WSRS Newsletter

Spring 2015

President’s Viewbox

by Eric Stern, MD, WSRS President

Glancing Back, Looking Forward

It’s been an eventful few months for our specialty. Most notably on the national front, as I am sure you are aware, CMS made a positive coverage decision for low dose CT screening for lung cancer detection, opening up this valuable service to millions of Americans. There are several important pieces being developed nationally that must be in place as part of providing this new service, such as data registries, proper low dose techniques/protocols, patient tracking, scoring systems, etc. At the time of this writing, the payments and codes for this service are not decided. The WSRS will be helping members stay up to date on any important news, education, and changes related to this hot topic. 

This past February, more than 24 WSRS leaders and government relations team members, including some of our best and brightest radiology residents in the RFS section, stormed Olympia to meet with our state legislators to discuss and provide opinions on a variety of Bills under consideration related to our specialty. With the help of our lobbyist, Brad Boswell, our team met with 18 different legislators, and spoke with a unified voice on pending legislation related to radiology benefit managers, telemedicine, and breast density reporting. Overall, our group was warmly received by our lawmakers, and we all felt that our time was well spent on behalf of our society members. I extend my deep gratitude to immediate past president and Government Relations Committee chair, Jonathan Medverd, and all of those who gave up a day away from their practices or training to impact the laws being created in our state. You will find more information on these efforts elsewhere in this newsletter.

WSRS leaders, along with a large contingent from the Residents and Fellows Section, took a break between meetings with legislators during their busy Day in Olympia on Feb. 24, 2015.

The past few months have seen our new leadership teams established and begin their work on your behalf. I hope you took note of the recent call for interested members to volunteer their time to our efforts.  Updates on the work of these committees will be provided periodically. As our society flourishes, we are also establishing a few new committees. The first one is the Historical Committee being chaired by Dr. Bill Warren. The WSRS has a long and rich history, and we feel it is important to capture and archive the past activities of our society. If you have stories, photos, or other reminiscences to share, please send them our way. 

Speaking of the richness of our society, in keeping with parallel efforts from our national organization, the ACR, we are establishing a new Woman and Diversity committee.  This new committee will be examining the tapestry of our profession throughout the state, looking carefully at expected topics such as race, gender, and ethnicity, but also cultural competency, age, veteran’s status, hiring, retention, etc. If you receive a survey in the future, please make the small effort to complete it and send us the needed information.

This summer, the WSRS leadership will have a formal strategic planning meeting to help us thoughtfully engage our volunteer member efforts and prudently use your membership dollars. It is our hope to proactively guide our future rather than react to issues as they come up. The session will be led by a formal strategic planning facilitator, Donna Cameron, of Melby, Cameron & Anderson. We will also have the great privilege and opportunity to have outside consultation from Dr. Paul Ellenbogen, the current ACR President.

Every non-profit society must ensure against fluctuations in its revenues and assets. The WSRS, while staying acutely aware of our fiduciary responsibilities for members’ resources, is instituting a new investment strategy for society assets. Thanks to Ruben Krishnananthan, our Society Treasurer, for leading this effort.

We are once again planning an annual meeting…Saturday November 7, 2015…please save the date. The program is being ably developed by Drs. Doug Green and Gautham Reddy. We will once again be focusing on socioeconomic issues that are important to our members. In addition to our local talent, we again fully expect to have national speakers from the ACR and the RLI, as well as from some of our lawmakers. Look for announcements and details in the near future.

We hope you enjoy this newsletter as we strive for ways to communicate with you, our staunchly supportive members. Thanks to Dr. Sammy Chu, our WSRS Secretary, for leading this newsletter effort.

Once again, thank you for your support.

Eric

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Name that Newsletter!

Now that WSRS has revived the tradition of a newsletter, we need members’ help to come up with an appropriate and catchy name for our new electronic publication.  As an incentive to get your creativity synapses snapping, the WSRS member who submits the winning entry will receive a complimentary registration to the annual meeting on November 7.  Please email your suggestions to Executive Director Debra Alderman by May 30:  debra@wsrs.org

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UW Residents Receive Coveted RLI Program Scholarships

D.J. Perry, MD and Patrick Richard, MD, both radiology residents at the University of Washington, have been awarded coveted Radiology Leadership Institute® (RLI) scholarships to the 2015 RLI Leadership Summit

Summit participants will learn to understand business trends driving health care change and how to position themselves and their practices for continued success. D.J is the president of the WSRS Residents and Fellows Section for 2015-16. The RLI Scholarship Program provides financial assistance to deserving radiologists who gain access to the RLI curriculum — including the annual Leadership Summit, Aug. 6-9, 2015 at Babson College in Wellesley, MA.  

Only 10 percent of scholarship applicants are selected to receive funding. Congratulations D.J. and Patrick!

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Resident and Fellow Section (WSRS-RFS) Report

This year has been exciting and eventful for the Washington State Radiological Society’s Resident and Fellow Section (WSRS-RFS). 

