0:01

Hello and welcome to today's new conference

0:04

co-sponsored by MRN line and aawr.

0:08

The aawr was founded in 1981 to

0:11

provide a form for issues unique to

0:14

women in Radiology radiation oncology and

0:17

related professions.

0:19

The association sponsors programs that promote opportunities

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for women and facilitates networking among

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members and other professionals as well

0:28

aawr strives to meet the first and

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changing needs of its members through mentorship opportunities

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for the next generation of women radiologist.

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Aawr has membership opportunities for those

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who have completed their training members and training and international

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Radiologists. You can learn more

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about their mission and membership at aawr.org.

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MRI online is thrilled to partner with aawr on

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these lectures and committed to advancing and supporting

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women in Radiology as part of our mission to transform the

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way wait Radiologists learn and Thrive you

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can access the recording of today's conference and

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You can also sign up for a free trial of our premium membership

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courses across all key Radiology subspecialties.

1:21

Today we are honored to welcome Dr. Amy Patel for a lecture

1:24

on breast Radiology. Advocacy updates.

1:27

Dr. Patel is a board certified certified radiologist

1:30

who specializes in breast Imaging.

1:33

She's a breast radiologist medical director of

1:36

the Breast Care Center at Liberty Hospital and assistant professor

1:39

of radiology at the University of Missouri, Kansas City

1:42

School of Medicine.

1:44

Dr. Patel is also the current president of aawr after

1:47

Dr. Patel goes through her

1:50

presentation. Please join her in Q&A and

1:53

you can put your questions in the Q&A box.

1:56

And please remember to submit those

1:59

as she talks.

2:02

And with that we are ready to begin today's lecture Dr. Patel.

2:05

Please take it from here.

2:07

Thank you very much. And thank you for sharing that information

2:10

on awr as well. I'm

2:13

very proud to be the president this year of awr in

2:16

my one-year term. And I

2:19

also wanted to mention for those who are joining internationally. We

2:22

now offer International membership. So

2:25

please you know, if you have any modicum of

2:28

Interest go online at www.awr.org check

2:33

that out we welcome all we have a robust

2:36

male membership to so you don't

2:39

have to just be a woman to join and it's free for trainees

2:42

if you're medical student or resin or fellow so really encourage

2:45

you to join and we're very grateful for our

2:48

partnership with MRI online. So so I'm

2:51

gonna just Dive Right into this talk today, so

2:55

Today, I'm going to give some breast Radiology. Advocacy updates.

2:58

Not just you know,

3:01

there has been some promotion about this lecture

3:04

and talking about particularly some the

3:07

final rule coming out from the FDA regarding

3:10

mqsa. We will cover that but we're going

3:13

to also cover some critical pieces of

3:16

legislation that affect breast Radiologists and other

3:19

things that you should be aware of in

3:22

regards to the field radiology and our legislative efforts and

3:25

ways in which you can get involved, so it will

3:28

be quite a comprehensive discussion today. And then of course at the

3:31

end of you have questions, please don't hesitate to ask me.

3:40

These are my disclosures and in

3:43

another disclosure, of course is I'm giving a lecture for

3:46

MRI online and I am involved with working with MRI

3:49

online on lecture content.

3:53

Okay. So today I have four questions for you.

3:57

Number one, what does advocacy mean for radiology and

4:00

our patients?

4:02

Number two, why is advocacy crucial for patient care

4:05

and access?

4:07

Number three, how can I get involved at the local state and

4:10

National level and finally why is

4:13

it important that the house of radiology work together when

4:16

it comes to breast Radiology advocacy efforts?

4:22

So first some key terms so the word

4:25

advocate comes from the Latin ad and velcare which

4:28

is to call and Advocate involves

4:31

efforts to affect some aspect

4:34

of society including individuals employers or

4:37

the government.

4:38

Now lobbying is advocacy that's focused

4:41

on specific legislative pieces with clear reporting requirements

4:44

and penalties for infractions from

4:47

the Federal Election Commission the FEC.

4:50

Now in the past, you know in the field of medicine lobbying, you

4:53

know might have suggested sort of a negative

4:56

connotation or people didn't want to use that word lobbying, but

4:59

we really in the house of medicine and especially in Radiology. We

5:02

need to embrace the word loving because the word because

5:05

lobbying is crucial for access to care

5:08

for our patients and it really needs to be a part of our

5:11

everyday vernacular as we fight for access to

5:14

care for our patients.

5:16

Now policy is a course or principal of action adopted or

5:19

proposed by a government party business or individual.

5:24

So why should you get involved in our advocacy efforts

5:27

because advocacy really represents our

5:30

commitment to the Future Radiology as the

5:33

old adage says if you aren't at the table you're on the

5:36

menu and that is certainly the case when

5:39

it comes to advocacy efforts.

5:41

It becomes a state of mind. Once you

5:44

start getting immersed in advocacy

5:47

Endeavors. I really inform here understanding of

5:50

Medical Practice throughout residency and Beyond. I I'll

5:53

also teach a class at the University of

5:56

Missouri, Kansas City school of medicine and today to

5:59

my medical students. We talked about advocacy and

6:02

I talk to them about getting involved even at the medical student level

6:05

the earlier the better.

6:07

And its habit forming and helps build momentum for

6:10

future involvement.

6:13

So this slide is so crucial. If you don't, you know,

6:16

if you zone out in this lecture today try not

6:19

to zone out on this slide if you can remember any luck as a

6:22

lecture slide, this is the slide I want you to remember.

