Mail Call September

I read your article, “Finger in the Wind,”¹ with interest. It is good to hear that those who have the ear of Congress are finally talking about the issue of imaging by nonradiologists and the cost related to the much steeper growth curve of these imaging studies performed by self-referring nonradiologists compared to imaging performed by radiologists. What kind of positive changes might result from such reports remains to be seen. However, I am not sure that they are on the mark with their statements regarding the need for reexamination of the professional component, with an eye on possible reduction of payment for possible decreases in the time and intensity of effort “due to advances in technology, technique, or other factors.”² I find that the intensity and the time that are required for me to interpret a spine CT, CT angiogram, or brain MRI have increased due to the very advances in technology and techniques of which they speak. It literally takes me longer to interpret these studies now, compared to 10 years ago, because I now have many more images to interpret. With the transition to digital imaging, with no need for printing of films and the associated cost no longer an issue, we seem to be generating more images, more pulse sequences, and more reformations and reconstructions, for which there usually is not any commensurate increase in payment. Maybe they will look at all of this again and decide to increase our payments? Probably not. Thank you for the article. Thomas A. Kim, MD Chair, Department of Radiology Carle Physician Group Carle Foundation Hospital Urbana, Illinois