Your Assistance Needed: Proposed IAC Vascular Testing Standards Ignore IR Expertise, Please Submit Opposing Comments by Nov. 5

By Marshall E. Hicks, MD, FSIR
SIR President

Dear Colleagues,
The Society of Interventional Radiology needs your assistance: I encourage you to oppose proposed Intersocietal Accreditation Commission (IAC) Standards and Guidelines for Vascular Testing Accreditation. The proposed standards recommend the Registered Physician in Vascular Interpretation (RPVI) credential or American Society of Neuroimaging (ASN) credentialing process over other training options—ignoring IR’s unique training and skill set. 

I ask that each SIR member copy and paste the below comments to the IAC review website or provide an opinion in your own words by the Nov. 5 review deadline. Please note: SIR is conveniently providing comments on the proposed standards because responses are limited to 1,500 characters (with spaces). 
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I strongly object to the comment that the RPVI credential or ASN credentialing process is recommended over all other training options.

1. Interpretation of vascular studies is already part of the training and board certification of radiologists. Radiologists have didactic and practical training in ultrasound and its interpretation, including vascular ultrasound, as well as formal extensive training in ultrasound physics and theory. Because this training includes vascular evaluation as well as evaluation of the end organ integrating multiple imaging modalities, one could argue that DR board certification is the superior alternative.

2. While the prerequisites for the RPVI and ASN include some of the elements in the IAC standard, there is no independent validating evidence that passing either exam qualifies one to interpret vascular studies.

3. By recommending the RPVI/ASN credentialing process without including board certifications in its list of physician credentials, the IAC vascular testing board is essentially creating a monopoly and abandoning the original multispecialty philosophy of ICAVL. This sort of recommendation (with or without the stated goal of eventually requiring the RPVI or ASN) will only lead to further division in the various physician specialties.

If IAC wants to strengthen the training and experience requirements for medical directors, radiology board certification must be clearly acknowledged as adequate for credentialing in this guideline.
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Here's how to submit comments on the proposed IAC Standards and Guidelines for Vascular Testing Accreditation.  

• Go to the IAC review website.

• Scroll down to the section for IAC Vascular Testing Standards and Guidelines Available for Comment.

• Select 1.1.1.4A and 1.3.1.4A: Medical Director and Medical Staff Section/ Changed.

• A window will expand with the description of the standard and the proposed change on the left.

• On the right, fill in your name and comment in the boxes provided. Comments on the proposed standards are limited to 1,500 characters with spaces.

• Hit Submit.

We are a small society, and—with your help—we can continue to make a big footprint on modern medicine. Thank you in advance for supporting the IR community on this important matter!

Resource
Download the IAC vascular testing standards.

Take a SIR-vey: Proposed IAC Vascular Testing Standards
SIR would like to know: Please indicate if you commented or will comment on the proposed IAC vascular testing standards.

Politically in Tune

By Marshall E. Hicks MD, FSIR
SIR President

Competing to be heard among the chorus of presidential candidates, parties, issue groups and their advertising blitz this election year is difficult. While small when compared to other national health care associations, SIR still can pack a solid punch when it comes to defending and promoting interventional radiology—but we need your continued help to strengthen IR’s voice with key decision makers.

Through SIRPAC—the Society’s nonpartisan political action committee dedicated to advancing the interests of SIR members, their practices and patients before Congress—we can help elect or re-elect political candidates who may help advance the Society’s public policy mission and legislative initiatives. As the election approaches, your contributions become even more critical to the success of IR. Your contribution helps us support candidates who focus on medical reimbursement, drug shortages, medical malpractice reform, appropriateness and accreditation standards, scope of practice, and medical research and funding.