6:25

94% of Congress has no Health Care

6:28

background. And this is I'm talking about the federal level

6:31

94% of Congress. No Health Care

6:34

background. That means only 6% do and all

6:37

of them are making decisions on behalf of

6:40

House of medicine are patients access to

6:43

care very reimbursement. So if we do not step up

6:46

and educate particularly this 94% of

6:49

Congress that has no healthcare background. No one

6:53

will and so it's really important that we are have these

6:56

close relationships with our federal elected officials as

6:59

we advocate for these pieces of

7:02

legislation that are so crucial for our patients. So like I

7:05

say said earlier getting involved early so imperative forming

7:08

these really staunt relationships. They really

7:11

rely on our expertise and we become the go-to

7:14

and as we'll talk about in some subsequent slides

7:17

Radiology has really positioned itself in such

7:20

a way that we are such a formidable source of

7:23

information and

7:25

Such a formidable go-to on Capitol Hill, which is

7:28

a testament to those Radiologists or committed to

7:31

radiology and are amazing staff our

7:34

government relations staff that works speciferously on

7:37

behalf of us when we cannot be physically there on Capitol

7:40

Hill.

7:42

So how can you get involved? There are

7:45

so many ways to get involved. It doesn't just have to be at

7:48

the federal level. It can be at the local level could

7:51

be at the state level and I'm going to share some examples.

7:55

So the local level a great way to

7:58

engage elected officials is a site

8:01

visit.

8:02

Have your state elected officials come over to where you

8:05

work and see who you are how you play a role? That's

8:08

so integral and patient care. So, you

8:11

know breast centers are a great Avenue to

8:14

do this. So when I came on as a medical

8:17

director of my breast center back in 2018, um,

8:20

I told my hospital staff

8:23

particularly our senior leadership that I wanted to

8:26

host a side visit. I wanted to invite our state elected officials

8:29

who represented us to see our Breast Center, you

8:32

know, what we do for patients the role we

8:35

play in cancer detection and Beyond

8:37

And so I invited these representatives and

8:40

then Senator Lauren Arthur who's in the right hand image to

8:43

come and just spend the day and it

8:46

can be an extremely effective Avenue to drive policy change

8:49

because from that encounter it

8:52

not only benefited me and our staff

8:55

and our Radiologists, but it benefited the hospital,

8:58

especially when it came time for covid and even

9:01

access to vaccines, and we we had these people

9:04

on speed dial and it was so so crucial so

9:07

building these connections is so so important. I can't

9:10

stress it enough and I'll give you an example of a relationship that

9:13

form from this site visit that ended up

9:16

with us passing some really critical breast Imaging legislation in

9:19

Missouri.

9:21

So at the state level you can join your state

9:24

radiological society and I'll talk about the Radiology.

9:27

Advocacy Network in subsequent slides. So

9:30

each state has their own

9:33

State radiological society that you can join that falls of

9:36

the under the umbrella of the American College of radiology

9:39

and most advocacy issues are State

9:42

specific. So getting involved at the state level is really

9:45

really important. There's a lot of State

9:48

specific issues going on right now around for

9:51

example scope of practice, which is a very

9:54

hot button issue right now in many

9:57

many states.

9:59

Um, also if you're trainee and you join your

10:02

state radiological Society efforts, there's usually funding

10:05

that's provided for trainees to attend the

10:08

American College of radiology meeting and even to

10:11

participate in the

10:14

Rutherford Levante government relations Fellowship that I'll talk

10:17

about in subsequent slide. So again for trainees getting

10:20

involved in these efforts whether you're medical student resident or fellow it's

10:23

free. So I got involved as a first

10:26

year resident and I never looked back. So I would really, you

10:29

know, those who are trainees on here listening today tuning

10:32

in. I would most certainly encourage you

10:35

to get involved now absolutely free and it

10:38

will become, you know, very habit forming and

10:41

will stay with you the rest of your life.

10:44

So at the state level also the Missouri

10:47

State Medical Association it for

10:50

example in our state is a great way to get involved. So

10:53

each state has its governing State Medical

10:56

Association and for where I practice

10:59

it's, Missouri.

11:00

And you know the house of radiology. It's so

11:03

important that we have close relationships with our

11:06

governing State Medical

11:09

bodies. And we have Radiologists in

11:12

the field that are doing some pretty incredible things at

11:15

the state level through their medical associations.

11:18

And so, you know, it's important

11:21

for us as Radiologists to have close relationships with

11:24

these governing bodies with their lobbyists because

11:27

whenever there's critical pieces of radiology legislation that

11:30

come to head in your state you want the

11:33

backing of this governing body. So for example, when we

11:36

pass breast Imaging legislation in Missouri in 2018 and

11:39

2020 having the support of msma was

11:42

so important when we testified in

11:45

Jefferson City, which is our state capital the msma

11:48

lobbyists were there to support us. They were there to submit

11:51

letters.

11:52

So important because that shows our state elected officials

11:55

that the whole house of medicine was behind us and

11:58

they're more likely to vote for your critical pieces of legislation. So I

12:01

would recommend, you know, if any of the Moda

12:04

committed of interest to get involved in your State Medical Association to

12:07

do so, I am involved in our State Medical Association,

12:10

too. It's so important for me to help bridge

12:13

that gap between the house of Medicine with the

12:16

house of radiology and it's just wonderful to

12:19

build these relationships and make sure that that we are all

12:22

on the same page fighting for Access for our

12:25

patients.

12:27

So I talked about a sar

12:30

as you know, these site visits that we host and from

12:33

a site visit. I met Senator Lauren Arthur that's

12:36

in this sort of purple jacket here.

12:38

And I met with her and then what had happened

12:41

was that if all if some of you recall in April

12:44

of 2018, there were recommendations

12:47

that came out from the American College of radiology and above

12:50

average risk women particularly when it came to

12:53

Imaging surveillance. So we started recommending

12:56

these we risk assess patients in our Breast Center.

