Journal of the American College of Radiology : JACR
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Hospitals routinely enter into contracts with radiology groups for the right to be the exclusive provider of radiology services at the facility in exchange for the group agreeing to provide and manage all aspects of that service within the hospital. These "exclusive contracts" generally result in the radiology department and associated equipment being closed off to physicians who are not part of the contracting group. Exclusive contracts are generally considered to be good for physicians who have them and bad for those excluded by them. ⋯ These agreements can also raise issues under the Stark II physician self-referral law if the contracting physicians are in a position to refer Medicare or Medicaid patients to the hospital. Part II of this article will discuss the advantages and disadvantages of exclusive contracts for physicians covered and not covered by such contracts, as well as strategies for avoiding them or minimizing their potential adverse impact. It also will discuss specific provisions of exclusive contracts that should be included or avoided.
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The introduction of pay for performance in medicine represents an opportunity for radiologists to define quality in radiology. Radiology quality can be defined on the basis of the production model that currently drives reimbursement, codifying the role of radiologists as being limited to the production of timely and accurate radiology reports produced in conditions of maximum patient safety and communicated in a timely manner. ⋯ Although potentially challenging to implement, the professional model for radiology quality is a comprehensive assessment of the ways in which radiologists add value to patient care. This essay is a discussion of the definition of radiology quality and the implications of that definition.
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Self-assessment is paired with continuing medical education in the "lifelong learning " component of the American Board of Radiology's (ABR) Maintenance of Certification program. The literature on the use of self-assessment in higher education and the professions is instructive with regard to the distinctiveness of this form of adult learning. ⋯ Data on the use of ABR-qualified SAMs are reported. On completion of this article, the reader should be able to describe the nature, role, and best practices of self-assessment; apply these concepts to the creation or use of a SAM; and identify future opportunities for SAM development and use that will enhance the lifelong learning of radiologists.