June 2018

President’s Viewbox

Pooja Voria, MD, MBA, President, WSRS

Dear Colleagues and Friends,

At the recent 2018 ACR Annual Meeting, the new Chair of the ACR Board of Chancellors, Dr. Geraldine McGinty, stated “The ACR is the voice of radiology. As the unified voice of more than 35,000 radiologists, radiation oncologists and medical physicists, we have power and influence. Let’s use that for the good of our patients.”

The work of WSRS exemplifies this sentiment, and I’m thrilled that our organization is so committed to making an impact in the community. As an example, we sent a delegation of 21 radiologists from the state of Washington to the 2018 ACR Annual Meeting in late May and 11 of them participated in the 2018 ACR Day of Advocacy, visiting Congressional representatives and senators on Capitol Hill in Washington D.C.

As many of you know, it can be challenging to showcase the value that we bring as members of the healthcare team to our lawmakers, as we are often mistakenly viewed as just image interpreters. “Hill Day” was a powerful way for us to partner with radiologists from across the country and meet with legislators to discuss healthcare economics and policy. This year, our delegation met with Senator Maria Cantwell, Congresswoman Pramila Jayapal, as well as the legislative staff in the congressional offices of Representatives Cathy McMorris Rodgers, Denny Heck, Derek Kilmer, Adam Smith and Rick Larsen and a staff member in Senator Patty Murray’s office.  The specific bills we discussed with these lawmakers and their aides dealt with coverage of CT colonography for Medicare beneficiaries and legislation regarding Medicare reimbursement for the work of Registered Radiology Assistants.

At the state level, legislation regarding breast density notification and mandated insurance coverage of tomosynthesis passed this year. Under the direction of Dr. Peter Eby, the WSRS Breast Imaging Task Force is currently working on developing tools to help both clinicians and patients navigate through the questions and concerns that may arise during the implementation of these new laws. We will be collaborating with other specialty societies in the process. Please keep an eye out for communications later this year.

Meanwhile the WSRS has been part of the successful effort to (so far) keep flawed “balance billing” legislation from passing in the state legislature.  This legislation will likely be back in 2019, so WSRS will continue to participate with WSMA and other specialty societies to make sure any proposed version of the law is reasonable and fair to the healthcare provider groups and we will continue to try to bring attention to what we believe is the real issue: narrow networks.

In addition to our advocacy efforts, WSRS demonstrated our commitment to women and diversity by holding two special events so far this year. In March, we co-hosted our first ever women’s mentoring event with the Women in Radiology group at the University of Washington. Approximately 20 trainees and 15 practicing radiologists attended the daytime event held at the Waterfront Activities Center at the University of Washington. The moderated  panel discussion offered insights into many of the challenges new professionals face as they launch their careers.  We hope to continue this collaboration with the UW faculty and residents in the future.
In late April WSRS held our second annual women radiologists’ networking event. This year we held an elegant afternoon tea at the Fairmont Olympic Hotel in downtown Seattle. Over thirty attendees gathered to enjoy delicious refreshments and  the company of old and new friends and to discuss ways that we can continue to invest in the diversity and inclusion space.

We are soliciting nominations for the WSRS Gold Medal Award, which is a lifetime achievement award for those who have significantly impacted the field of radiology. This can represent noteworthy service to the profession, particularly meritorious scientific achievement or distinction in education and mentorship. Nomination forms are on our website at https://wsrs.org/about/gold-medal/ and will be accepted through July 31, 2018.

Thank you to all of our members who have helped support these efforts. Have a wonderful summer!

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

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WSRS 2018 Gold Medal Award

Please consider nominating a colleague or mentor!

Each year the WSRS board honors a member radiologist, radiation oncologist or clinical medical physicist with its prestigious Gold Medal Award recognizing outstanding service to our profession demonstrated throughout the recipient’s career. Nominations for the 2018 Gold Medal Award will be accepted between now and July 31, 2018. Download the nomination form from the Gold Medal page of our website.

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Government Relations

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

Day of Advocacy in Washington DC, 2018

Eleven members of WSRS spent a very successful day of advocacy on Capitol Hill in DC on May 23, 2018. Photos below show our delegation in action. For details on the issues we raised during the Hill Day meetings, see the "President's Viewbox" article, above. 
 

