September 2018

President’s Viewbox

Pooja Voria, MD, MBA, President, WSRS

Dear Colleagues and Friends,

Warm jackets, golden orange pumpkins, and falling leaves are just a few of the things that remind us of autumn. But in the radiology community, the beginning of fall marks a very busy season for the breast imaging radiologists. With October as Breast Cancer Awareness Month, media coverage this year will likely include information about the new breast density law. The WSRS Breast Imaging Task Force has created educational materials to help both clinicians and patients navigate through the questions and concerns that may arise. Most of our materials are in the final drafts and will be available to the public this fall.  We will send out a separate communication when everything is ready.

The WSRS held a networking event for our radiologists in the Young and Early Career Professional Section (YPS) at Art Marble 21 in South Lake Union earlier this month. A short article about the event and photos are below.  This is our second year where we have sponsored activities to encourage young professionals and those early in their careers to network and become more involved with the WSRS.

Next month, the WSRS will be hosting our first President’s Dinner. The purpose of the dinner is to bring the leaders of radiology and medical community together. We hope to build relationships and improve our specialty’s visibility within the house of medicine. Invited guests include presidents of radiology groups, leaders of state specialty societies and state medical association, and past presidents of the WSRS. 

Our 2018 WSRS Annual Meeting will be held on November 3rd at the Embassy Suites Downtown-Pioneer Square. The program has come together very nicely under the direction of Dr. Puneet Bhargava. I would like to thank Puneet for his efforts in developing the program. We have several local speakers as well as national speakers from the ACR and the RLI, including Dr. Bibb Allen and Dr. Frank Lexa.  Registration is now open on the WSRS website.

Finally, do please save the date for our 6th Annual Olympia Advocacy Day on Wednesday, January 23, 2019. It is a great way for us to connect with our local legislators at both the personal and professional level. Registration for that event is open on this page of our website.

I would like to thank Dr. Kathy Choi Chinn for her efforts with these newsletters over the past two years as WSRS Secretary. Kathy will be stepping down from the WSRS  board. I wish Kathy and her family all the best. Her commitment to the newsletters has been instrumental in having improved our communications with you, our members, over the past few years.

As always, we are always open to suggestions and comments. You can always reach me at or our executive director, Debra Alderman, at I look forward to seeing you all this fall at our annual meeting.

Warmest regards,
Pooja Voria, MD, MBA
President, WSRS

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2018 WSRS Annual Meeting

Puneet Bhargava, MD, Program Chair

We are anticipating a highly successful and well attended annual meeting this year on Saturday, November 3, 2018, in Seattle.
Highlights of the morning program include Dr. Frank Lexa speaking on “Future Shocks to Radiology in 2018 and Beyond,” Dr. Bibb Allen providing talks on “Artificial Intelligence in Health Care: Radiology’s Next Frontier” and “AI In Medical Imaging: Leveraging The Value of Radiology Professionals,” and Dr. Puneet Bhargava presenting on “Mindful Approach to Productivity.”

From noon to 2 p.m. we’ll be holding our annual members’ business meeting/luncheon which will feature elections and bylaws amendment approval, as well as awards and recognition of leadership for both individual members and practices that have demonstrated a commitment to ACR/WSRS with 100% membership.

During lunch there will also be a panel discussion for residents and fellows about launching their careers, and another track specifically for medical students considering pursuing careers in radiology and related specialties.
The afternoon will have multiple tracks:
Thanks to support from Seattle Cancer Care Alliance, we will be offering a special track for radiation oncologists. The content will be updates based on the 2018 ASTRO conference in the areas of breast cancer, genitourinary, thoracic, gastrointestinal/sarcoma, lymphoma and palliative care.  This is a great opportunity for radiation oncologists who are not able to attend ASTRO to get briefed on the latest research.  SCCA network radiation oncologists can register for free for the conference!

In our diagnostic radiology track, the afternoon program will include, Dr. Christoph Lee speaking on “Improving the Value Proposition through Enhanced Radiologist-Patient Communications,” Dr. Jeff Robinson giving insights into “The radiologist entrepreneur,” Dr. Gail Morgan and Dr. Marie Lee will present on “Radiologist Burnout: Myth or Reality?” and UW resident Dr. Mazen Zawaideh will offer a talk on  “Looking Deep Within: The Future of Radiology in the Era of Deep Learning.”

Another program during the afternoon will be “Exploring the Patient Journey with Problem-Based Learning.” This program, sponsored by the France Foundation, is an interactive, problem-based learning session based on ATS/ERS guidelines for diagnosing ILD and interpreting HRCT findings effectively to the pulmonary care team. Presenters will be UW faculty members Dr. Ganesh Raghu, and Dr. Sudhakar Pipavath.

