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July
8
- Current Trends
in Imaging
As new imaging practices emerge, CT remains a vital
tool in the evaluation of patients in the emergency department (ED)
with symptoms of chest pain and those involved with trauma, according
to an article in the July issue of the Journal of the American
College of Radiology. Recent data from the Centers for
Disease Control and Prevention state that out of the 11 million ED visits
per year in the United States, 44% of patients undergo imaging studies.
In Emergency Department Imaging: Current Practice, by John Thomas, MD,
et al., the demographics and current imaging practices of radiologists
providing coverage for EDs were evaluated through the results of an
online survey. CT scanners were the most common pieces of imaging equipment
found in EDs (40%) followed by ultrasound units (27%).
All surveyed groups used multiple methods for communicating findings
to ED physicians; however, the most prevalent method was via telephone
(49%), followed by delivering the results in person (21%). Twenty-one
percent of groups had dedicated emergency radiology divisions, the majority
of them being in academic centers (73%). Of the groups surveyed, 15%
obtained written consent before performing either noncontrast CT or
MRI scans, as compared to 47% that obtained written consent before performing
contrast-enhanced CT or MRI scans.
The Growing Size of Radiology Practices, by Mythreyi Bhargavan,
PhD, and Jonathan Sunshine, PhD, reports on trends in the size of radiology
practices as well as the causes of trends and how they compare with
physician practices as a whole. Radiology practices grew in size throughout
the 1990 to 2007 period, with significant growth occurring in practices
with 30 or more radiologists. The median radiologist was in a practice
with seven radiologists in 1990, which increased to 11 in 2000 where
it remained in 2007. The fraction of radiologists in small practices
(one to four radiologists) decreased from 29% in 1990 to 22% in 2007,
the fraction in medium-sized practices (five to 14 radiologists) decreased
from 51% in 1990 to 38% in 2007, and the fraction of practices with
15 to 29 radiologists increased from 14% in 1990 to 21% in 1995 and
has since remained constant. In general, the authors state that the
changes were more rapid in 1990 to 2000 than since. The authors also
discuss the advantages of a larger practice, citing increased opportunity
for diversity in subspecialization and more leniency in negotiating
leverage with insurers and hospitals.
Quality and consistency are just some of the advantages
of standardizing radiology reports, as described in the paper, Structured
Reporting: Coronary CT Angiography, by Arthur E. Stillman, MD,
PhD, et al. With the increased usage of electronic medical records,
reporting trends in diagnostic imaging have shifted to an increasingly
standardized format. Structured reporting allows for more streamlined
communication with referring physicians, ensures all required elements
are included for billing purposes, and helps facilitate data mining.
The essential elements of a structured report for coronary artery CT
angiograms are outlined in the paper.
Finally, techniques for negotiating nondepartmental conflicts and a
discussion on mutual benefits achievable by maintaining open dialogue
with cardiologists are outlined in Interdepartmental Conflict Management
and Negotiation in Cardiovascular Imaging by Hansel J. Otero, MD,
et al. Innovation in health care has fostered the development of noninvasive
radiological procedures, including cardiac CT, which presents challenges
to radiologists and cardiologists who maintain that each respective
specialty is better suited to provide the service. The authors encourage
radiologists to entertain an ongoing communication with cardiology,
because in many cases, both sides can benefit. The benefits of a negotiated
outcome include minimizing internal competitors, incorporating cardiologists’
expertise to cardiac imaging algorithms, and more effective training
opportunities.
Source: Journal of the American College
of Radiology
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