12:59

We started recommending these recommendations, but

13:02

the problem was is that insurance providers were

13:05

not covering it. So we were getting all these phone calls and just

13:08

you know, my insurance provider doesn't cover

13:11

this. Like how can you recommend this and there's no coverage and

13:14

you know, there's a whole thing. So I met with Senator

13:17

Arthur for coffee one day and I said listen like this is what is

13:20

happening and I want to see if you would be willing to

13:23

Champion a bill in the Missouri legislature to

13:26

try to pass some sort of high risk or

13:29

above average risk breast Imaging legislation. So we got to

13:32

work she is a very she's a champion for Women's Health.

13:35

She was a new senator in,

13:38

Missouri.

13:38

She needed some sort of platform. So it was sort of

13:41

an opportune time for both of us in that regard and she

13:44

really championed this through and

13:47

In essentially this is an image of us on the left. We testified in

13:50

front of the the finance committee

13:53

on the Senate side in March of 2020 right

13:56

before the covid shutdown and somehow miraculously, we

14:00

got this bill passed the governor signed it into law in August

14:03

of 2020 and we never looked back. So, um,

14:06

just you know, these site business can just lead to just incredible

14:09

things that can affect so many patients which did

14:12

for our patients in Missouri. And then in 2018.

14:15

We were also prior to the high risk breast

14:18

Imaging legislation. We were able to secure digital breasts to

14:21

most synthesis coverage and I was honored to be involved in getting that

14:24

past as well and now

14:26

Working on in the state of Missouri passing a diagnostic

14:29

breast Imaging coverage without co-payer deductible

14:32

a much more lofty goal, but it's something

14:35

that will continue to fight for because that is

14:38

something that we know that patients need access to so again

14:41

relationships with your elected officials can help

14:44

tremendously getting your state rad Society on

14:47

board medical societies on board can be important for

14:50

this legislation. Msma was behind us the

14:53

pathologist. We're behind us. There are many Medical Specialties that spoke

14:56

up on behalf of our patients and it helped tremendously to

14:59

get these bills past the finish line.

15:04

So I'm going to switch gears now. So the American College of radiology of

15:07

kind of mentioned that now that is a great way for you to get

15:10

involved at the national level. It truly is our

15:13

governing body at the national level that

15:16

oversees the profession of radiology in

15:19

so many ways and one of the pillars that

15:22

the Acra or the ACR really focuses

15:25

on is advocacy. Advocacy government

15:28

relations. They are truly the go-to of

15:31

when it comes to that piece of

15:34

what we do is Radiologists.

15:37

So advocacy is one of the fundamental missions of the American College

15:40

of radiology.

15:42

Entails representing the interests of Radiologists and

15:45

their patients to Congress State legislatures and Regulatory Agencies

15:48

educating Radiologists and

15:51

Radiologists and training regarding legislative and

15:54

Regulatory developments and then supporting Grassroots participation

15:57

and advocacy via Capitol Hill days legislative

16:00

calls to action and the Radiology. Advocacy

16:03

Network.

16:06

So as I alluded to earlier you want to meet with elected

16:09

officials early. So an example

16:12

is the ACR has a Rutherford

16:15

Levante government relations Fellowship. This

16:18

is a one-week Fellowship in DC but expose residents

16:21

to all of gr's activities.

16:24

The acr's role in Federal and

16:27

State Legislative and Regulatory processes. It

16:30

is a one-week program and usually the

16:33

deadline for this is in June of each calendar year. So these

16:36

are some images of me.

16:38

With some federal elected officials at the time in Kansas

16:41

because I was a resident at University of Kansas in Wichita.

16:45

And I was a Rutherford fellow my senior year. So I started getting

16:48

involved in the ACR as first-year

16:51

resident and starting to immerse myself going to

16:54

Capitol Hill day, which I'll talk about in the next slide, but then

16:57

my senior year when I did the Rutherford, I got

17:00

to meet these elected officials spend time with them and

17:03

really understand how important this work is

17:06

when you're practicing radiologist the

17:09

clinical so important but this kind of work is equally

17:12

as important when it comes to access to care for our patients and

17:15

very reimbursement for the services that we provide now

17:18

this come this Fellowship is very competitive lots of

17:21

residence apply for it. So if you're a resident who applies and

17:24

doesn't get it don't despair because a lot of State radiological societies

17:27

will sponsor a resident and

17:30

send them so Missouri, you typically will send a

17:33

resident if they applied for the ACR Fellowship didn't

17:37

get it. Then we try to sponsor them through the state. So

17:40

there's always an opportunity to figure it out how to get to this

17:43

fellowship and do it.

17:45

And again, it's only one week but it's only in residency.

17:48

Once you're a fellow it's not available. Once you're

17:51

practiced it's not available. So if you're a resident you have

17:54

any modicum of interest in this try not to miss this incredible

17:57

opportunity, which will truly change

18:00

your life.

18:03

So on the national level as well, so

18:06

we talk about you know, we're talking about the ACR and

18:09

now you know when it comes to ACR meaning

18:12

the Wednesday of the ACR meeting you have

18:15

what's called Capital Hill day and Capitol Hill

18:18

days such a powerful day where all of these State rat

18:21

societies bring together. The residents their fellows

18:24

attending Radiologists and we storm Capital Hill and

18:27

we advocate for critical pieces of radiology legislation.

18:30

So some years we have advocated for

18:33

trying to prevent NIH funding

18:36

Cuts one year, we multiple years

18:39

we've advocated for access to mammography screening

18:42

CT colonography coverage to

18:45

name a few and it's just a really great day build a lot

18:48

of camaraderie amongst the profession of radiology. We're all on

18:51

the hill together. We get our elected officials involved this

18:54

image in the middle is a senator Rob Portman from

18:57

Ohio. He took a picture with some residents from Ohio. It's

19:00

a pretty cool day and it's just a way for

19:03

us.

19:03

To come together to show our federal elected officials that

19:06

we're all in for our patients.