In April 2014, four of our members attended the ACR Annual Meeting and Chapter Leadership Conference in Washington DC. One of our ACR delegates, Alvin Wyatt,  found it to be “an amazingly transformative experience and enriching for any resident who is able to attend.” The conference gave residents opportunities to interact with practising radiologists and ACR leadership directly, as well as participate in “Capitol Hill Day,” where they met with congressional representatives and their aides to ensure that radiology's voice was heard for several key bills and issues.

State legislator, Rep. Laurie Jinkins, (far right), met with WSRS board members and RFS representatives for a discussion of healthcare policy and radiologists’ perspectives.

At the state level, many RFS members participated in the annual WSRS conference in November 2014. We networked with radiologists in the community, learned about the latest issues affecting our field, and listened to inspiring words from a state legislator, Sen. Cyrus Habib. The RFS organized a breakout session with local radiologists for trainees to openly discuss effective strategies when job-hunting and the current state of the job market. We thank our panelists, Drs. Frank Wessbecher, Laura Nason, Michael McNeeley, and Nicholas Krause, for sharing their experiences and candid advice.

Recently, our members traveled to Olympia with WSRS Board members to speak directly with state legislators, and to advocate for our patients and future practice. Our residents witnessed how these personal conversations with legislators could affect bills, and in turn impact our ability to deliver quality patient care. We hope to continue our efforts to build relationships in Olympia in order to foster opportunities for open communication with our legislators.

Our members also meet on a regular basis for journal clubs and to work through the ACR Radiology Leadership Institute’s online courses together as a group. By touching on issues related to the business of radiology, economics, and work-life balance, the RLI courses will help us enter the job market with higher confidence, a better understanding of the workplace and more realistic expectations.

The RFS is thankful to have the ongoing mentorship from the WSRS, as well as the support from our residency programs. We look forward to continuing our success in helping our members develop leadership skills, learn about advocacy, and grow into future leaders in our field. 

-Vicky Nguyen, DJ Perry, Whitney Shofner-Michalsky, Sana Parsian, Linda Chen, Anika Mirick, Alvin Wyatt

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ACR Fellowship Application Deadline: June 30

WSRS board member, Kalpana Kanal, PhD, DABR, FACR, FAAPM, FSCBT-MR, provided her perspective on the application process for ACR Fellowship:

In 2013, I became aware of the ACR fellowship and decided to apply. Nominees for Fellowship are nominated under one or more of the following criteria - service to ACR at national or chapter level(s), significant scientific or clinical research in field of Radiology and/or outstanding service as teacher of Radiology, Radiation Oncology, or Medical Physics.

The process is pretty straightforward and paperless with the nominee applying online on the ACR website to their State Chapter. The deadline for the State chapter to review your nomination and submit their decision to the ACR is typically June 30th of each year. The nominee has to also request two current Fellows of the ACR to write letters of recommendation on their behalf. Allow for at least 2-4 weeks for the letters of recommendation to be submitted on your behalf and for your State chapter to review your nomination and make their recommendation to ACR. ACR staff is always available to help you if you have any questions.

Getting approved for fellowship is a great honor and a recognition of your reputation and contributions to the field of radiology. ACR holds an amazing convocation ceremony at their annual meeting to make the new fellows feel special. Family and friends are also welcome to attend.

I encourage all of you to review the eligibility criteria and apply for fellowship if you qualify. The process is painless and getting approved for fellowship a great honor.

The deadline for this year is June 30th. Good Luck!

If you are interested in applying or need assistance, please contact Fellowship Chair Bill Marks: wmarks@radiax.com  or J.P. Baird at ACR:  jpbaird@acr.org

Fellowship application information and online nomination form can be found on the ACR website.

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Breast Imaging Update- Breast Density Legislation and Tomosynthesis

by Pooja Voria, MD, MBA, WSRS Vice President
Chair, Breast Imaging Task Force

Currently, 21 U.S. states have adopted breast density reporting legislation.   For those of you who haven’t heard, a bill mandating reporting of dense breasts was introduced in Washington state in the fall of 2013. The Washington State Radiological Society (WSRS) has been working diligently to educate our lawmakers about the impact of breast density legislation, including benefits as well as potential harms and unintended consequences. We have had the support of the Washington State Medical Association and the American College of Obstetrics and Gynecologists. Together, our groups were able to halt passage of the bill in 2014. In addition, we persuaded lawmakers to request the Health Technology Assessment (HTA) Program at the Washington State Health Care Authority to perform a comprehensive review of breast cancer screening.

The HTA performed an extensive analysis over the course of 10 months, and engaged in continuous dialogue with breast imaging experts from all over the state.  In March of 2015, the final results of their analysis were published. The HTA concluded that “the evidence is sufficient and to cover digital breast tomosynthesis (DBT) for breast cancer screening for woman aged 40 to 74 who are candidates for screening mammography. The committee concluded that the available evidence is not sufficient to support coverage for magnetic resonance imaging (MRI), Hand Held Ultrasound (HHUS) and Automated Breast Ultrasound (ABUS) for supplementary screening following mammography.”