Members of WSRS met with Congresswoman Pramila Jayapal, of Washington's 7th District, while participating in the ACR's Day of Advocacy on Capitol Hill, May 23, 2018.  

 

WSRS' delegation visited a number of Congressional offices on May 23rd in DC.  The conversations with both Representatives, Senators and their staffers were extremely productive. 

 

State legislative and regulatory affairs

Balance Billing
The Washington State Office of the Insurance Commissioner (OIC) will start a stakeholder process to develop legislation concerning balance billing on July 23 in Olympia. WSRS will participate in the stakeholder process. In recent years WSRS, in conjunction with the Washington State Medical Association (WSMA), Washington State Hospital Association (WSHA) and other physician associations, has opposed balance billing legislation in Olympia as counter-productive to good faith contract negotiations. This year, WSRS will seek balance billing legislation that better aligns with their objectives, including reimbursement and network adequacy. It is expected there will be legislation introduced in 2019.     

Tomosythesis
A new law passed by the Washington Legislature this year became effective on June 7. Senate Bill 5219 is intended to mandate insurance carriers cover tomosynthesis or 3D mammography under the same terms and conditions currently allowed for mammography; the new law clearly states the application of a deductible or cost sharing is prohibited. Health care plans doing business in Washington State should be filed with the Washington State Office of the Insurance Commissioner (OIC) and must comply with the new law. 

Positron Tomography Scans for Lymphoma
Recently the Health Technology Assessment Program (HTA) within in the Washington State Health Care Authority (HCA) announced its seeking comments on their clinical review of Positron Emission Tomography Scans for Lymphoma. Specifically, the comments are upon thesis questions that will guide the clinical review. 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 SeaTac Airport.

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Trauma Notes from Harborview

Jeff Robinson, MD, FACR, WSRS board member

Accurate identification of rib fractures on a trauma chest CT can take as much time as interpreting the rest of the scan put together. Many of us wonder whether it is worth the bother to scroll back and forth through 24 ribs of each chest, when little if anything is ever done with the information.

The patient with three or more consecutive segmental fractures is a different story, as such a patient can develop flail chest.  Patients that have had CPR may have multiple bilateral costal cartilage fractures, resulting in flail sternum. But what of nonsegmental rib fractures? Does anyone care?

In the last few years, trauma and thoracic surgeons have begun to plate ribs in an effort to reduce ICU stays by improving ventilation on multiple trauma patients. Some plates attach to the outside of the rib with screws, like an extremity long bone orthopedic plate, and others shaped like a bayonette, with the blade part inserted into the medullary space of the rib, and a smaller hub emerging from a hole drilled into the rib. The newest prostheses are bioresorbable, so when the rib heals, there is no permanent foreign body left in the rib.

As with most innovations in medicine, there are so far few rigorous studies comparing patient outcomes with rib plates to those without. However, there are a few centers that are promoting their use. At Harborview, our surgeons are somewhat skeptical, but are trying to identify patient populations in which plating may prove the most useful. AS a result, we are putting more effort into identifying exactly which ribs are fractured, and which fractures are nondisplaced, displaced by more than one cortical width and segmental. Combined with clinical data, we hope to be able to predict who will benefit from this new procedure.

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WSRS Political Action Committee (PAC)

Jonathan Medverd, MD, FACR, Chair

Dear Members –

"80 percent of success is just showing up." —Woody Allen

In our representative government, presence, visibility and voice are imperative. WSRS PAC is here to help assure Radiology in Washington State has a seat at the table. Over the past several years, consistent progress has been achieved, and member support of WSRS PAC has been an instrumental component. PAC funds amplify our efforts to support the advancement of common sense measures that simultaneously benefit patient care and our radiology, radiation oncology and medical physics practices. By supporting WSRS PAC, you are showing up in the ever more important political scene surrounding health care. Particularly in this election year, where the foundations of health care policy appear to be constantly shifting, please consider leveraging your voice and your impact by making a donation via our website today. 

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Congratulations to our new Fellows!

Three members of WSRS inducted as Fellows of the ACR at recent meeting Congratulations to Dr. Katherine Choi-Chinn, Dr. William Keyes, and Dr. Justin Smith who all were inducted into the elite group of Fellows of the American College of Radiology at the ACR Annual Meeting’s 2018 Convocation on Sunday evening, May 20, 2018. 