19:09

You can also get involved at the national level by attending, you

19:12

know, the ACR annual meeting and of course Capitol Hill

19:15

day, but during the ACI no meeting we have

19:18

What's called the radpat gala and we'll talk about rad pack in some

19:21

subsequent slides as well. But does gal is a really great

19:24

way for us to show our support of our

19:27

advocacy efforts. And this is an image in the

19:30

lower left-hand corner of a bunch of residents who actually tend

19:33

to the gala we try to we try to send as many residences as

19:36

we can to this Gala as well try to bring them as

19:39

well and every year at the gallery, we recognize a champion.

19:42

Um, and you one year we recognize in

19:45

recent years. This is representative Debbie Wasserman Schultz,

19:48

and she is in a monography champion. So she

19:51

is a breast cancer survivor herself. She's very passionate.

19:54

She's played an instrumental role in access to

19:57

mammography coverage beginning at age 40 and

20:00

that year we recognized her and we gave her an award.

20:03

So, you know, we have a very close relationship with

20:06

her and we know she's a champion for mammography.

20:09

Screening and that relationship is purely due to

20:12

our incredible ACR government relations

20:15

staff who has just formed such a strong

20:18

relationship with her and through that so many of us Radiologists have

20:21

met her have formed stalwart relationships

20:24

with her and we know that we can go to her

20:27

for anything and that's what we really want in the professional Radiology Federal

20:30

elected officials that we can go to we can rely on

20:33

they can rely on us so that we can get critical pieces

20:36

of legislation past for patients.

20:40

So also the national level you can join the Radiology. Advocacy

20:43

Network and

20:45

this is an infrastructure of over 200 plus trainees and

20:48

Radiologists that represent their training program practice or

20:51

institution. Now, there are ran

20:54

leaders estate ran leader. Each state

20:57

has a ran leader and they sort of service the point

21:00

person. And then from there, we now are forming a

21:03

yps ran a young and early career professional Radiologists. Meaning

21:07

they are under the age of 40 or within the first

21:10

eight years of practice who would work with the ran leader.

21:13

And then each Residency program has a ran leader.

21:16

So the thought is that they all work together when it

21:19

comes to Grassroots advocacy or efforts getting the

21:22

word out on anything that we need Radiologists in

21:25

that state to know about and to act

21:28

So I'll talk a little bit about what ran 3.0 is

21:31

in a moment, but the rain is truly crucial for tackling federal

21:34

policy issues, but we can provide

21:37

support at the state level if need be in the

21:40

form of calls to action.

21:43

So ran 3.0. So I was really honored

21:46

to take over as chair of the Radiology. Advocacy

21:49

Network last spring and brand

21:52

1.0 was just the Rand that

21:55

started as a glorified sort of email chain by

21:58

Dr. Andrew Wu ran 2.0 was

22:01

essentially the next phase of

22:04

Rand that was chaired by Dr. David Yeomans where

22:07

we started to bring in digital media and social media and now

22:10

ran 3.0 is under the direction of me and

22:13

I'm going to kind of go into what that means for you and

22:16

the house of radiology.

22:18

So we've done a lot in very short period of

22:21

time we have now devised in inaugural Rand

22:24

board. So it's not just a chair and a vice chair when it

22:27

comes to the ran and our amazing executive director Melody

22:30

balusters. We have included we have expanded our

22:33

tent. So not only do we have these ran leaders in each

22:36

state, but now we have a governing board and this

22:39

board is comprised of incredible Radiologists of

22:42

different career levels and practice types A Very

22:45

diverse group that provides incredible input for

22:48

the direction of the Radiology. Advocacy Network and our

22:51

Grassroots advocacy efforts throughout the country. We are

22:54

in the process of completing the yps ran which

22:57

I talked about and we talked about

23:00

sort of how they work in concert with our main state

23:03

ran leaders and Residency program trainee ran

23:06

leaders.

23:07

We've also this year established a pre-radiology ran

23:11

which is comprised of medical students and those students who

23:14

are now interns who unfortunately did not match

23:17

into Radiology. We've had a lot of interns who

23:20

have reached out and now they have joined us and

23:23

they have joined medical students and that's been really amazing

23:26

because pipeline creation is crucial to the advocacy movement

23:29

as we say the sooner you

23:32

can sit on the radically Kool-Aid the better it will be for patients

23:35

in the future of radiology.

23:37

We have more frequent communication all year round.

23:40

We have a brand newsletter that goes out quarterly. We

23:43

have webinars that are quarterly we have tweet chats.

23:46

We have in-person meetings. We have a ran in-person meeting at

23:49

the ACR meeting every year. So we are really trying to

23:52

increase communication. So everybody in the house of radiology knows what's

23:55

going on. We also have undergone a tremendous

23:58

website refresh it took months and

24:01

we finally got it going and I couldn't be

24:04

more grateful to our government relations team. Particularly Melody

24:07

Bell stero's Haley Brown to mention a

24:10

few that worked really hard on this website

24:13

and it's designed to be as user friendly

24:16

as possible and act as a repository of all things

24:19

advocacy. So if you go to www.radiology advocacy.org,

24:22

you can see it there check

24:25

it out. Give us feedback. We're trying to make this as user

24:28

friendly and accessible to you as possible.

24:32

So this is sort of the interface of the website and you

24:35

can toggle back and forth between ran and rad pack, which

24:38

is really nice. So I would really welcome you

24:41

to go and check this out and see

24:44

everything that the website has to offer.

24:48

You can also look at there's a section ran leaders

24:51

by state where you can essentially toggle over

24:54

your state. You know, my State's Missouri.

24:57

So it's in red and when you toggle over it, it can show

25:00

you how many who you're in how many ran leaders

25:03

you have? How many if there's a recent call

25:06

to action how many calls to actions were sent out

25:09

from your state? So it's a really nice way to

25:12

see who are your main ran leaders in your state

25:15

and then what's the activity like in your state? You know

25:18

who's responding to the call to action who's engaged which

25:21

dates are engaged? It's a really nice map that

25:24

we have.

