Welcome to the California Radiological Society (CRS) Resident and Fellow Section (RFS) website.

Residents and fellows represent the future of radiology. With health care undergoing continuous change, residents and fellows need to be aware of the major issues facing our specialty to ensure that radiologists maintain a strong voice in the health care arena. Political and economical issues will affect all radiologists in the course of their careers. Unfortunately, we, as members in training, are exposed to little, if any, political or economic issues without our field. Yet, we are the ones who have the most at stake, to win or lose, and should be actively involved in the issues shaping our future. The American College of Radiology is the national organization representing all radiologists in regards to these issues. The CRS is the organization representing radiologists in California and our state representative society to the ACR. Both organizations welcome resident and fellow participation and have recognized the importance of our involvement. In addition, the RFS sections of the CRS and ACR continue to grow annually as residents and fellows realize that these issues are important for our future.

Some of the issues that I am speaking of include self referral, the practice of non-radiologists referring patients for studies to imaging equipment in which they have a financial stake, leading to overutilization. During the interval from 1993-1999, non-radiologist imaging has increased 32% compared with 7% by radiologists. This dramatic increase in imaging has resulted in marked escalation of health care costs. In addition, the practice of self referral threatens our specialty. This issue is the ACR’s top priority this year.

California is a model state for medical malpractice reform, having passed limits on noneconomic (punitive) damages at $250,000 over 25 years ago. Malpractice premiums on average nationally have increased 569% compared with 182% in CA. This reform works and does not adversely affect the quality of patient care or their right to bring suit in malpractice cases. However, many states in our country are in crisis situations. Dramatically rising malpractice premiums are forcing physicians to retire early or leave these states, limiting patient’s access to care. Measures to adopt a policy nationally have widespread public support and passed the House twice, only to stall in the Senate. Backed by a strong trial lawyer political action committee, opposition to malpractice reform remains, despite public opinion to the contrary.

Medicare reimbursement is another top issue. Falling reimbursement rates and a flawed conversion factor which determines physician payment, threatens to cut reimbursement by 40% by 2014. With increasing medical student debt and years dedicated to training, occupation as a physician may become less appealing to those best and brightest young minds in our country.

These and other issues will shape the field of radiology for years to come. It should be clear why it’s important to get involved. It’s your future. It is time for physicians to reestablish their voice in medicine, to regain control of our patients from insurance companies and administrators, and to make medicine, and radiology, desirable for the next generation. The CRS and ACR are our voices and means to this end.

Greg Galdino
CRS RFS President 2003-2004