The deadline is now passed to apply for Fellowship in the 2019 convocation year. It’s not too early to begin assembling your application materials for the 2020 convocation year! WSRS has set a deadline of May 31, 2019 to complete your application. To begin the process, please visit the Fellowship page of the ACR website. If you need assistance with your application, please contact Debra Alderman, WSRS Executive Director: debra@wsrs.org and she can put you in touch with the appropriate WSRS leaders.

If you have questions about your eligibility, the online application process or anything else, feel free to contact the ACR Fellowship office staff via email: facradmin@acr.org

Congratulations to (left to right): Dr. Justin P. Smith, Dr. William Keyes, and Dr. Katherine Choi-Chinn, who were inducted into the elite group of Fellows of the American College of Radiology at the ACR Annual Meeting’s 2018 Convocation on Sunday evening, May 20, 2018.

 

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Breast Imaging Task Force

Peter Eby, MD, FACR, Chair
 

The task force has been dealing with two important developments that came out of the 2018 Washington State legislative session. One new law mandates the coverage of tomosynthesis by private insurance carriers.  In addition, the legislature passed a bill mandating patient notification of breast density. The Breast Imaging Task Force’s research into the roll-out of these two bills in 2018 and 2019 is detailed below.

Report on roll out of SB 5912:
New law assuring insurance coverage for tomosynthesis/3D mammography goes into effect June 2018

As you may recall, the Washington State Legislature passed a bill during its 2018 session requiring insurance carriers to cover tomosynthesis. WSRS supported and lobbied for the bill during our annual Day of Advocacy in Olympia on February 1, 2018.  The bill became effective on June 7, 2018. 

We have been waiting for an official statement from the Office of the Insurance Commissioner regarding the exact coverage. That statement was released yesterday and is provided below. The coverage is summarized in the final sentence which states:  “Like all methods of mammography, coverage of 3D mammography may not be subject to any cost sharing, including deductibles, copays, and coinsurance, consistent with 42 U.S.C. Sec. 300-gg-13.”

This means that tomosynthesis must be covered the same way 2D mammography is covered for patients with private carrier insurance. So if patients ask about coverage for tomosynthesis, please tell them that it is covered the same way 2D is covered for them.

Thanks to WSRS lobbyist Jim Hedrick for being our liaison with the OIC.

Please share with our mammography technologists and schedulers as needed.

Washington State bill SB 5084, passed by the Washington State Legislature and signed into law by the governor this past spring, mandates the following specific language regarding individual breast density to be included in the result letters sent to patients after mammography. The message is as follows: 

"Your mammogram indicates that you may have dense breast tissue. Roughly half of all women have dense breast tissue which is normal. Dense breast tissue may make it more difficult to evaluate your mammogram. We are sharing this information with you and your health care provider to help raise your awareness of breast density. We encourage you to talk with your health care provider about this and other breast cancer risk factors. Together, you can decide which screening options are right for you.”

The BITF held a conference call on April 17th, 2018, to discuss how the WSRS can and/or should help radiologists and other providers prepare for the mandatory breast density reporting which takes effect on January 1, 2019. Radiology potentially faces a backlash when state-mandated density reporting goes live. Our proactive role in density notification will help our WSRS members and non-member providers and all of our patients. It supports the “Rads Have a Face” and “Patient First, Patient Facing” initiatives from the ACR. We agreed that we should help educate via our own website, hosted by the WSRS, as well as downloadable and printable educational materials for providers and patients. Timothy Gleason, Kara Carlson and Craig Hanson generously volunteered to lead the website development. We hope to have the materials ready in time for October (breast cancer awareness month) and the WSRS meeting in November. And how can we help radiologists that will be required to notify about breast density but cannot offer supplemental screening?

Anika McGrath is joining the BITF as a member in training. Jennifer Oschner is joining and will represent southwest Washington. We hope to add members to represent the Olympic peninsula and northwest Washington and Eastern Washington.