25:27

So ran leaders are asked to communicate information regarding legislative

25:30

calls to action. So like let's say

25:33

so so a lot of you know recently we sent out

25:36

multiple calls to action to prevent Medicare cuts. And

25:39

so our ran leaders try to send that

25:42

information to their you know,

25:45

practices institutions to encourage others

25:48

to respond to these calls to action. They also

25:51

share information regarding radical because

25:54

you Journal clubs and then rad pack events.

25:58

So if you want to become an advocate, if you go to the Radiology advocacy

26:01

website, you just go up to oh,

26:04

I'm so sorry. That kind of my mouse

26:07

is very touchy if you go up to.

26:11

Become an advocate. This will come up

26:14

and you can just type in your information and we

26:17

can offer you advocacy content.

26:20

We can get you involved in the fight. So it's a very

26:23

easy way for you to become an advocate and for us to

26:26

add you to the list.

26:29

So Switching gears a little bit. We're gonna

26:32

talk a little bit about Rat Pack. So what is rad pack

26:35

so rad pack is the non-partisan multi-candided political

26:39

action committee of the American College of Radiology Association. So

26:42

rad pack is Under the Umbrella of

26:45

ACR a not specifically ACR

26:48

and that is just purely for tax purposes. So if you see Acra,

26:51

you might be confused. It's just simply a

26:54

designation that's related to different tax filings

26:57

and red pack focuses on the political

27:00

influence of radiology in Washington DC. It

27:03

contributes to the campaigns of candidates based

27:06

on their ability to best represent the interests

27:09

of radiology and we have a really

27:12

good success rate. So those who we have supported in

27:15

their campaigns and who support the house of radiology

27:18

and our patients the success rate for those campaigns that

27:21

we've contributed continues to be over 90% So

27:24

we usually know which people are going

27:27

to

27:29

Do well and win and that means a win for our

27:32

patients.

27:34

So some people ask me know what you know,

27:37

where does the money go? What does it mean? And so I wanted

27:40

to go over very quickly, you know, what is hard money

27:43

versus soft money. So hard money

27:46

is a contribution that's hard money

27:49

contributions are made from an individual radiologist trainee

27:52

from a personal bank account in contributions

27:55

can be used to directly support proradiology

27:58

candidates. Okay, and again, if so,

28:01

it's coming from a personal bank account the contributions can

28:04

only be used to directly support Pro Radiology candidates.

28:07

And this is all under FPC regulations. Now soft

28:10

money contribution is made by a group practice from a

28:13

corporate account in contributions can be used to support

28:16

staff to travel on behalf of radpad such

28:19

as presenting at a grain rounds or attending the

28:22

Democratic or republican national conventions.

28:26

So these are the top packs in

28:29

2020 and 2021 and you

28:32

can see that rad pack. You know, we're at number four in 2021

28:35

a historically, you know, we have been you

28:38

know at one and two but we've sort

28:41

of lost our footing in the last few years. So really trying to

28:44

get back to where we were I am,

28:47

you know excited to say that the last couple years we're

28:50

starting to go up again, which is really great. It's showing

28:53

an interest again in the profession of our Radiology of

28:57

our patients. They're well over 40 specialty physician

29:00

packs in the country. So this is sort of where we fare.

29:03

It's still very good but we really want to try to get into

29:06

the one or two slots again, you know, the anesthesiologists are

29:09

totally rocking it right now, so that might be a tall

29:12

order but we could certainly most certainly beat the

29:15

dentist that I am certain. So, you know

29:18

for the second consecutive year we did see Rat Pack

29:21

did see an increase in both contribution dollars raise as

29:24

well as the number of contributors.

29:26

And we raised 30,000 more than in

29:29

2021 and we saw 215 more

29:32

contributors. So that was really great. We also

29:35

increased the number of fundraising events hosted and

29:38

in which Rat Pack participated.

29:41

And increased its total dollars and contributions made

29:44

to Federal campaigns to 974,381. So

29:48

we're definitely back, you know

29:51

on the upslope again, but it's going to take an

29:54

effort from all of us to really get to where we once were

29:57

but I'm you know, I'm cautiously optimistic we will get there. We

30:00

have so many Radiologists who are dedicated to our

30:03

profession.

30:05

So, what does this tell us?

30:07

Safe to say the rat packs visibility and impact on

30:10

Capital Hill really is and an all-time high and it's

30:13

critical that rat pack maintains its

30:16

status as Radiology continues to face many legislative challenges

30:19

ahead.

30:21

Including but not limited not limited to Ferry reimbursement

30:24

cancer screening coverage, you know, we're always

30:27

on a chopping block from mammography screening and

30:30

access when we talk about the pals act which I'll talk about in subsequent

30:33

slides scope of practice issues and

30:36

larger Medicare reform initiatives.

30:41

So as alluded to earlier, we have some events for rad

30:44

pack all year round to get people involved. We do

30:47

have the March chapter challenge. It's coming up

30:50

where the states compete against each other in a

30:53

March Madness style bracket. And what's up

30:56

for grabs or bragging rights raffle tickets and the winning States

30:59

given $500 to send it to trainees

31:02

to the annual ACR meeting. So the March chapter

31:05

challenge is going to be underway soon. So look out for

31:08

more information on that.