SIR continues to meet with members of Congress to share its ideas about policy reform since Congress and the administration have made it no secret that they intend to revamp the current Medicare fee-for-service system and replace it with an alternative payment system. Delivery system model reform will be one of the key driving forces behind overall health care reform as we approach the next Congress and presidency.  SIR has introduced and educated Congress about its efforts to promote quality and efficiency, as Congress and CMS look for new payment reform models that move away from the traditional fee-for-service system. SIR has offered input into key legislative issues, such as medical malpractice reform and drug shortages. Most recently, SIR provided comments on efforts to improve health care outcomes and efficiency in the Medicare program to members of the Health Subcommittee of House Ways and Means Committee, an influential body charged with writing tax legislation and bills affecting Social Security, Medicare and other entitlement programs. SIR’s response will be used to review value-based measures and practice arrangements for improving outcomes and efficiencies in Medicare and reforming the sustainable growth rate.

Ensure representation: I want to thank all members who helped Save Our Seat on the AMA House of Delegates by joining or renewing memberships. For 20 years, SIR held an AMA seat, allowing us to send advisers to both the CPT Editorial Panel meetings and the RBRVS Update Committee (RUC). These are the only venues where new CPT codes are vetted and then receive a physician work value that is forwarded to CMS. By keeping our seat, your AMA membership ensures that IRs will defend IR. I know that many physicians disagree with many AMA policies; however, those who joined or renewed understand that our aim was not simply to maintain our seat and keep the status quo but to seize this opportunity to be an instrument of change—to promote progress and reform from within.

Continue appropriate value: SIR continues to have a strong presence at coding and reimbursement venues. For 2013, new CPT codes for carotid angiography, chest tube procedures and thrombolysis will be introduced. Thank you to our volunteer members who spearhead the work in this process and invest countless hours to ensure fair valuation for IR procedures. If we don’t participate aggressively in these forums, the consequences would be detrimental to our specialty.

Make a difference: Finally, I want to ask that you consider serving your Society. Volunteers don’t get paid—not because they’re worthless, but because they are priceless. During this election year, please consider volunteering for an elected or appointed position or as a member on our diverse committees.

If we’re politically in tune, we can strengthen IR’s voice. Please consider helping: As you can see, the common element to success in these efforts is you.

Please Note

SIRPAC’s ability to support key leaders is directly dependent on your generous support. If you have not done so in the past, please consider contributing to SIRPAC. If you have contributed in the past, we sincerely appreciate your contributions and hope you will consider donating again. 

Get Schooled: Smart SIR Tips

By Susan E. Sedory Holzer, MA, CAE

SIR Executive Director

Just as readying a daughter or son for a new school year takes more than new clothes and a shiny apple, so does preparing yourself for the rigors of treating patients in a health care environment that continually asks you to know more, do more and be more. How can you enhance your clinical practice skills? After hitting the stores for kids’ notebooks and pens, it’s a great time for you to take advantage of SIR’s valuable resources. 

1.     Register for SIR 2013: Your unique educational needs will be met—indeed exceeded—April 13–18 in the vibrant city of New Orleans at our Annual Scientific Meeting, which will feature a re-imagined up-close-and-personal format and collaborative theme of “IR Reaching Out.” Nearly 400 scientific presentations and posters covering the newest trends in IR research will be presented to more than 5,000 attendees—but we can’t provide research outcomes without you—so please consider submitting your original IR research.

2.     LEARN to keep PAD practice strong: This four-day course September 27–30 in Chicago is designed for physicians with training and experience in the fundamentals of vascular medicine, endovascular therapy and clinical management of PAD and AAA who seek to upgrade their knowledge and skill base.

3.     Find CLOTS: This perennial favorite is the most comprehensive stroke training course available worldwide. The five-day training course Oct. 21–25 in Dallas covers stroke pathophysiology, clinical neurological evaluation and the NIHSS, neurocritical care, multimodal neuroimaging, techniques of catheter-directed stroke care, patient-specific decision-making and more.

4.     Visit SIR Learning Center: Here’s where you can access educational activities on-demand. Current offerings include meeting proceedings, Webinars and JVIR CME tests. The site provides professional education on a wide array of clinical topics, including PAD, IO, stroke care, coding and billing and overall IR patient care. Register now for new IO, PAD and Venous Service Line Webinars.

5.      Get coding: Don’t forget that the 2012 Coding Update is available for free download to SIR members. Have coding questions? There’s also a convenient coding question form.

