Large scale government involvement in U.S. radiology? 
Author Message
 Large scale government involvement in U.S. radiology?

What is happpening to American radiology?

There seems to be a huge government effort to regulate everything
(mammography, MRI etc.).

In addition to that: mandatory continuing education, relicensure etc.

Here you have the best radiologic science in the world and the most
obnoxious government interference that will probably kill it before
long.

----------------



Tue, 21 Jul 1998 03:00:00 GMT
 Large scale government involvement in U.S. radiology?

Quote:
>What is happpening to American radiology?

>There seems to be a huge government effort to regulate everything
>(mammography, MRI etc.).

   A lot of this is being driven by the need of "Managed Care" to be able
to document quality and to track utilization.  To untrained business
people who are directing how health care dollars are spent, one mammogram
looks like another.  They don't know if one is better than the other, so
they are dependent on some type of score (accreditation) to tell them
that the service they are providing meets some quality standard.
   Then, they want to know if the test they are paying for is providing
any cost benefit; ie. are we finding cancers with all those mammograms,
or are we wasting a lot of money to find a few cancers-- this is the
thinking behind the concept that mammograms for women under 50 are not
cost effective.
  All of our sites are ACR/FDA accredited for mammography; a program that
was initially voluntary and now government mandated.  We are now starting
to  accredit all of our ultrasound sites; another voluntary program which
will probably follow mammograms to Capital hill.  Maybe chest x-rays will
be next.
  Let's just hope that the CME courses keep this in mind so that we can
get specific credits in multiple specialties in order to keep reading the
exams we have been doing for years before accreditation.
-



Fri, 24 Jul 1998 03:00:00 GMT
 Large scale government involvement in U.S. radiology?

Quote:

>   A lot of this is being driven by the need of "Managed Care" to be able
>to document quality and to track utilization.  To untrained business
>people who are directing how health care dollars are spent, one mammogram
>looks like another.  They don't know if one is better than the other, so
>they are dependent on some type of score (accreditation) to tell them
>that the service they are providing meets some quality standard.
>   Then, they want to know if the test they are paying for is providing
>any cost benefit; ie. are we finding cancers with all those mammograms,
>or are we wasting a lot of money to find a few cancers-- this is the
>thinking behind the concept that mammograms for women under 50 are not
>cost effective.
>  All of our sites are ACR/FDA accredited for mammography; a program that
>was initially voluntary and now government mandated.  We are now starting
>to  accredit all of our ultrasound sites; another voluntary program which
>will probably follow mammograms to Capital hill.  Maybe chest x-rays will
>be next.

First they kill all the motivations of physiciancs by capitation
schemes and then they worry about the quality of the health care
delivered in a system that rewards those who do the least and those
who use the cheapest means (i.e. machines).
Quote:
>  Let's just hope that the CME courses keep this in mind so that we can
>get specific credits in multiple specialties in order to keep reading the
>exams we have been doing for years before accreditation.

Quality cannot be mandated by goverment edict. They should have
learned from the fall of Soviet Russia!

----------------



Mon, 27 Jul 1998 03:00:00 GMT
 Large scale government involvement in U.S. radiology?

Quote:

>>What is happpening to American radiology?

>>There seems to be a huge government effort to regulate everything
>>(mammography, MRI etc.).

>   A lot of this is being driven by the need of "Managed Care" to be able
>to document quality and to track utilization.

Rick:

You miss the gentleman's point from Germany.  He is trying to warn us that the government is not our friend.  The rise of "managed care"
is merely a response to 30 years of government interference in health care with a resultant inflation of costs and "hidden" costs to
overinsured individuals who obtain their private insurance as a "benefit" from work.  The result is that most people have no clue
as to what the actual costs of procedures are, and are in no postition to wiegh costs and benefits.
People have substituted freedom of choice and individual responsibility for "carte blanche" benefits that cannot exist for long in any society.
Managed care is merely a rationing scheme.  One that will spiral down to single party payor, or one that will self destruct and lead to
freedom if people realize that they should be managing their own health care and money for health care through tools such as MSA's or
superIRA's that are available to all individuals and not just those employed by companies that offer "health care" benefits.

As radiologists, the worst thing we did was letting the govt take our standards for mammo. .Though we think there is short term gain in
quality, we have merely allowed govt to set standards in our field.  Politicians are not better than corporate executives in running
our lives.  And when the debate about standards boils down to who has what to offer to whom - the market approach - we in America
will be relegated the role of "special interest group" radiologists merely lobbying the government for more pay, more "quality" and more
reimbur{*filter*}t.  We made the mistake in the past of offering lower pay reimbur{*filter*}ts so that Stark would prevent others from entering our
arena (by "preventing" self referral).  What did we get?  Lower pay and further erosion of our specialty by non-radiologists.   Political solutions will not be
anyone's salvation.  Removing politics and government from health care - a daunting but necessary task - is the only way forward if we hope to avoid the
rationed conditions of the European welfare states, and the debt ridden Canadian provincial mess.

btw Rick...how are you???

Gregg Gaylord



Wed, 29 Jul 1998 03:00:00 GMT
 
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