31:12

So recent topics in breast Radiology

31:15

advocacy, so, you know, why do I talk about Acra and

31:18

ACR and why do I talk about rad pack and rant

31:21

they have played in integral role to

31:24

advocating and helping us Radiologists

31:27

when it comes to breast cancer

31:30

screening and particularly the

31:33

pals act the protecting access to

31:36

life-saving screenings act. We have to

31:39

give credit to this body who has worked so hard

31:42

on behalf of us when we can't be in DC to ensure

31:45

that our patients have access to breast screening coverage

31:48

additionally some recent

31:51

topics that also affect the world of breast Radiology

31:54

our CMS Cuts. We know that we unfortunately

31:57

have seen two rounds

32:00

of seeing some of Medicare cuts to achieve

32:03

budget neutrality for evaluation and

32:06

management coding Physicians who typically aren't

32:09

us and we were on the chopping block

32:12

again.

32:12

Have a 4% cut. We regained about

32:15

2.5% of that this year, but we lost 1.5% So

32:18

we are pleading with our federal elected

32:21

officials that they achieve some sort of,

32:24

you know, reform for Medicare.

32:27

We cannot continue to have cuts that are

32:30

affecting patient care and access affecting our elderly. If

32:33

it's it's you know, something that we are

32:36

going to continue to fight for and this affects everyone of

32:39

us in the house of radiology doesn't matter. If you're in private practice,

32:42

if you're an academics, it doesn't matter if you're a pediatric

32:45

radiologist or breast radiologist, it affects all of us

32:48

and we all need to get involved and be educated on the

32:51

subject and help in any way we can

32:54

I'm also going to talk a little bit about the National Breast density

32:57

notification rule some information

33:00

on that but really the

33:03

two things that you know, the acri Acra has

33:06

worked so hard on is the pals act

33:09

and particularly are Medicare cuts.

33:12

So the protecting access to life-saving screenings

33:15

act this involves annual mammography

33:18

coverage beginning at age 40 and essentially

33:21

this legislation is

33:24

a moratorium on the USPS TF

33:27

recommendations that recommend any of mammography

33:30

screening every other year beginning at 50

33:33

this essentially shuts that down and although

33:36

you know, the pals act has

33:39

been introduced by champions in our field. I

33:42

mentioned wasterman Schultz. We've had incredible

33:45

others Fred representative Fred Upton

33:48

on the Senate side Dianne Feinstein. We've had

33:51

Senator Blackburn just some really great champions

33:54

for us. We did get a moratorium

33:57

again on the uspsd of Rex extended

34:00

to 2028 now, but it was through Appropriations

34:03

bills a part of the larger package. So we are,

34:06

you know still being able

34:09

to sort of stipend.

34:12

Sort of stymie the uspsdf Rex. But

34:15

again, this is only through 2028. This is going to come up again. We

34:18

all need to be able to fight this to

34:21

ensure that women have access beginning at age

34:24

40 firm mammography. Now also this

34:27

moratorium includes clarification that

34:30

service women should benefit from the same screening

34:33

mammography protections beginning at age 40.

34:36

So that's really really wonderful that we can you

34:39

know, in terms of Equitable care for all

34:42

patients and especially our service women who have given such a

34:45

sacrifice and then clarifying language that

34:48

specifies all modalities is

34:51

intended to include digital breast to most synthesis and

34:54

and the clarifying language is really so that

34:57

we can ensure that everyone is covering digital breasts

35:00

to most synthesis as we know that certain states

35:03

are still having this issue where their insurance

35:06

isn't covering a digital breast synthesis for

35:09

screening.

35:12

So some people know about these the

35:15

National Breast density notification rule. So

35:18

this has been something that came

35:21

out, you know, as far as back as 2019 and at

35:24

the FDA was going to issue a

35:27

final Rule and in covid happened and everything

35:30

got pushed behind. So in a recent

35:33

letter to representative Rosa de lauro the FDA

35:36

noted that the final rule on amendments to

35:39

the mammography quality standards act will be

35:42

issued. They said late 22 early 23, we never

35:45

heard back and late 22, so it's likely to be early

35:48

23 about this.

35:51

And this will include a national reporting standard for

35:54

breast and sea notification. Now, there's been

35:57

talk of there might be language of

36:00

we will be required to include patient-oriented

36:03

summaries of high or

36:06

low density breasts or language

36:09

about the significance of breast density or an

36:12

include one of the four breast density categories.

36:15

Now some of this stuff we already a lot of us

36:18

is breast images include, you know, a lot of us in the country already include the

36:21

one of four breasts and sea categories 38

36:24

states of us have breast and see

36:27

notification laws. So we're required to include that language

36:30

in the report Missouri's one of them it passed in 2015.

36:33

So we have to have a little disclaimer about

36:36

dense breasts and what that means in our reports too,

36:39

but this is sort of what has been said that will

36:42

be included in it, but it's still unclear. So

36:45

I want to make it clear that the final language of what we

36:48

are going to have to include for a national reporting.

36:51

Standard it remains to be seen so we have an

36:54

idea, but we don't know for sure and we need to wait until the

36:57

FDA tells us what needs to be included.

37:01

So also you might

37:04

have seen in the media particularly as of

37:07

recently the find it early Act.

37:10

So the find it early Act was introduced by

37:13

representative delauro and representative Fitzpatrick. So

37:16

it's a bipartisan legislative effort in

37:19

December of 2022. Now this

37:22

bill would provide coverage with no cost sharing

37:25

for additional screening and diagnostic breast

37:28

Imaging exams for the detection of breast cancer, either

37:31

2D or 3D mammography breast ultrasound

37:34

breast MRI or any other

37:37

technology as determined in accordance

37:40

with specified Criterion guidelines with no

37:43

limitations on the frequency for in certain

37:46

individuals assess to be at increased risk

37:49

for breast cancer. So increased risk whether it be

37:52

the recommendations from the ACR or the

37:55

nccn.

