AuntMinnie 1999: Managed care, Medicare cuts hamper radiologist research, patient care

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Editor's note: As part of the celebration of's upcoming 25th anniversary, we're presenting 25 for 25 -- a new article series featuring our most popular content for each of the last 25 years. New articles will be published each Monday up until our official anniversary at RSNA 2024. Our top article from 1999 featured coverage of the RSNA President's address from our inaugural RSNA meeting.

CHICAGO - Managed care and Medicare cuts are hindering the ability of radiologists and radiation oncologists to engage in research and education and to provide optimal patient care, according to Seymour H. Levitt, MD, head of therapeutic radiology-radiation oncology at the Fairview University Medical Center in Minneapolis and the new president of the Radiological Society of North America.

Speaking at the opening session of the 1999 RSNA conference, Levitt reported the results of an RSNA-sponsored study on the impact of changes in the healthcare system on scholarly activity and patient care.

The past five years have seen dramatic changes in the healthcare system, Levitt said. Managed care has risen in prominence, and the 1997 Balanced Budget Act has led to substantial cuts in Medicare reimbursements. According to the American Association of Medical Schools, the nation’s teaching hospitals will incur nearly 15 billion dollars in losses due to Medicare cuts alone by the year 2002.

The goal of the RSNA study was to determine the impact of these changes on research, education, and patient care in departments of radiology and radiation oncology. Six radiation and six radiation oncology departments with low (0%-29%), medium (30%-49%), and high (>/=50%) managed care penetration completed questionnaires for fiscal years 1993-1998, and RSNA staff followed up with site visits.

More patient care

The study found that departments with medium to high managed care penetration reported more difficulty achieving their educational and research goals, primarily due to increased clinical responsibilities.

"The primary influence of managed care on academic radiology and radiation oncology departments over the past five years has been the need to increase clinical time to make up for decreasing patient care revenues," Levitt said. "This has decreased the time and money devoted to scholarly activities."

Ultimately, the de-emphasis of research and education will compromise patient care, Levitt said. "Without a strong focus on research to develop and test the benefits and risks of new technology and pharmaceuticals, the quality of future care is in jeopardy," he said.

Levitt concluded that radiologists will need to keep the focus on patients as others try to move the focus to budgets and profit margins. "We need to better inform the public and our patients of how essential research and education are to high-quality care," he said.

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