ACR Capital Hill Day

By John P. Tobben, PGY-II, R-I

As radiologists, we work mostly behind the scenes, aiding in diagnosis and helping guide care through our unique knowledge of anatomy, pathophysiology, and imaging technology. Despite ​important efforts to get out of the reading room and put a face to radiology such as the ACR’s Imaging 3.0 initiative, radiology will never be a “glamour” specialty. Television medical dramas such as House and Grey’s Anatomy routinely give short shrift to radiology’s role in the process of diagnosis and treatment. While most of us are content with this arrangement, the lack of public visibility for the field can prove problematic when it comes to healthcare policy. Radiologists do not conform the the tradition archetype of “doctor” the way that surgeons and internal medicine physicians might — a fact that is likely as true for politicians shaping healthcare policy as it is for the person at home watching ER. Yet as a specialty we do have one valuable tool for putting a face to the name of radiology in the political arena — lobbying.​

​Lobbying sometimes gets a bad reputation — being perceived as an avenue for powerful entities to manipulate legislation to their advantage. Yet in at its core lobbying is a crucial aspect of representative democracy — especially to a field such as radiology which may not exist at the front of the public’s consciousness. The lobbying efforts of the ACR and the Radiology Advocacy Network recently struck a huge victory in lowering the professional component multiple payment reduction (PC MPPR) from 25% to 5%. At the ACR’s annual meeting, attendees of the conference have the opportunity to be involved in lobbying for radiology via “Hill Day.”

The event, which typically marks the culmination of the week-long meeting, provides an opportunity for radiologists (both practicing and in-training) to meet their congressmen/congresswomen. At this year’s meeting, members of the Indiana Radiological Society again participated in Hill Day. A group which included residents and staff physicians from Indiana University as well as private practice radiologists from around the state met with representative, senators, and their aides to discuss specific pieces of legislation identified by ACR leadership as essential to the future of radiology.

​The major initiatives of this year’s Hill Day were concerned with recommendations and reimbursement for screening examinations. The first, The USPSTF Transparency and Accountability Act (H.R. 1151/S. 1151) aims to make the US Preventative Task Force more transparent in its methodology and rationale for implementing specific recommendations. The task force’s 2009 and 2016 mammography recommendations — which have since been discredited — were highlighted as notable pitfalls of the task force’s current approach. We emphasized that this proposed legislation aimed not to dissolve the USPSTF — which plays a vital role in our nation’s healthcare system — but rather to improve it and thus ensure a science driven, publicly accountable process for generating recommendations.

The latter piece of legislation, The CT Colonography Screening for Colorectal Cancer Act (H.R. 4632/S. 4632) aims to ensure that medicare will cover CT Colonography as a method of colon cancer screening. Screening rates for colon cancer are just below 60% in most parts of the country. CT Colongraphy offers a valuable alternative screening method for those for which traditional colonoscopy is impractical or impossible — such as those unable arrange transportation to and from a procedure requiring sedation (or if you’re President of the United States). Again, it was emphasized that the aim of this legislation was not to replace traditional colonoscopy as a screening method, but to ensure that CT Colonography was available as a medicare approved screening method with aim to improve the overall nationwide compliance with colon cancer screening.

Overall, the event was a valuable opportunity to take an active role in radiology advocacy and get face time with the congressmen and congresswomen who will help shape the future of healthcare. In these face to face meetings radiologists have the opportunity to educate our elected representatives with knowledge, facts, and personal accounts that enable sound decisions and policy. 

Getting involved serves the interest of both our patients and specialty.