December 2000 Newsletter

President's Message

Daniel Singer, MD

dansingerThe OSRS leadership has been redoubling our efforts to be more responsive to our membership. We of course realize that time is the most valuable commodity for the radiologists of Ohio. All of us have seen our workloads increase while at the same time it has been more difficult to recruit new radiologists into our practices. To be successful we will need your input. Thanks to electronic communication it has been easier to disperse information . Regionally our local societies have seen a rebirth. In Northwest Ohio our local society has seen a doubling in the number of radiologists attending our meetings. The discussions of local issues at the regional level allows the state chapter leadership to concentrate our resources where it will benefit the greatest number of radiologists in our state. This information is also passed on to the ACR to benefit the national membership in addition to those of us in Ohio. The state leadership depends on your input to your local councilor. The most important aspect of a councilor’s position is to listen to your concerns and then forward it to the state chapter and if necessary to the national leadership of the ACR. There are ample opportunities to participate in the state chapter. At present we find that both councilor and alternate positions are open for the Dayton Region. There is also a need for radiologists to work with the Medicare CAC Committee to review payments for the many new and complex procedures being performed by radiologists throughout the state.

To better meet the needs of our membership the annual meeting format has been completely overhauled. Rather than another attempt at an academic meeting in the spring, the meeting focus will change to one devoted to political and economic issues. It has become apparent that a state academic meeting could not compete with those offered at the top ski resorts in the west or the Florida sunshine. There are many economic and political issues confronting our members in Ohio and although many are national problems there are those peculiar to Ohio. To accommodate the busy schedules of Ohio radiologists the meeting will be shortened to one day from 10am to 5pm on Saturday April 28, 2001. The location will be the Beachwood Hilton in the metro Cleveland area. This will allow any radiologist from all parts of Ohio to make this a one day trip if desired. National ACR speakers will address key issues, including manpower needs, service standards, and the direction of national healthcare. In this state many of us have been battling with our hospitals over contracts. This issue will be addressed by an Ohio attorney specializing in this arena. These are a sampling of these issues that are important to all of us but are difficult to face alone in practice. This meeting will provide ample opportunity to learn by sharing our experiences with others throughout the state with each lecturer devoting much time for open discussion.

Harvey Neimen, ACR Chair Board of Chancellors, was very accurate with his prediction of a tight presidential race. Writing this portion of this letter one week after the election I cannot confirm who is the next U.S. President. No matter what the outcome we as radiologists must gain access to our representatives. Many of you have been involved in the political process offering support to those candidates supporting the positions of radiologists and our patients. For those of us without the time or the close relationship to these politicians RADPAC and ORSPAC contributions provide the needed access to these political circles. RADPAC is off to a strong start with over $300,000 already raised. This money is used to support those elected officials who have the potential to advance the interest of radiology regardless of party affiliation. Those of us in the field have an obligation to let our national organization recognize those politicians who have helped advance those issues important to radiology. Your regional ACR councilor serves as the conduit to the RADPAC advisory council. This identification process is just as important as your financial commitment to our radiology PACs.

ORSPAC, our radiology PAC for state issues is off to slow start this year in raising funds. Contributions received through November 15, 2000 for this year are $9,291. This is unfortunate since resources are badly needed to ward off many threats to radiology such as the push by nurse practitioners to set up imaging facilities and to interpret these studies. Funding is also needed to support legislation to help radiologists with prompt pay and to deal with large insurance companies on an equal footing. Although are funds have been limited our political strength has been enhanced thanks to the keen insight of our representative to our state government, Victor Goodman. Victor identified 20 legislators as candidates to support OSRS issues and all 20 won their election races. All candidates that received ORSPAC contributions won election except for one. This is a phenomenal record of accomplishment! Victor is building our political base it is now up to us to support this with contributions to ORSPAC. Please consider ORSPAC and RADPAC for contributions this holiday season.

Daniel Singer

ORSPAC

If you would like to help support Ohio Radiology as a player in the Ohio political arena, mail your check today to:

ORSPAC
c/o Billie Fiori, Treasurer
88 East Broad Street, 9th Floor
Columbus, OH 43215

  • $200.00 Club: $200 or greater donation
  • Sustaining Membership: $75 or greater donation
  • Resident Membership: $10 or greater

Note: Contributions to PAC organizations are not tax deductible, and should be made by personal check.

Appreciation for ORSPAC Contributors

The Ohio State Radiological Society would like to recognize and thank the following members who have supported the political voice of radiology through contirbutions to ORSPAC in 2000.

