LETTER TO THE EDITOR Re: “An Introduction to ‘Business Essentials’: Purposes and Plans” I was delighted to see the introduction to “Business Essentials” by Sherry and Canon [1]. This changed to disappointment as I encountered yet another tiresome assault on teleradiology. The assertion that teleradiology companies focus more heavily on the bottom line than on patient care is misleading and unfair. The recent “ACR White Paper on Teleradiology Practice” is impartial and comprehensive [2]. I was hopeful that forward progress was being made. What is puzzling is that the concept of teleradiology has never seemed unusual to me. I was introduced early, in the 1990s, as a resident and navy officer, when I was occasionally tasked with reading films from ships deployed at sea. We were “bringing radiology to the deck plates.” In current health care jargon, this is known as increasing access to care. From the Navy, I moved to private practice and eventually to teleradiology. Nothing has changed. My practice has allowed me to provide much-needed coverage to critical-access hospitals. The gratitude in the voices of the physicians I speak with daily says it all. Repetitive reproach of teleradiology shows resistance to change
and inability to come to terms with the fundamental business principle of competition. It is human nature to resist a threat. But if you believe that “the growing prevalence of corporatized professional interpretations through teleradiology arrangements threatens the bedrock of independent radiology practice” [1], then you may also lament that “if there were no taint of commercialism in the medical profession of today.radiology as a specialty would rest on a much firmer foundation.” The problem is that the second statement was written in Radiology in 1924 [3]. Is this as far as we have come in 90 years? Are we to believe that the abolition of teleradiology (if even possible) would put radiology on easy street? There’s no question that radiology has taken a legislative pounding. Is it possible that teleradiology has become a scapegoat? As we forge ahead from quantity to quality, fear mongering and infighting have no place. Teleradiology and Imaging 3.0 are not mutually exclusive. Someone has to read the cases. Not every radiologist has the precious gift of time to interact face to face with patients, lead change, collaborate with hospital administration, take charge in accountable care organizations, and advocate in Washington. No one person can do it all. It will take a
ª 2014 American College of Radiology 1546-1440/14/$36.00 http://dx.doi.org/10.1016/j.jacr.2014.02.011
village to keep radiology strong. Many teleradiologists have compelling, and sometimes even heartbreaking, reasons for choosing to practice this way. We are here to serve our specialty as partners, not rivals. I never forget that every examination I read represents a patient who is depending on me to do my very best. No doubt, this is patient-centered care. Do we really want to propagate a radiology rift? No practice model is perfect. There are predatory teleradiology companies and private radiology groups that forgot to stay ahead of the quality curve. The bottom line does matter—to everybody. But it has never been the radiologist’s main focus. Not now, not ever. Mary L. Grebenc, MD, MBA Aris Teleradiology 5655 Hudson Dr. Hudson, OH 44236 e-mail: [email protected] REFERENCES 1. Sherry CS, Canon CL. An introduction to “business essentials.” J Am Coll Radiol 2014;11:110-1. 2. Silva E, Breslau J, Barr RM, et al. ACR white paper on teleradiology practice: a report from the Task Force on Teleradiology Practice. J Am Coll Radiol 2013;10:575-85. 3. Bissell FS. Future of the roentgenologist. Radiology 1924;2:267-8. http://dx.doi.org/10.1016/j.jacr.2014.02.011 S1546-1440(14)00084-2
1
and inability to come to terms with the fundamental business principle of competition. It is human nature to resist a threat. But if you believe that “the growing prevalence of corporatized professional interpretations through teleradiology arrangements threatens the bedrock of independent radiology practice” [1], then you may also lament that “if there were no taint of commercialism in the medical profession of today.radiology as a specialty would rest on a much firmer foundation.” The problem is that the second statement was written in Radiology in 1924 [3]. Is this as far as we have come in 90 years? Are we to believe that the abolition of teleradiology (if even possible) would put radiology on easy street? There’s no question that radiology has taken a legislative pounding. Is it possible that teleradiology has become a scapegoat? As we forge ahead from quantity to quality, fear mongering and infighting have no place. Teleradiology and Imaging 3.0 are not mutually exclusive. Someone has to read the cases. Not every radiologist has the precious gift of time to interact face to face with patients, lead change, collaborate with hospital administration, take charge in accountable care organizations, and advocate in Washington. No one person can do it all. It will take a
ª 2014 American College of Radiology 1546-1440/14/$36.00 http://dx.doi.org/10.1016/j.jacr.2014.02.011
village to keep radiology strong. Many teleradiologists have compelling, and sometimes even heartbreaking, reasons for choosing to practice this way. We are here to serve our specialty as partners, not rivals. I never forget that every examination I read represents a patient who is depending on me to do my very best. No doubt, this is patient-centered care. Do we really want to propagate a radiology rift? No practice model is perfect. There are predatory teleradiology companies and private radiology groups that forgot to stay ahead of the quality curve. The bottom line does matter—to everybody. But it has never been the radiologist’s main focus. Not now, not ever. Mary L. Grebenc, MD, MBA Aris Teleradiology 5655 Hudson Dr. Hudson, OH 44236 e-mail: [email protected] REFERENCES 1. Sherry CS, Canon CL. An introduction to “business essentials.” J Am Coll Radiol 2014;11:110-1. 2. Silva E, Breslau J, Barr RM, et al. ACR white paper on teleradiology practice: a report from the Task Force on Teleradiology Practice. J Am Coll Radiol 2013;10:575-85. 3. Bissell FS. Future of the roentgenologist. Radiology 1924;2:267-8. http://dx.doi.org/10.1016/j.jacr.2014.02.011 S1546-1440(14)00084-2
1