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Residents and Fellows Section (RFS)

Reflections on ACR national meeting

Meghan Macomber, MD, outgoing chief radiation oncology resident, University of Washington

The American College of Radiology (ACR) is an organization that represents both radiology and radiation oncology. Although radiation oncology is a smaller field, the ACR allows a variety of opportunities to get involved and have a larger voice.

This year, I attended the annual meeting as both the ACR-Resident Fellow Section (RFS) Radiation Oncology representative, as well as the WSRS-RFS RO representative.

RFS events at the meeting began on Saturday. We hosted a new networking event based on attendee feedback from the last meeting, which included a meet-and-greet with a variety of individuals, including a table discussion with some of the radiation oncology attendees. It was a great way to get to know each other, learn how to get involved in ACR, as well as how to network effectively and make the most of the meeting.

New this year, CARROS members were very gracious in sponsoring travel grants to several residents. Their experience was overwhelmingly  positive, as highlighted in a blog post by Dr. Chelsea Miller, the new RFS-RO Rep.
https://acrbulletin.org/departments/blog/1595-radiation-oncology-corner-a-new-year

The meeting continued with a range of interesting and inspiring speakers, as well as economics forums and practice parameter discussions. There were also several dinners, including the WSRS dinner, that are always great to attend.

Attending the ACR national meeting always leaves me inspired as to the hard work of others to advocate for our fields, and ensure we are able to provide the best care for our patients in the future, at both the state and national level. Thank you to the ACR and WSRS for allowing us to get involved as residents, and I encourage others to consider attending the meeting in the future!

 

 

Congratulations to new WSRS Residents & Fellows Section Leaders for 2018-19

The RFS section recently held elections and members have selected their board and committee chairs for the coming academic year.  We thank Anika McGrath, MD, outgoing president, for her hard work on the RFS board and congratulate her on a very successful year!

The following will be leading the RFS for 2018-19:

President: Derek Khorsand, MD (UW resident in interventional radiology)

Vice President: Preethi Raghu, MD (Virginia Mason resident in diagnostic radiology)

Secretary: Jing Luo, MD (UW resident in diagnostic radiology)

Co-Treasurers: Tanner Clark, MD and Keegan Hovis, MD (both (UW residents in diagnostic radiology)

For the full list of committee chairs and members, please visit the RFS page of the WSRS website.

 

 

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ACR Chapter Recognition Award

WSRS was honored at ACR national meeting last month with a Chapter Recognition Award in the Area of Quality and Safety. 

 

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Spring WSRS Events

Two women's events this past spring encouraged sharing and professional mentoring for women in radiology and radiation oncology. 

Preethi Raghu, MD, incoming Vice-President, WSRS Residents and Fellows Section

WSRS hosted two successful events for women radiologists and trainees this spring!  On Sunday, March 11th, the WSRS and UW’s Women in Radiology group jointly hosted a mentoring event featuring a panel of women radiologists at the UW Waterfront Activities Center.  We had a diverse array of panelists from private practice, academic, community, and military backgrounds.  Hot topics were discussed included job hunting, offer negotiations, career advancement, work life balance, and burnout. 

On Sunday, April 29th, the WSRS hosted a women radiologists’ afternoon tea at the Fairmont Olympic Hotel.  Practicing radiologists and members-in-training mingled over tea and refreshments, giving everyone a respite from their busy work schedules to spend time with friends and mentors in the radiology community. 

Both events were well attended by members-in-training from our RFS and YPS divisions.  Thanks to everyone who attended, and stay tuned for future WSRS events!

Attendees at the mentoring event developed their networks and got their questions answered. 

 

Dr Preethi Raghu moderates panel discussion at joint WSRS - UW Women in Radiology mentoring event March 2018. 

 

WSRS' second annual women radiologists' networking event - this year an afternoon tea at the Fairmont Olympic Hotel - was well attended and participants enjoyed connecting with colleagues from the entire Puget Sound area. 

 

Women Radiologists Tea attendees enjoyed socializing and networking over delicious refreshments. 

 

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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.


Deadline to apply for 2019 scholarships is August 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 nominations for the 2018 WSRS Gold Medal Award: July 31, 2018. For details  nomination form, visit this page of our website. 

Deadline to submit applications for the WSRS Leadership Scholarships for use toward RLI programs in 2019:  August 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 will be posted on this page of our website soon.

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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