The conference will wrap up with a joint reception to bring all of the attendees together to socialize and network and celebrate International Day of Radiology.

Our venue this year is the suite of King Street ballrooms on the 6th floor of the brand-new Embassy Suites Downtown-Pioneer Square. The hotel is located adjacent to the Amtrak station and across the street from the bus/light rail station.  In addition, there is ample parking in the neighborhood.

Registration is open now on the Annual Meeting page of our website.   Please register and encourage your colleagues to do so!

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Government Relations

Phil Lund, MD, Chair; Jim Hedrick, WSRS Lobbyist

Balance Billing returns

The issue of patient billing for out-of-network health care providers or “balance billing” is certain to be an issue in the 2019 Legislative Session that begins in January. Other issues discussed with WSRS members and legislators including public health and mental health issues as the mental health will be a major public health in Olympia.

PAC representatives attended political fundraisers - both Democrat and Republican - during summer 2018


Positron Tomography Scans for Lymphoma

The Health Technology Assessment Program (HTA) within in the Washington State Health Care Authority (HCA) has selected Positron Emission Tomography (PET) for re-review to determine to cost effectiveness and clinical efficacy of the health technology. PET scans were first selected for assessment in 2011. The HTA has developed an initial scope of review to commence the PET review process. The HTA is welcoming public comments on the PET scan assessment until close of business on October 1. Please visit this link to review the draft scope assessment:

The Health Technology Clinical Committee (HTCC), as part of the HTA, is scheduled to consider coverage policies for PET scans in a public meeting on November 16, 8am to 5pm at the Conference Center at the SeaTac Airport.

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Trauma Notes from Harborview

Jeff Robinson, MD, FACR, WSRS board member

Quality Improvement initiative

When patients are transferred to Harborview, their progress is monitored by the Harborview Transfer Center. The transfer center sends a clinical summary to the sending facility describing the patient’s hospital course at Harborview following discharge.

While it has become routine to send imaging studies over the VPN when patients are transferred, our handling of the studies once they arrive has been variable. We have recently standardized the processing of these exams, and now routinely overread all CT and MR exams acquired prior to the transfer. A recent study has shown discrepancies in up to 15% of CT scan reports on patients transferred to HMC.

For quality improvement purposes, the radiology department is working with the transfer center to include the dictations of CT and MR exams with discordant findings with the discharge communication sent from the transfer center to referring facilities. We anticipate this to start in September. Please direct feedback to me at

Robinson JD, Linnau KF, Hippe DS, Sheehan KL, Gross JA. Accuracy of Outside Radiologists’ Reports of Computed Tomography Exams of Emergently Transferred Patients. Emergency Radiology, 2018 25(2), 169-173 DOI 10.1007/s10140-017-1573-8.

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WSRS Political Action Committee (PAC)

Jonathan Medverd, MD, FACR, Chair

Dear Members –

Dear WSRS members,
The membership has repeatedly stated that the most important activity of the Washington State Radiological Society should be to provide political representation. Effective representation requires contact with reps and their aides. When possible, we attend political fundraisers with financial donations. The latter are important for the Society to be taken seriously. Our state WSRS Political Action Committee (PAC) requires more funds for the current election cycle. Please consider donating to the WSRS PAC as an individual or as a practice.

WSRS executive committee members attended both Republican and Democratic State House and Senate fundraisers in late July. Jon Medverd (Past President and Chair of WSRS PAC), Jim Hedrick (lobbyist for WSRS) and I attended the WA Democratic Caucus and WA Senate Democrats fundraiser in Seattle on July 24, 2018. Several Democrat House and Senate reps were present, and we were able to speak with them personally. Our conversations included matters of direct interest to radiologists such as balance billing legislation. We also discussed wider issues including state plans to improve public health. These broader discussions indicate our interest in the health of the community we all live in. As your representatives, we made ourselves available to discuss healthcare issues in general and to provide real-world perspective on current or future healthcare legislation.

Jon attended the Republican fundraiser on July 18, 2018 and had similar personal conversations with a half dozen legislators, including the Minority Leaders of the State House and Senate.
At each of the above events, we were able to personally deliver modest contribution checks to the host political party from the WSRS PAC. Campaign season fundraisers are an opportunity to increase the visibility of radiologists as a physician group. Effective lobbying requires financial donations.  At this time the funds we have available are extremely low.

Please consider donating to the WSRS PAC.  You can made an online donation on our website

If you prefer, you can also contact our Executive Director, Debra Alderman, and she'll be happy to take a credit card donation over the phone:  206-956-3650. Or you may mail a check to:

Attn:  Debra Alderman
2001 6th Ave., Suite 2700
Seattle, WA  98121

Thank you for your support.