6.     Listen to JVIR podcasts: JVIR has launched audio (or video) podcast discussions with authors regarding current journal articles. These short, focused interviews delve into study rationale and design and implications of results for current practice and future research.

7.     Shop for you: The IR Store for everything to help you build and grow your clinical practice—from learning to set up and run an office-based clinical practice (with a sound business plan) to getting outfitted in the best back-to-school scrubs, caps and tees.

8.     Engage patients: Need to explain a treatment to a patient? SIR has easy-to-understand patient info brochures with detailed medical illustrations that give a good understanding of IR treatments and your special training. Add your business info to the back flap and market your practice.

9.     Get social: Don’t be anti-social: Tell us your successes and patient stories and/or follow us on Facebook, Twitter, YouTube or LinkedIn.

10.   Volunteer: Giving your time helps to make SIR stronger! Nominations for elected and appointed positions are being accepted. Or, work on practice guidelines, assist with a new task force, recruit medical students or help with coding. We need your help.

11.   Make due(s): SIR develops and delivers programs and services that bring measureable value to you and your patients. Thank you for submitting your membership fees by July 1! If you haven’t, there’s still time so you can take advantage of all an SIR membership has to offer.

12.   Find change: Are you looking for different? Career HQ, SIR’s dedicated job center for IR professionals, provides access to our specialized niche for job seekers or employers (interventionalradiologyjobs.sirweb.org/home/).

SIR has something for everyone when you’re in the “back to school” spirit; visit our website to learn more.

Originally published in SIR's September/October IR News

Question

What SIR educational product or service best meets your clinical practice needs?

Navigating Our Future

“Without goals, and plans to reach them, you are like a ship that has set sail with no destination."

By Marshall E. Hicks MD, FSIR

SIR President

By the time you read this column, SIR leaders—with your input and suggestions—have begun to set a new course for the Society. This is an exciting time as we begin to navigate our future, and we’ll keep you informed of the strategy plan process and progress in IR News and other SIR communications efforts. Over this summer, our draft strategy plan will continue to be evaluated and refined, culminating in its final review and approval by the Executive Council in November.

Executive Council members, including Service Line and resident representatives, met in May to set the direction for the Society over the next several years. During intense long-range strategic planning sessions, we discussed many topics, including turf issues/increased competition associated with procedures, changes in practice environments, the unknowns related to continuous changes to the health care system, continued growth of minimally invasive procedures, increased need for the field to define and support its identity, constant changes in technology and the addition of new devices, changing patient demographics, increased fragmentation in the field, continued need to attract medical students and the continued lack of understanding by other health care professionals and the public of the role and scope of interventional radiologists.

Additionally, we listened to you. Whether you spoke personally with Society officers or participated in our Idea Café or in committee meetings during the Annual Scientific Meeting—your input and comments were included in our strategy planning discussions. Additionally, phone interviews were held with members who represented current and past leaders, U.S. and international members, manufacturers, inactive members, students, and young and experienced professionals and who practice in a variety of settings. Thanks to all who have contributed to envisioning our future!

From all these discussions, we explored ideas for our core ideology, our long-term envisioned future (10+ years), five-year goals, factors that could affect our ability to succeed and the choices we need to make in defining our long-range plan. While not finalized, I can share with you that our new strategic plan will center on four main ideas that will steer and prioritize SIR’s efforts in the coming years.

• Clinical care in the practice of IR (ensure every interventional radiologist provides longitudinal care, for example, by promoting clinical practice with key stakeholders, ensuring implementation of the dual certificate, identifying/eliminating barriers to longitudinal clinical care practices)
• Outcomes data and evidence (develop a standardized data collection system, for example, by improving the effectiveness of organizational structure and oversight, decreasing duplication of current data collection projects, prioritizing studies, encouraging member participation, standardizing reports)
• Branding IR (increase the understanding and support of interventional radiology among key decision makers, for example, by identifying and prioritizing target audiences)
• Enhancing revenue growth (provide necessary resources to fund SIR’s defined goals by increasing net revenue, for example, by smartly using and repurposing our expert educational content)

As we continue the process of determining where we intend SIR to go in the future, it’s clear that we continue to advocate the value of interventional radiology. One concrete long-term vision that strategy planning participants kept voicing was that IR should be the first choice for image-guided therapy—for patients, referring physicians, private and federal funding sources and insurance payers.

