRS Executive Board

Thank you to everyone who attended our first ever virtual annual meeting on Saturday, November 14! Please help us congratulate our new executive officers:

PRESIDENT: Sammy Chu, MD, FACR
VICE PRESIDENT: Jennifer Favinger, MD
TREASURER: Edward Kim, MD
SECRETARY: Rachel Gerson, MD

And please help us thank Dr. Ruben Krishnananthan, our immediate past president, for all of his hard work and commitment to WSRS as president for the past two years!

Registration is OPEN for the WSRS 2020 Annual Meeting

Register TODAY for the WSRS 2020 Annual Meeting

Saturday, November 14, 2020
8:00am – 12:30 pm
Online via Zoom Webinar

Please join us for our first ever virtual meeting, a half day of hot topics and timely updates, including presentations from Howard Fleishon, MD, Chair, Board of Chancellors, American College of Radiology, and Jim Hedrick, WSRS lobbyist. View the full agenda here.

Due to the pandemic, we are waiving registration fees for members. 

Registration has closed for this event. Thank you to everyone who joined us!

Campaign Finance Webinar: Wednesday, September 23

Thank you to everyone who joined us on Wednesday, September 23 at 7:00pm PT for our first fall webinar. Just in time for the general election, WSRS lobbyist Jim Hedrick will cover several topics, including:

  • How Campaigns are Financed
  • Regulatory Structure in Washington Campaigns
  • The Effect of Campaign Money on State Legislature / Public Policy Development
  • Biggest Players in Financing Campaigns
  • Why it’s Important for Organizations to Engage in the Political Process

Jim Hedrick has been the WSRS lobbyist for 4 years serving the radiology profession as its advocate in state government and consultant on public policy matters important to radiology. Jim has worked various issues including scope of practice, balance billing, insurance coverage of tomography, and patient notification of breast density. Jim has worked in Olympia for over 30 years in the legislative arena with stints in state agencies and the governor’s office and has represented not only health care clients but also has extensive experience in state budgets and taxation, natural resources, higher education, and economic development.

SBI Recommendations for a Thoughtful Return to Caring for Patients

The Breast Imaging Task Force of the WSRS fully endorses the recent statement put forth by the Society of Breast Imaging which outlines a thoughtful and sensible approach to re-opening of breast imaging services during these uncertain times. We strongly encourage anyone considering this to read the “SBI Recommendations for a Thoughtful Return to Caring for Patients.” We also strongly recommended adhering to evolving guidelines issued by State Government to protect patients and healthcare providers from coronavirus infection.

A message from the WSRS Board

Dear Members,

As you are aware, the Washington State government has taken several measures to slow the coronavirus pandemic, such as social distancing and a pause on all elective medical procedures. The latter includes non-urgent imaging studies and screening examinations. The latest data suggests these measures may have succeeded in slowing the spread of the virus. The WSRS continues to support the WA government’s stance on pausing non-urgent imaging until data supports a return to more normal levels of activity.

The WSRS is an all-volunteer organization and the Board and Executive Committee are composed of practicing Radiologists in the academic and private sector as well Fellows and Residents. As such we too are impacted by the state government public health measures. We are familiar with many of the practice-related and wider economic and societal consequences of the shutdown and extend our empathy and best wishes to all members. The pandemic and its consequences may have provided the time and incentive for members to consider taking a role in some of WSRS’s committees including Government Relations, Membership and Professional Development, and Education and Events. Please forward any expressions of interest to the Executive Director Emily Jones at emily@wsrs.org.

Stay safe,

Dr. Ruben Krishnananthan, MBBS, MPH
President, Washington State Radiological Society

COVID-19 Response

The Washington State Medical Association (WSMA), Washington state officials, and the state’s health care community have joined the Centers for Disease Control and Prevention in responding to an outbreak of respiratory illness caused by a novel coronavirus (COVID-19). Initially detected in Wuhan City, Hubei Province, China in December 2019, COVID-19 is now spreading in Washington state and other U.S. locations. 

WSMA has a dedicated COVID-19 resource page that features patient and professional resources: www.wsma.org/covid19.

The ACCME has compiled a list of educational resources about COVID-19 for physicians, all of which include CME credit. The education consists of online courses, video, or articles, and most of these resources are free: https://accme.org/coronavirus-resources.

Image Wisely 2020

WSRS pledges to endorse and promote the goals of Image Wisely among our members and students:

Image Wisely is committed to raising awareness throughout the medical community of opportunities for eliminating unnecessary imaging exams and to lowering the amount of radiation used in necessary imaging exams to only that needed to capture optimal medical images.

Image Wisely is a joint initiative of the American College of Radiology, Radiological Society of North America, American Society of Radiological Technologists and American Association of Physicists in Medicine. Learn more here.

3D Mammography in the News

The Seattle Times published a front-page article on Oct. 27 about 3D mammography. This piece, which was written by Kaiser Health News and published in USA Today last week, stated that digital breast tomosynthesis (DBT or 3D mammography) was no better than 2D. This is simply not true.

Since you or your fellow team members might receive related questions from patients, we wanted to provide you with talking points about the benefits of 3D mammography.

They include:

  • The Seattle Times article refers to a study published in 2019, which found more cancers in patients getting 3D mammography, but not enough to reach ‘statistical significance.’ Although this Norwegian study involved 30,000 patients, results from a similar study published in The Journal of the American Medical Association (JAMA) in 2014 (Friedewald) looked at 450,000 patients and found a significant increase in cancer detection (29 percent) among Americans who were studied. If the Norwegian study had been larger, it may have reached the same statistical significance.

  • While cancer detection is the reason for screening, it is not the only goal. The Norwegian study confirmed that 3D mammography lowers recall or false-positive rates. In that study, rates dropped 22.5 percent. That is significant for patients and groups that cite false positives as a major risk of screening. The 2014 JAMA study also reported a 15 percent decrease in recall – which saves money, time, radiation and anxiety.

  • Fewer false positives lead to a significantly better positive predictive value (PPV) for 3D compared to 2D mammography. That is also in the Norwegian study, but not mentioned in the Kaiser Health News article. Again, this saves money, time, radiation and anxiety for patients and the health care industry.

  • Other peer-reviewed articles not mentioned in the Kaiser Health News article have shown the simultaneous increase in cancer detection and decrease in false positives. (Skaane, Rafferty, etc.).

  • Lastly, the WSRS does not have any industry related relationships that would bias this recommendation.