200 CLUB

    • Thomas Poulton
    • Bradford Woodall
    • Amitabh Singh
    • Thomas Seward
    • Jeffrey J. Kornick
    • Charles M. Perme
    • Charles C. Church
    • Samuel Hissong
    • Murray A. Howe
    • Allan S. Kaufman
    • Chonggi Mah
    • William G. Novak
    • David A. Parker
    • Philip J. Silverman
    • Gerald Smidebush
    • Sandra K. Yobbagy
    • Thomas Sardells
    • Daniel Singer
    • George H. Belhobek
    • Stanley B. Ignatow
    • Robert H. Hamor
    • Jonathan S. Moultron
    • John T. Chiles
    • Daniel A. Dessner
    • Antoinette LaValley
    • Kenneth K.W. Seo
    • Craig Parker
    • Keith D. Wilson
    • Tamara S. Martin
    • Michael J. Seider
    • Robin Shermls
    • Blaine A. Keigley
    • James E. Masten

SUSTAINING MEMBERS

    • Andrew Kurman
    • William Buente
    • Glenn P. Carney
    • Raymond Rost, Jr.
    • Yagnesh Raval
    • Allen Rovner
    • Brooks H. Sitterley
    • Paul A. Klatte
    • Martin W. Mitchell
    • Robert Basista
    • Sarah G. Pope
    • Karen Sheehan
    • Colleen C. Doyle

RESIDENT MEMBERSHIPS

    • George F. Jones
    • Thomas C. Mick
    • Douglas E. Lemley
    • Peter W. Fanton
    • Steven J. Mustric

Fellowship Committee Report

  • Two Fellowship nominations and one resubmission will be considered by the ACR for approval in January 2001.
  • July 1, 2001 is the deadline for submission to the ACR for fellowship consideration in 2002.
  • Councilors and alternate councilors should begin a review process to identify candidates for ACR fellowship in their regions, and encourage them to apply.

Respectfully submitted,
Stanley B. Ignatow, MD, FACR

Radiation Oncology Committee Report

Radiation Oncology has been facing a manpower shortage in regards to therapists over the past several years. This shortage has become critical in the past year, with subsequent rises in pay for therapists, dosimetrists and other personnel. There has been little help from the Federal Government since Medicare is in a cost-cutting phase and has reduced payments to hospitals for educational purposes. I have seen several national articles in regards to this shortage and we submitted a resolution to the ACR in an attempt to address this issue. We may need to address this issue in more detail,specifically how to increase the number of therapists in training and in the field.

Secondly, there is now a shortage of radiation oncologists (and I am told radiologists) in the field. What I really would like to know is how this situation developed when just a few years ago, we were inundated with articles on the approaching glut of specialists.

Another problem being faced by community radiation oncologists is the problem of large referral centers using unethical “sales tactics” in order to keep patients at their center and not allow them to return home for treatment at a closer and more convenient treatment center. These sales tactics include telling patients that the local center does not have the equipment or expertise to perform the treatment and telling patients that they will get substandard care in their local community. They may even state that the patient will die of their disease if they are not treated in the referral center. This needs to be addressed as an ethical problem. It is unethical to tell patients their care will be substandard if in fact it is not. I feel it is morally reprehensible to tell a patient that they will die if they aren*t treated at institution X. If referral center physicians really believe that their center is the only one who can treat a condition, then we need to educate them that this is not the case. If the reason is economic, then the institutions need to be educated.

Respectively submitted,
Michael Seider, MD

Committee on Physics and Radiation Safety Report

  1. An e-mail notice was sent to Ohio Medical Physicists using the AAPM listing for solicitation of comments to recent rules making by the Ohio Department of Health, Bureau of Radiation Protection. The response was lackluster. A followup will be sent.
  2. There are 3 ambulatory PET [Positron Emmission Tomography] operating in Ohio.

Action Item: None

Respectfully submitted,
George W. Callendine, Jr.
Jerome G. Dare

Ohio CAC Meeting Report

On June 6, 2000, the non-coronary vascular stent policy was discussed. You can obtain the policy by Web-site: Nationwide Medicare Policy Manual (www.Nationwide-medicare.com\mednol.htin) or Nationwide Medicare medical policy drafts (www.nationwide-medicare.com\medipoldrafts.htm). PTA is not allowed to treat obstructive disease of the carotid, vertebral or cerebral arteries by HCFA.

On Sept. 5, 2000, Endovascular Repair of Infrarenal Abdominal Aortic Aneurysm policy was discussed. The CPT code number is 37799 for surgeons. If intervenional radiologist works with surgeon for this procedure, you should submit the bill with modifler-62. The discussion on indication was size of aneurysm. Aneurysm size should be 5 cm.or greater diameter. If aneurysm is 4.5 cm. It should be documented to show the expansion of 0.5cm. in six month or documented claudication or documented pain/tenderness on palpation of aneurysm.

Second item related to radiology policy was percuteneous vertebroplasty/ kyphoplasty. The CPT code number is 22899 including all the pre and post procedure imaging. This code should be billed one time per level. If you log on to Nationwide policy drafts and have any comments to make, please E-mail your comment to Dr. Robert N. Ludwig (www.ludwigr@nationwide.com).

Dr. Mudin I. Syed, interventional radiologist from Mercy Medical Center, Springfield, Ohio presented the vertebroplasty to CAC members with great interest. The procedure will be paid after 45 days comment period.

We have a new medical director. His name is Robert R. Kamps, MD. (www.kampsr@nationwide.com).

Respectfully submitted,
S. Christopher Lee, MD

Treasurer's Report

Dr. Robert Tyrrell submitted a report that the society has a balance on hand of $180,068.72.

