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A great deal of our time has been spent trying to find ways to make ourselves more efficient. One of those ways we began looking at several years ago was reducing the time we spend in nonbillable activities and in performing procedures that our hospital affiliation requires but that are relatively time-intensive for their reimbursement. To do this, we looked into hiring physician extenders.

With concerns about x-ray exposure mushrooming and anecdotes circulating about patients balking at exams involving ionizing radiation despite a commanding medical need for those exams, it’s not surprising to hear of documentation that the number of procedures for any x-ray related modality has gone down. Such was the case earlier this week, when the IMV Medical Information Division released the results of a survey that studies performed using radiography/fluoroscopy equipment at hospitals with more than 150 beds dropped about 9% from 2004 to 2009.

This is the third and final article in a series reviewing why and how radiology practices set themselves up to lose their long-held professional services agreements. What steps groups can take to turn an adversarial relationship to a collaborative partnership is the subject of this third article. Included is a challenge to change how we conduct business, with the goal of long-term success for everyone involved.

Is it time to add another physician? We have asked this question quite a bit recently, especially on busy days, which seem to be happening more often. Because adding another full-time physician would be expensive-especially if we guessed wrong-we wanted to make sure that it really was time to expand.

To paraphrase Harry Truman, what virtual colonoscopy needs is a one-handed analyst. This was made clear earlier this week in the share price activity of iCAD , which leaped about 18% on news that the FDA had cleared the company’s VeraLook software for interpreting virtual colonoscopy exams. The next day the stock gave back about as much ground as it had gained.

A number of radiology practices were able to significantly reduce the radiation dose associated with multislice CT scans by participating in a one-day dose optimization workshop provided by the Royal Australian and New Zealand College of Radiologists (RANZCR) and supported by the local state health department, according to a study in the August issue of the Journal of the American College of Radiology.

Medical acronyms are intended to boost efficiency. The advantages of brevity should be weighed against the possibility of crypticness (making the communication harder for others to understand) and ambiguity (having more than one possible interpretation). In other words, a smart communicator uses good shortcuts but makes sure that other people will understand what he or she means.

Because of all the attention currently focused on radiation dose, a California imaging bill addressing radiation exposure has the potential to spread like wildfire to other states. California is a state that doesn’t wait for others to address a problem, so it’s possible similar bills could pop up around the country. The bill has passed the California senate and is now in the California Assembly Appropriations Committee with a hearing set for Aug. 4. Sen. Alex Padilla (D-Pacoima) is lead sponsor of the bill.

From the hospital's perspective, a radiology group's quality is measured by quality assurance reporting, working well with others, participating on medical staff committees, and other administrative duties. Still, a highly competent radiology practice, one with "quality" radiologists, can lose a contract over basic service issues, nonphysician interpersonal relationships, or other common administrative expectations.