37:56

Or if they are do have to

37:59

express now the proposed coverage requirements

38:02

would apply to private insurance Medicare Medicare

38:05

Advantage Medicaid Tricare the

38:08

VA now since this was introduced in

38:11

December of 22, it will need to be reintroduced in

38:14

the current Congress. This is also the

38:17

the bill that if you all may

38:20

recall that Katie Couric worked on with these

38:23

two Representatives after she

38:26

you know revealed her breast cancer diagnosis and treatment

38:29

now as you can imagine as I describe this

38:32

bill, it's pretty expensive. So it you

38:35

know, if this is reintroduced into the current

38:38

Congress, then it would be subject to a

38:41

multi-committee jurisdiction. It will have to be you know,

38:44

raised With the Energy and

38:47

Commerce Committee ways in means they

38:50

have jurisdiction over Health Care armed services

38:53

Veterans Affairs. So it's it's definitely a

38:56

order but it has been introduced in

38:59

December and will need to be reintroduced in the current Congress.

39:04

So Switching gears a little bit another way to

39:07

get involved with our breast Radiology advocacy efforts

39:10

and advocacy efforts in general is social media. We have

39:13

a very robust Radiology twitterverse. These

39:16

are some of the hashtags we use these are

39:19

some of the Twitter handles that you can tag, and you

39:22

can follow acran rad pack RFS. Yps.

39:25

And we use social media

39:28

as a means to in a positive way

39:31

thank our elected officials for

39:34

championing our advocacy efforts, especially when

39:37

it comes to breast cancer screening and access that you

39:40

know, if you're going to be involved in social media

39:43

efforts for breast Radiology political. Advocacy, you

39:46

want to try to keep it as positive as you can.

39:49

And elected officials, sometimes they

39:52

like to get involved in our advocacy effort. So this is

39:55

an image of Senator Cory Booker in 2017. We

39:58

went to Capitol Hill to Advocate to prevent NIH

40:01

funding cuts at year and he was for it

40:04

as well and he said hey, can I shoot a video? So he should

40:07

have he shot a video here with two New Jersey Radiologists and

40:10

within a day he had over 15,000 views.

40:14

So it's just a really great way to you know, Advocate together

40:17

for important causes and just

40:20

show from a you know, a digital

40:23

landscape that we are working with our elected officials

40:26

on behalf of our patients for access.

40:30

I often for all of my legislative efforts.

40:33

I share on social media kind of what I'm

40:36

up to and in a lot of it is because if

40:39

there are others who need to seek guidance from

40:42

me in regards to these topics or others who have

40:45

the knowledge on it. I can steer them in the right direction and also

40:48

to thank those who have been such champions

40:51

for us. This was a one of my tweets, you know,

40:54

say expressing my gratitude to

40:57

representative delara. She's just been really really amazing and

41:00

as one of our Champions as

41:03

well. So social media again can be just

41:06

a really great way to amplify our price Radiology advocacy

41:09

efforts.

41:11

And Facebook is still relevant to so specifically

41:14

when we were advocating for

41:17

high risk breast Imaging legislation in the state of Missouri. I know

41:20

that women who are getting a mammogram,

41:23

you know, they tend to be in that sort of, you know late 30s

41:26

40s 70 plus sort of

41:29

age range and there, you know.

41:31

Given that social media is the oldest platform. A lot

41:34

of these women are on social media particularly Facebook. And

41:37

so we started sharing our efforts of

41:40

what we were doing to Rally support for

41:43

this legislation. You can see the engagement from

41:46

these two posts one by me one for us from

41:49

Senator Arthur and from here. We had so many women reach out

41:52

saying, how could we help can we submit a letter we had like 40

41:55

letters submitted 40 or 45 litters that

41:58

we had submitted when you know,

42:01

the the legislature was going to

42:04

decide on this bill and it was just so hard to deny that

42:07

there were so many women reaching out saying I'm high risk.

42:10

I mean, you know, I would benefit from this coverage or my,

42:13

you know, loved one died and she would have benefited from this

42:16

coverage and it was very very powerful. So social media can truly

42:19

make a difference when you're advocating for critical pieces of

42:22

radiology legislation.

42:25

So other ways to get involved and stay informed we have

42:29

an amazing Radric podcast. It has really great content

42:32

keeps you in the know for all advocacy Endeavors

42:35

including breast Radiology. Advocacy Endeavors from

42:38

experts. We have the advocacy and

42:41

action E news that you may be getting if you're an ACR

42:44

member you should be getting it in your email every Saturday morning for

42:47

the most part which is content crafted by

42:50

our expert government relations staff and then

42:53

radvik you see Journal clubs. We have those periodically as

42:56

well as virtual webinars, which

42:59

we try to do quarterly now,

43:03

And this is if you go to the rad vacancy

43:06

website Radiology. Advocacy website, there

43:09

is a section of the podcast and you

43:12

can have you can see all the episodes there. You can

43:15

listen to the podcast on Apple or Spotify.

43:19

So in conclusion, advocacy represents our

43:22

commitment to the future of our profession, which you control as

43:25

doctors seek, Silva says who's the former

43:28

chair of the commission for economics and

43:31

ACR now, he's very high up in

43:34

the AMA representing Us in his amazing. He often

43:37

says make advocacy automatic and if

43:40

you can make it automatic, it really will

43:43

stay with you for the rest of your life and really better

43:46

not only you as a radiologist but your patience

43:49

and access to care and an increasingly competitive Health

43:52

Care environment. It's really gonna be up to this generation

43:55

to blaze the radicancy trail. There's a

43:58

diverse opportunities to get involved the local

44:01

state and National level as I have shared with you today. We

44:04

truly need radicates of all types to ensure the

44:07

future success of medicine and that our patients have

44:10

continued access to life-saving breast examinations. And

44:13

finally, we really need to work together in the

44:16

house of radiology because we really, you know,

44:19

Only competing interests. We don't want to dilute our efforts. We want

44:22

to make sure we're all working together all Radiology governing

44:25

bodies, whether it's you know, Society breast

44:28

Imaging American college Radiology. We need to be working

44:31

together and ensure our profession is cohesive and an

44:34

effective force in the house of medicine because in

44:37

the end, all we care about is ensuring that

44:40

our patients have access to care that they deserve and the only

44:43

way we're going to get this legislation pass is by being on

44:46

the same page and working together.