Secretary's Report

The minutes of the September, 2000, executive council meeting offered by Thomas Poulton, MD, were approved.

Membership Committee Report

New Members

  • Gamboa, Pablo A., MD, Columbus
  • Glowacki, David M., MD, Perrysburg
  • Jones, Blaise V., MD, Cincinnati
  • Lafont, Michael, MS, Canton

Transferred from Ohio

  • Gilda Cardenosa, MD, North Carolina
  • Bennett G Gray, MD, Indiana
  • Ayyangar M Komanduri, PhD, Nebraska
  • Judith R Samuels, MD, Florida
  • Michael A Samuels, Florida
  • Martin E Morin, MD, Arizona
  • Christopher A Meyer, Indiana
  • Frank E Zink, MD, Minnesota

Transferred to Ohio

  • Laurain M Dean, MD, Texas (Dayton)
  • Sara M O’Hara, MD, North Carolina (Cincinnati)
  • Gary S Sudakoff, MD, Illinois (New Albany)
  • Awat A Aliyar, PhD, Maryland (Independence)
  • Curtis L Reece, Msc, Maine (Brecksville)

Retired

  • John A. Vanek, MD, Oberlin
  • Charles McCarthy, MD, Cincinnati

Resident Section Update

This is the inaugural update letter for the Ohio State Radiological Society, Resident Section (OSRSRS), and I am Phil Calendine, the current President of this society, and a third year (PGY IV) radiology resident at OSU. The current vice-president is Rosemary Klecker, also a third year radiology resident at OSU. Now, before your interest is lost, allow me to say that I do apologize for all the acronyms usually used in letters like this… OSRS, ACR, DOA. etc. I will strive to be as clear as possible, without belaboring points, as I am doing now. But first, a pause for humor…

You know you’re a radiologist when….

  • Friends recognize you have an M.D. (or D.O.) but can*t figure out what it is you do.
  • You know that concha bullosa isn’t a tropical drink.
  • NHL means lymphoma, not hockey.
  • You verbally punctuate when talk with people. . . “You can put that on the table, period, new paragraph. . . please indent, how was your day, question mark”
  • You don’t fall asleep watching ultrasounds.
  • You DO fall asleep listening to surgeons and internists!
  • You talk to yourself much more than usual…even in public.
  • SOB is not a derogatory comment.
  • You hedge on whether the cafeteria “meat dish” is chicken or pork.
  • All your physician friends wish they had your job!

Who are we?
The Ohio State Radiological Society (OSRS) is the state chapter of the American College of Radiology (ACR)… the ACR is a national college (or group) dedicated to protecting the field of radiology while ensuring the best radiological imaging for patients. It is analogous to the Surgeons College or Pathology College. There is a national meeting for the ACR every September when specific laws and such with potential influence on the field of radiology (including radiation oncology) are reviewed. Also, many standards are created to ensure high quality studies… Mammography being the first, but now including U/S. Mm, and others. The OSRS acts locally on state issues influencing our field. The OSRS meets annually, rotating through the major cities (this year it is in Cleveland).

Why do I care? I just want to pass boards!
In the last several years remarkably important legislation (that word makes me cringe) has been passed which has influenced repayment… MONEY WE GET (or don’t get) SOMEDAY in the “Big Leagues”. Example: HCFA (Health Care Financing Association) is a Federal group used to “contain cost”. They are responsible for the recent legislation passed allowing NURSE PRACTITIONERS to open, run and INDEPENDENTLY ORDER, PERFORM, and INTERPRET X-.RAYS, if the state oks (okays) it. So far this has not happened in Ohio, but unless the OSRS keeps an ear to the ground and fights, it will. The nurses union is very strong and very wealthy (money makes it happen).

But I’m broke…
Hey, me, too! But there is essentially NO COST to us as residents (might have to drive somewhere for a meeting, but the food is good). As a resident you are already a member of the ACR, OSRS and OSRSRS!

Lemley Elected Vice-Chair of ACR Resident Physician Section

Douglas E. Lemley, MD was elected Vice-Chair/Chair-Elect of the Resident Physician Section during the annual meeting of the American College of Radiology that was held in New York City in September. Dr. Lemley is a former vice-president and president of the OSRS Resident Physician Section, and served as one of Ohio’s resident delegates to the ACR in 1998 and 1999. He has been a member of the ACR Resident Physician Section Executive Council for the past year acting as a liaison between that organization and the American Association of Academic Chief Residents in Radiology, and the Council of Medical Specialty Societies. Lemley was selected this year by the ACR as the only diagnostic radiology resident in the nation to serve upon its Task Force for Patient Safety.

Dr. Lemley is a senior resident, and former Chief Resident, in the Department of Radiology at Ohio State University. Upon completion of his training there in 2001, he will begin a musculoskeletal imaging fellowship at Duke University. Lemley assumed chairmanship of the ACR Resident Physician Section at the annual meeting of the college which was held in San Francisco next September.

In Memory of...

Radiologist and Past OSRS President M.M. Thompson passed away Saturday, November 4, 2000. Dr. Thompson served his community for over 40 years and he will be sadly missed by all.

Morgan McBeeDecember 2000 Newsletter