Ruben Krishnananthan
Washington State Radiological Society

WSRS board president-elect Dr Ruben Krishnananthan with Nicole Macri, State Representative from Seattle at a political fundraiser over the summer.


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Payer Relations Report

Sammy Chu, MD, CAC representative and WSRS Payer Relations Chair

About a year ago, in this very forum, I was mentioning the work involved in reviewing a policy (LCD) that our state’s Medicare contractor (Noridian) had drafted on coverage of CT and MR of the Head & Neck (incl. brain).  The list of ICD-10 codes went on for over 100 pages, yet was still missing some key diagnoses.  I teamed up with the California Radiological Society, and we submitted comments to the draft in a joint letter.

It took a year, but Noridian finally posted their responses to everyone’s comments a few weeks ago.  To our great dismay, our comments were not even listed on Noridian’s website!  After discussions with the California CAC reps, I have talked to two Noridian medical directors about correcting this oversight.  Both Noridian and the three CAC reps are trying to rectify this situation, but this is a painfully slow process with the voluminous material.  This carries HUGE financial implications for radiologists.  These studies are as ubiquitous as chest x-rays (the policy recently finalized by Noridian), but of course, the reimbursement of each exam is much greater.  One group in the San Francisco Bay area has run a preliminary analysis, and it is predicting that about 40% of its head and neck studies would be deemed “not medically necessary”!

After many, many hours combing through this LCD, it looks like your Payer Relations Committee will be spending several more trying to rectify this situation.  I will keep you updated as things change (hopefully for the better).

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Breast Imaging Task Force

Peter Eby, MD, FACR, Chair

The BITF is actively preparing material to support patients, radiologists and non-radiologist providers for the impact of the new breast density notification law that passed last year and is setto go into effect in Washington State on January 1, 2019.

Materials will be disseminated and available through a new website funded by the WSRS. We are collaborating with non-radiologist providers to assure widely acceptable and easily interpretable documents. We are working to launch that resource website this fall. 

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Young Professionals' Section (YPS)

Diana Lam, MD & Baiju Shah, MD, co-chairs

WSRS YPS Fall Meet and Greet Event

WSRS YPS Members got together on September 8th for an early afternoon of fun, food, and games at Art Marble 21 in Seattle. We got a chance to catch up want meet other colleagues in different practice groups. We also got to witness a different competitive side and ninja skills YPS members had in bocce ball, skee ball, and shuffle board.

A number of topics were discussed, including transitioning to living in the Pacific Northwest, different neighborhoods for real estate and work environments, etc. This program is geared to early career professionals, defined by the ACR as members who are 40 years of age or younger and/or within their first 10 years of practice.  Diana Lam, MD ( and Baiju Shah, MD ( are co-chairs of the WSRS YPS. Let us know if you have any suggestions for future events and stay tuned!

Young professionals enjoyed beverages and games during their early September event at Art Marble 21 in Seattle's South Lake Union neighborhood


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Leadership Scholarships for RLI Programs

Applications are now being accepted for the WSRS Leadership Scholarships for 2019.

The Washington State Radiological Society (WSRS), a chapter of the American College of Radiology (ACR), supports the highest standards of diagnostic and therapeutic radiology for our members and their patients. To most effectively fulfill its mission and to best represent the profession, the Membership has a strong interest in identifying prospective leaders and fostering their skills development and growth. To this goal, the Society has teamed up with the ACR Radiology Leadership Institute (RLI) to create an annual WSRS Leadership Scholarship Award. These scholarships can be used towards any RLI programs, which provide excellent online and in-person training in leadership for radiology professionals at every stage of their career.  

How to Apply:

• Applicants must be in good standing as a dues paying members of ACR and WSRS.

• Fill out the online application form.

• The scholarship committee will evaluate the applications and recommend the top candidates for the WSRS Board’s consideration.

We have extended the deadline to October 15, 2018. 
Scholarship recipients will be announced at the WSRS Annual Meeting on November 3, 2018. Ideally, all of the recipients will be there in person to be acknowledged. Up to three scholarships may be awarded this year. Click here to go to the online application.

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Save the Dates

Deadline to submit applications for the WSRS Leadership Scholarships for use toward RLI programs in 2019:  October 15, 2018.  For more information, visit this page of our website. 

WSRS Annual Meeting- November 3, 2018, at the brand new Embassy Suites hotel near Century Link Stadium in Seattle. Details and online registration are available on  this page of our website.

International Day of Radiology, November 8, 2018.  Let us know how you plan to celebrate!  This year's theme is cardiac imaging. 

WSRS Day of Advocacy in Olympia, WA, January 23, 2019. For details and to register, visit this page of our website. 

May 19-23, 2019, ACR Annual Meeting, Washington, DC. 

FACR nominations for the 2020 convocation year should be submitted by May 31, 2019.  For more information, visit this page of our website.

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