44:48

So special things to Ted Burns Melody Ballesteros

44:51

and Gloria romanelli. They are

44:54

just amazing of resources and support for me.

44:57

So I just wanted to give them a shout out.

45:00

And if you have any questions, here's my Twitter handle. You can also contact

45:03

me at Patel AK at umkc.edu.

45:08

And finally many of you know, I have been

45:11

honored to be named the 2022 can't see

45:14

Chiefs fan of the Year competing for NFL fan of the Year through February

45:17

8th if you feel so inclined to vote for me, here's a

45:20

QR code. I'm the first physician chosen. My platform has

45:23

been breast cancer awareness and early detection. And

45:26

so I'd really really appreciate your vote. I

45:29

want to win this for the house of medicine definitely to House

45:32

of radiology, and of course Chiefs Kingdom. So with

45:35

that I thank you so much and I'm happy to answer any

45:38

and all questions.

45:42

You have any questions go ahead and put those in the Q&A feature

45:45

the bottom of the screen.

45:47

We'll pause to see if we can get any questions

45:50

in.

45:53

Dr. Patel, that was a great presentation. Thank you so much for sharing all of

45:56

that and Illuminating how much work has

45:59

been done and how far we still have to go. It's it's really

46:02

nice.

46:04

Of course.

46:08

right

46:10

Thank you blew him away, Dr. Patel. No questions. And

46:13

if you need to reach out to retail

46:16

she provided her contact information, if you think of a question after we

46:19

do see well there's questions about yes.

46:23

There's a couple in chat Doctor Patel. Is there

46:26

any movement on breast density legislation uniform text written

46:29

for patients?

46:32

So we are waiting from the FDA of

46:35

what they're going to require. We don't know at

46:38

this time. You know, like I said in that pre one of

46:41

the slides that there's some talk of what will be required. We're

46:44

hopeful that they'll provide some sort

46:47

of uniform language but it truly remains to be seen so

46:50

we don't want to be speculative or presumptive but

46:53

we're really just waiting for what the FDA says

46:56

on this. We just don't have any updated information,

46:59

you know, I checked in with Gloria this morning and there's

47:02

just nothing there yet to to guide us one way

47:05

or another but I will say this that if

47:08

the FDA does come out with your requirements, but

47:11

they don't provide a template language. I

47:14

would say that, you know reaching out

47:17

to other states that have passed breast dense

47:20

tea legislation and seeing kind

47:23

of what their language is or what they put together can be

47:26

really helpful. So like for Missouri, like I said, we pass legislation

47:29

in 2015, so, you know, please

47:32

Reach out to me. I can share what template language

47:35

we have. But I'm hope you know we're hoping that the

47:38

FDA will give us more Direction on it. We're just waiting to see what they

47:41

provide.

47:44

Right another question in

47:47

here. Oh my goodness. Oh

47:52

Can you throw some light on how to participate in Ran 3.0?

47:57

Yes, so if you want to get involved in the ran, what you

48:00

can do is you can email me or you can email Melody

48:03

Ballesteros and Ballesteros at

48:06

ACR dot acra.org.

48:09

I'm sorry acr.org and Bella

48:12

steroes at acr.org and we can get

48:15

you plugged in whether it's plugging you in at

48:18

the state level whether it's you know, if you have interest in

48:21

serving on the board in the future, we can certainly get you involved.

48:24

There's a lot of opportunities.

48:27

Awesome. Do you have any advice on changing

48:30

policies at one's Hospital level?

48:33

Yeah, so, um, you know.

48:36

So every institutions different and you know,

48:39

I used to practice at a lot much larger

48:42

institution. I used to work at Beth Israel Deaconess in

48:45

Boston. Now, I work at it more community-based hospital.

48:48

So, you know a lot easier to

48:51

pass policy and things and you know

48:54

at the bi but you know, I would say

48:57

that if you are at an institution that

49:00

has you know, some larger institutions have

49:03

their own lobbyists. I would

49:06

talk to that lobbyist about you know, who are the go-to's for

49:09

that person at that institution to enact

49:12

certain policy and they

49:15

can give you a lot of they can shed a lot of light or

49:18

even meeting with their chief medical officer can be

49:21

a really great way to sit down regardless of

49:24

how large your institution is. The CMO

49:27

can be a huge wealth of information and

49:30

support and guidance of how to direct

49:33

you because every hospital system.

49:36

Different with their policies and procedures like for

49:39

example just for you know, although

49:42

a little bit more vanilla, but for a

49:45

social media like it Beth Israel, they have a social

49:48

media committee that governs the whole system and

49:51

I was the physician liaison that represented the system.

49:54

Whereas now where and we

49:57

all made decisions together. Whereas now where I

50:00

am at my hospital in Kansas City metro and Liberty Hospital,

50:03

we don't have a committee like that. We have a PR marketing

50:06

team and we needed to put together a policy for

50:09

social media. And so they just turned to me and said can you

50:12

help us and it was something as simple as that so every system

50:15

is so different with policy changes, but you

50:18

know, if you're institution has a lobbyist reach out

50:21

to them. Otherwise going to the chief medical officer can

50:24

be really really helpful. If you don't get anywhere, you're

50:27

CMO even meeting with the CEO, I

50:30

would recommend I know going to the top can be

50:33

daunting but it can make a world of difference.

50:36

To help guide you in the correct direction.

50:40

Awesome. Yeah. Thank you so much for answering All Those Questions Dr.

50:43

Patel, and thank you so much for your lecture today and thank

50:46

you for participating in the audience.

50:49

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