ABSTRACT
We examine the relationship between the rationing of health care resources and disparities in health care delivery and the specific implications for radiologic resource allocation frameworks such as the ACR Appropriateness Criteria. We explore what rationing is in this context and how it is manifested in radiology. We review how rationing has taken many forms and how rationing has influenced the development of disparities in access and outcomes within health care and specifically within the context of radiology. We describe how the relationship between rationing and health care delivery disparities manifested during the coronavirus disease 2019 pandemic and the corrective measures that were proposed to established rationing frameworks to facilitate more equitable pandemic-related resource distribution. We offer suggestions regarding how such solutions might be brought into radiologic resource allocation schemes to help mitigate disparities in radiologic care in the future.
Subject(s)
Health Care Rationing , Healthcare Disparities , Radiology , COVID-19 , Humans , Practice Guidelines as TopicABSTRACT
Today's female physicians face a "triple whammy" of structural discrimination, rigid work expectations, and increasing educational debt. Coronavirus disease 2019 is disproportionately amplifying these forces on women. The burden of these forces on women, the likely long-term consequences, and some preliminary solutions are discussed.
Subject(s)
COVID-19/epidemiology , Mothers , Physicians, Women , Radiologists/economics , Radiologists/education , Adult , Education, Medical/economics , Female , Financing, Personal/statistics & numerical data , Humans , SARS-CoV-2 , Sexism , Training Support/economics , WorkloadABSTRACT
OBJECTIVE. In this article, we review models for clinical integration across the full spectrum of radiologic services in merged health systems that include both academic and community practice components. We also discuss the issues involved in the integration of disparate practice models and reward systems for both the community radiology group and the academic faculty practice group. CONCLUSION. Although we see advantages to the current trends in mergers and acquisitions within academic radiology, it remains to be seen whether academic and community practice radiology groups can truly work and play well together.
Subject(s)
Academic Medical Centers/organization & administration , Health Facility Merger , Hospitals, Community/organization & administration , Practice Management, Medical/organization & administration , Radiology , Delivery of Health Care/organization & administration , Group Practice , Humans , Models, Organizational , Organizational ObjectivesABSTRACT
PURPOSE: To investigate and document the attitudes toward careers in breast imaging among Massachusetts radiology residents. METHOD: Written surveys were distributed to all senior radiology residents in the state asking whether they were interested in pursuing a fellowship in breast imaging or whether they planned to interpret mammograms as part of their future practice. If they were not interested, residents were asked why. RESULTS: Of 63 residents who responded, only 1 was interested in a breast-imaging fellowship. Only 3% of radiology residents surveyed in the state agreed that they would like to spend a substantial time interpreting mammograms in the future. The most common reasons cited for not wanting to interpret mammograms in the future were "fear of lawsuits" (76%) and "not an interesting field" (49%). CONCLUSIONS: Very few Massachusetts radiology residents are interested in pursuing breast imaging in their future careers. This lack of interest in breast imaging will ultimately affect women's access to breast imaging services in the future.
