Tuesday, October 4, 2022

Very Brief Blog: Two Interesting Articles in JACR

 I ran across Journal of the American College of Radiology around 2010, working on CMS PET scan policy, and I've been a fan ever since.   While lab and pathology journals (e.g. AMP's Journal of Molecular Diagnostics) have important policy articles from time to time, JACR is mostly policy and business articles, some of them really intriguing.  I've always assumed that there's crossover between imaging and lab diagnostics, both being, diagnostics.  I mused on this in March 2022 here.

Here are two interesting articles from the September issue, and if I read correctly, both are flagged as open access.

In a really unique eight-page article, Stefan Tigges MD presents diagnostic test metrics (NPV, etc) in a sophisticated way yet using a cartoon format.  Find it here.

On a wholly different topic, Brandser & Kothari talk about the pressure of unpredictable work volume and reading queues in day to day radiology, and how their group practice came up with some novel work plans to improve effectiveness.  (Some of the fastest readers in the group, were happy to get paid extra to do "bunker shifts" reading a fixed aliquot of images in queue.  And during that time - say, on a Saturday - having no other duties, and just working from home.  Sounds simple, but someone had to think of it.)  Sort of like an attorney going into the home office on Sunday and knocking out 1.5 billable hours. 

One thing I noted - while CMS doesn't have a fixed time for physician RVUs, they are often around 3 per hour.   E.g. a 45-60 minute office visit, gets 2.6 work RVUs.   This radiology practice has a standard metric of an output of 10 work-RVUs per hour.   (For an internist, that would be 4, "45 minute" office visits per hour to log 10 w-RVU per hour).  (It's like the joke about a procedure that gets on the books 37 or 42 CMS minutes, but is scheduled every 20 minutes at all clinics in the real world).