Q&A: ACR's McGinty on differing radiology practices in U.S, England

Packing his bags and traveling to England, Chris Hobson, senior communications manager of Imaging 3.0 from the American College of Radiology (ACR), set out to learn how radiology is conducted in the United Kingdom, to compare such practices to those in the United States.

"Perhaps, I thought, in doing so I could identify lessons American radiologists could learn and then import into their own practices and departments," wrote Hobson. "After all, the American healthcare system is experiencing fundamental changes at the moment with respect to payment reform. So I wanted to learn all I could about the system in England and share my findings with ACR members." 

Hobson published "The Commodity-Proof Radiologist" in the Journal of the American College of Radiology, outlining his findings in coordinated care, financial pressures, value-based care and more. 

Radiology Business spoke with Geraldine McGinty, MD, vice chair of the ACR Board of Chancellors, to get her take on what the ACR and radiologists across the country can learn by looking at practices from across the Atlantic Ocean.

Radiology Business: What prompted the ACR to want to travel abroad to compare how Radiology is performed in England as opposed to in the United States?
Geraldine McGinty: We are always interested in learning from other practices, other types of radiology practices, other health systems. I think, specifically, we were interested in understanding how the National Health Service (NHS) radiologists managed, given they were pretty resource-constrained, short-staffed and how they leveraged their expertise in that kind of situation.

What were some of the biggest findings?
Clearly when you got constraints on resources, it is interesting to see how positions adapt to that. So, I think it was interesting to see how they were able to connect with their referring physicians to demonstrate their expertise, and as we thought about making radiologists value more apparent to the rest of the healthcare delivery system in the U.S., it’s been interesting for us to look for ways that we can connect more effectively with our referring physicians. 

Were there any similarities in performance between the two countries?
Many. We’re basically radiologists—we’re using many of the same technologies—so I think from that point of view, many, many radiologists, an increasing number of radiologists, interact very frequently with our referring physicians. I think, in essence, there are so many more aspects of that which unites us than divides us.

How do you think the information received will help the field of radiology in the U.S.?
Understanding how other radiologists are connected with their referring physicians—I think that’s helpful and we’re always looking for new ways to have that interaction as powerfully as possible. We are looking forward to the Protecting Access to Medicare Act (PAMA) legislation finally being implemented next year, where ordering providers will have to consult clinical physicians support for advanced imaging for medicare. We want radiologists to be seen as consultants and experts for our physician colleagues. You know we don’t like the use of the term "gatekeeper." We like to be collaborative and, honestly, when we think about appropriate imaging, we’re often thinking about more imaging, not less imaging, more breast cancer screening, more lung cancer screening. But certainly, we acknowledge that we can prove that it’s the right test the first time, getting to the answer as quickly as possible.

Do you think this trip would be beneficial for radiologists in the U.S. to get insight on other countries' practices? 
We do interact with our colleagues from around the world. You know at RSNA we check in with one of the major radiology societies from around the world and share: This is what our opportunities are, these are what our challenges are and we look for opportunities to collaborate. Clearly the ACR is an organization that largely focuses on American radiology, but we think it’s important that we have good relationships with our colleagues from around the world.