 I’m honored—and humbled—to represent you and to assist in setting a new long-term direction for SIR along with the dedicated volunteer members who are collaborating on this project. This ongoing planning process—to address your future needs—pairs nicely with Executive Director Sue Holzer’s management focus that SIR undergo positive change, battle complexity with innovative efforts and serve as your IR source to meet your current needs (please see page xxx). More information about our new strategic plan will be released in the coming months.

Question

Which of these four SIR priorities is most important for you in the next five years: (1) clinical care in the practice of IR, (2) outcomes data and evidence, (3) branding IR or (4) enhancing revenue growth? 

Originally published in SIR's July/August IR News

Change, Complexity and a Desert Island

By Susan E. Sedory Holzer, MA, CAE

SIR Executive Director

As part of my professional development each spring, I attend DigitalNow, one of the association community’s top events for technology, innovation and leadership. While thinking about the challenges we face in shepherding SIR staff and resources on your behalf, I was struck by three ideas—change, complexity and a desert island. I gained insight about each from three leading experts at this year’s meeting.

DigitalNow Panel 

Change: We all are facing an increasing rate of uncertain change in our workloads, evolving business and payment models and fast-paced personal lives. Your natural reaction should be to ask: How will SIR provide solutions to your issues today—and a year from today? My answer is to exercise our ability to change. SIR needs to be innovative and stay technologically relevant—whether it’s engaging in social networking, mobile opportunities, cloud-based collaboration or on-demand learning. But gravity draws us backward, even to things we want to change (think e-mails, landlines, attached files and classrooms). How do leaders escape this pull of the past? By constantly analyzing, changing and aligning, says Geoffrey Moore, a leading high tech strategist and the author of “Crossing the Chasm” and “Escape Velocity: Free Your Company's Future From the Pull of the Past.” Societies, like SIR, are in a unique position to mobilize their “power gears” (meaning, our members and others we enlist with our passion) to propel us forward. In short, we need to be the place where our bold innovators—the ones who start out “dancing” alone—meet with support and a willingness to join in and change.

Complexity: Rita McGrath, a Columbia Business School professor and leading expert on strategy in highly uncertain and volatile environments, worries that many are trying to solve today’s complex problems with outdated methods. She recommended that society leaders forecast differently. More time should be spent examining leading—not lagging—indicators and watching growth “outliers” who defy the odds by thinking and doing things differently. She urged society leaders to mitigate risks differently: Stop investing in prevention to keep bad things from happening and instead commit to learning from “intelligent” failures. And, she reminded society leaders to allocate resources through “disengagement” (or discovering what SIR should stop doing) and investment of time and resources on innovation.

Desert island: I’m sure you’re wondering what a desert island has to do with addressing change and complexity. Another speaker posed this question: If your members were stranded on a desert island, and they could only bring one information source with them, would it be you? Steven Rosenbaum, a U.S. television producer and author of “Curation Nation,” stressed that members should look to their professional society as a filter and funnel, a curator who handpicks what’s crucial for members from the mass of information that we’re bombarded with daily. From the dawn of civilization until 2003, five exabytes (one quintillion bytes) of information was created. “Now, that much information is created every two days,” said Rosenbaum.

SIR embraced its responsibility to be your trusted IR authority. In the months and years to come—and with your help—we will curate (continue to gather and organize relevant IR information and store it for your use), clarify content (validate info by separating signal from noise), provide context (what is relevant and necessary), bundle quality information for you (facts, links, images, etc.) and give a point of view (to help predict the near future for you).

Undergoing positive change, battling complexity with innovative efforts and serving as your IR source, we will ensure that your needs are met—and exceeded. SIR wants to be with you on that desert island.

Question

We hope you say “SIR”; however, if you were stranded on a desert island today, and you could only bring one information source with you, what would it be?

Originally published in SIR's July/August IR News