New ACR CEO outlines key concerns for radiology
Dana H. Smetherman, MD, MBA, has taken the helm as the new CEO of the American College of Radiology and first female CEO in the organization's 101-year history. She sat down with Radiology Business to discuss her new role and outline several pressing issues facing the specialty and the advocacy efforts led by the ACR.
"My goals for the ACR are to position us for the future, embrace things like AI and the possibilities of population health in the field of radiology. I also want to address some of the real concerns that we have with things like the significant workforce shortage of radiologists and radiologic technologists, challenges with reimbursement," Smetherman said.
She took over from William T. Thorwarth Jr., MD, who retired June 30, after more than 10 years of service. He guided the college through the COVID-19 pandemic and oversaw the launch of the ACR Data Science Institute.
Smetherman, a diagnostic radiologist specializing in breast imaging, previously served as chair of the Department of Radiology and associate medical director for medical specialties at the Ochsner Medical Center in New Orleans. She also was the secretary-treasurer of the ACR and a member of its Board of Chancellors. She served as chair of the ACR Breast Commission, ACR councilor from Louisiana, chair of the ACR Breast Imaging Economics Committee, president of the Radiological Society of Louisiana, board member for the American College of Surgeons National Accreditation Program of Breast Centers, the American Roentgen Ray Society advisor and alternative advisor to the American Medical Association Current Procedural Terminology Panel, and chair of the Technical Exhibits Committee of the Radiological Society of North America.
Top concerns for the ACR
- Radiology workforce shortage: "This is a significant issue facing radiology," Smetherman stated. The ACR is advocating for an expansion of radiology residency positions to help increase the number of radiologists and address the growing demand for radiologic services.
- Reimbursement reform: Smetherman highlighted the continuing decline in Medicare payments for radiologists, which threatens to reduce access to care. "The idea of budget neutrality as we look at Medicare reimbursement is unrealistic," she said. With more advanced imaging studies being ordered and new diagnostic tools being developed, the budget neutrality requirement, which necessitates cuts elsewhere to balance the budget, often results in reductions in physician payments. Hear more details from Smetherman on what ACR is doing on medicare reform.
- Artificial intelligence: AI presents both opportunities and challenges in radiology. Smetherman emphasized the need to understand AI drift and verify that AI is functioning as intended. Radiologists have experience with computer-assisted detection, but as AI tools evolve, ensuring their reliability and integration into clinical practice remains crucial.
Smetherman also outlined key areas for ACR advocacy efforts.
Appropriate use criteria vs. prior authorization
Since the enactment of the 2014 Protecting Access to Medicare Act, the use of appropriate use criteria software consultation was supposed to be required for payment of advanced imaging studies. There have been many technical issues and concerns about the mandate and some medical societies have advocated to repeal AUC provisions because of its added administrative burden.
While AUC was removed from the 2024 Medicare Physician Fee Schedule, Smetherman believes that AUC can help reduce the large number of low-value imaging exams, allowing radiologists to focus on higher-value studies. In the context of radiology staffing shortages, this would help reduce the number of low-value or unnecessary exams performed and that need to be read. She also noted that AUC may present a smaller administrative burden compared to the recent explosion of prior authorization requirements.
Medicare coverage for CT colonography
Smetherman hailed the recent inclusion of CT colonography in Medicare payments for 2025 as a victory for the ACR. This noninvasive imaging tool, which does not require sedation, provides an alternative for patients who may not have the means or support to undergo traditional colonoscopy.
No Surprises Act
The ACR has concerns about the implementation of the No Surprises Act and is closely monitoring the Texas Medical Association's court challenge. The act, designed to protect patients from unexpected medical bills, has implications for radiology practices and reimbursement.
State-level radiology scope creep
The ACR is also focused on state-level advocacy, particularly regarding scope of practice laws. These laws often seek to expand the responsibilities of clinicians with less training than radiologists. Smetherman stressed the importance of maintaining high standards for radiologic interpretation while recognizing the role of nonphysician providers in supervised settings.
Future ACR goals
Smetherman is committed to ensuring that the ACR remains indispensable to its members. A new website is in development to enhance member access to radiology resources. She also is focused on positioning the ACR for the future by embracing AI and population health while navigating the rapidly changing healthcare environment.
"We need to be the organization that radiologists can rely on for the information and support they need," Smetherman said. "Our advocacy efforts will continue to address the workforce shortage, appropriate use criteria, physician payment reform and the implementation of the No Surprises Act."
Dave Fornell has covered healthcare for more than 17 years, with a focus in cardiology and radiology. Fornell is a 5-time winner of a Jesse H. Neal Award, the most prestigious editorial honors in the field of specialized journalism. The wins included best technical content, best use of social media and best COVID-19 coverage. Fornell was also a three-time Neal finalist for best range of work by a single author. He produces more than 100 editorial videos each year, most of them interviews with key opinion leaders in medicine. He also writes technical articles, covers key trends, conducts video hospital site visits, and is very involved with social media. E-mail: dfornell@innovatehealthcare.com