Beginning January 1st, 2015, Medicare established coding, coverage and reimbursement for tomosynthesis above standard digital mammography. The HTA analysis, as well as the Medicare coverage of tomosynthesis, has been a breakthrough for us. WSRS is currently working to get private payors to cover this important screening tool.

Breast density legislation in the state of Washington is no longer being pursued at this time, but will likely resurface again in 2016. We will be ready to restart discussions with the legislators given the final HTA report and interval favorable publications on tomosynthesis.

I would like to take this opportunity to thank the members of the WSRS Breast Imaging Task Force* for their efforts over the past two years in working with me on these important issues.  The Breast Imaging Task Force has been instrumental in creating statements on Breast Density Communication as well as Digital Breast Tomosynthesis, which are available on our website at www.wsrs.org. I look forward to their continued support and expertise as new breast imaging developments arise.

*Breast Imaging Task Force members (alphabetical order) : Kara Carlson, Peter Eby, Mary Kelly, Janie Lee, Constance Lehman, Gail Morgan, Nancy Neubauer, Jay Parikh, Eric Rosen, Khai Tran, Pooja Voria (Chair)

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WSRS Lobbyist's Report

by Brad Boswell, WSRS Lobbyist

The 2015 Washington State Legislature has finished the regular session, however the House and Senate have not yet reached resolution on the General Fund budget.  The Governor has scheduled a 30-day special session to begin on April 29th to allow for more time to reach a resolution on the budget and other key issues such as a statewide transportation package. 

WSRS leaders engaged state legislators in conversations about issues of concern at the annual Day in Olympia in late February.  Pictured left to right:  Pooja Voria, MD, Vice-President; Jonathan Medverd, MD, PAC Chair and Immediate Past-President; Vicky Nguyen, MD, Immediate Past President of the RFS;  Sammy Chu, MD, Secretary; Eric Stern, MD, President.

February 24th was WSRS Legislative Day on the Hill and we had a great turn out with over 24 participants and 18 meetings with legislators.  We also had great conversations with Dr. Bob Crittendon, senior health care policy advisor for Governor Inslee who discussed the Governors priorities for Health Care.  In addition Mary Ann Lindenbladt, Director of Washington State Medicaid, came and discussed how the Medicaid system is changing with Health Care reform and how she sees the Medicaid system evolving in the future.  Special thanks go out to all of the WSRS Board members who attended and the residents that took time off to participate.

Members of WSRS board and RFS met with Dr. Robert Crittenden, senior policy advisor on healthcare to Governor Inslee for a briefing during their day in Olympia Feb. 24.

WSRS worked with other stakeholders and passed House Bill 1183, An Act Relating to Radiology Benefits Management Companies (RBMs).  This legislation simply requires RBMs that work in Washington to register with the Department of Revenue.  This legislation is the beginning of a long-term conversation about the role of RBMs and how they should be used and hopefully by working with the insurance industry help them move towards a decision support model and away from a traditional RBM prior authorization system.  We will be working with the Office of the Insurance Commissioner during the interim on next steps related to RBM policy  in Washington State and hopefully have additional public policy options to discuss with the legislature in the coming sessions.

We have also been working in coalition with the Washington State Medical Association and the Washington State Hospital Association on Senate Bill 5175, An Act Relating to Telemedicine.  This legislation will require insurance companies to reimburse physician for telemedicine consultation the same way that they would for a traditional in office visit.  This legislation has passed out of the House and Senate and was signed by the Governor.

We are happy to report that while Senate Bill 5040, An Act Relating to Breast Density Reporting, was introduced this session by Senator Steve O’Ban of Tacoma, it did not get a hearing in the Senate Health Care Committee.  At this point it is considered dead for this session.  Senator O’Ban has indicated that he plans to continue to push for breast density reporting next year, so we will be monitoring the issue closely going forward.

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Save the Date!

WSRS Annual Meeting, Saturday, Nov. 7, 2015
Seattle area venue to be announced soon

Other programs of interest:

ACR Annual Meeting 2015, May 17-21, 2015
Washington DC
http://www.acr.org/meetings-events/acr-2015
Members of WSRS will be participating in visits with members of our state’s congressional delegation and their staffs.  If you plan to attend, please let  our office know so we can include you in communications.  Debra Alderman, executive director, can be reached at 206-956-3650  or  via email:  debra@wsrs.org

Imaging on the Island: Radiology Update and Workshops in the Northwest
June 6 and 7, 2015, Victoria, BC
Presented by Pacific NW Radiological Society, BC Radiological Society and Univ. of BC
For full details and online registration, visit: http://pnwrs.org/meeting.html

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