Dr. James Borgstede

Q&A with RSNA president Dr. James Borgstede

November 29, 2020
by Sean Ruck, Contributing Editor
Dr. James Borgstede is the president of RSNA. He is also a professor and vice chair of the department of radiology at the University of Colorado. He spoke with HealthCare Business News on the lead-up to this year’s RSNA, which will be very different, compared to prior annual meetings. Borgstede discussed his background, his work in the association and the latest news from the RSNA regarding membership support and the upcoming conference.

HCB News: What inspired you to pursue a career in healthcare?
Dr. James Borgstede: I always wanted to be a physician; from the time I was a child. We had a family friend, actually a world-renowned internist, his name was Carl Moore — our family just idolized him and what he did for patients. So the thought of in some way being able to emulate Dr. Moore made it always the profession that I wanted to pursue.

HCBN: How long have you been a member of RSNA?
JB: I’ve been a member for 44 years. I joined when I was a first-year resident at the University of Colorado in 1976. It’s been many years and I’ve been having a good time all the way.

HCBN: What inspired you to become a member?
JB: I attended the first RSNA in 1975. At that time, I was a resident and the senior residents told me this was the meeting to attend and they were correct. It so happened, that I had that week off and the RSNA had just moved out of the Palmer House into McCormick Place. When I went to McCormick for that meeting, I was stunned. The quality of the presentations and the organization of the meeting, the way it worked with so many people in the venue — they were just outstanding, as they are today. The annual meeting was and still is really one-stop shopping. A radiology resident or a practicing radiologist — you can accomplish anything you want to at the meeting. You have research, scientific papers, educational refresher courses, equipment evaluation, you can meet with the vendors, collaborate with colleagues from around the world. You have it all in one place. So I thought from the start that it was the organization I wanted to be a part of.

HCBN: What fueled your decision to lead the association?
JB: From my perspective, I see it as an opportunity to give back to a great organization that has really given me so much in my career. But the decision to lead the organization really wasn’t mine. That was the decision of the membership and the RSNA board of directors. I had leadership experience in the International Radiology Society as president and as chairman of the board and president of the American College of Radiology. So I had leadership experience in international radiology. The RSNA wanted to expand into the international arena with an international portfolio. They asked me if I’d be willing to serve on the RSNA board of directors as a leader of that portfolio. Again, I agreed to serve to give back to the RSNA because it had provided me such wonderful research and education opportunities throughout my whole career. That position on the board of directors led to me becoming an officer.

HCBN: Who should consider joining the association and why?
JB: I think all radiologists in training and in practice, whether academic, institutional or private practice, should join the RSNA. That would include radiation oncologists and interventional radiologists. So should medical students who are interested in radiology, physicists, technologists and allied professionals. There’s something for everyone. It’s diverse and world-wide and we welcome everyone who’s interested in imaging and image-guided therapies to be a member. They should want to join because it is the organization that unifies our profession and shapes the future of our specialty. They should join because of the great education, science, research, research funding through the Research and Education Foundation and the vendor relationships that the RSNA has.

The benefits of joining include free registration to the annual meeting. But there are also the subscriptions to our five outstanding journals, CME and grant opportunities, practice tools, and the opportunity to collaborate with colleagues and participate in the cutting-edge future of an amazing specialty.

HCBN: What initiatives are you backing as president?
JB: My year as president is almost over, it will end after the annual meeting in December. When I started my presidential year in December of 2019, I really envisioned a year that was focused on strong, quality patient care, patient interaction and the opportunities of RSNA as an organization, to impact radiology care across the world through multi-organizational unity. That is what I envisioned then. Then came our worldwide pandemic. My goals throughout the year really haven’t changed, but the expression of those goals and their focus and direction certainly did.

Radiologic patient care became COVID-focused. Radiologists worldwide have faced a lot of challenges. How do we interact with patients and colleagues? Sometimes remotely, but we still want to provide the high-quality care patients require and expect. I think we’ve seen that all our organizational unity and partnerships are now more important than ever. So if I reflect back on what my goals were then, they’re the same, it’s just how they’re going to be expressed is a little different, but I’m really pleased with our collaboration and how we’ve fought this virus.

HCBN: What challenges are members facing beyond the pandemic-induced struggles?
JB: There are practice challenges. That includes who owns the practice. Is it an equity firm? Is it a large multispecialty clinic? And what role does the individual radiologist or medical physicist have in practice leadership so that you can direct your own future?

I think the second challenge members are facing is research funding in medical imaging and intervention. Will the funding be there and can we grant fund young researchers through the R & E foundation?

The third challenge is appropriate reimbursement for the services we provide for patients. Currently, the Centers for Medicare and Medicaid Services is planning an inappropriate 11 percent cut in professional reimbursement for our imaging services.

A fourth challenge is how radiologists will embrace and lead the development and implementation of artificial intelligence and machine learning. AI has a great deal to offer, but we need to implement AI responsibly and efficiently. At RSNA 2020, we will have an “AI imaging in practice” demonstration that will take attendees through clinical scenarios and demonstrate the interoperability required to make AI useful in daily clinical practice. We’ve had a number of webinars and educational opportunities related to AI and recently received a grant from the department of energy’s national nuclear security administration to develop a global learning center in Sub-Saharan Africa.

The RSNA is going to assist our members in meeting all these challenges.

HCBN: Are there members concerned that AI will replace them?
JB: I think we’ve gone beyond that. That was perhaps a concern in the beginning. One of my colleagues on the RSNA board, Curt Langlotz, has made a statement that articulates things well, “AI will not replace radiologists. But radiologists who use AI will replace radiologists who don’t.”

If I look at radiology throughout my long career, when CT came in, people said “cross-sectional picture! We won’t need radiologists anymore, we’ll be able to see the pathology right there.” Then they realized there was a lot of pathology to see and they needed a radiologist to help them out. And back when MR was called NMR (nuclear magnetic resonance) before the “nuclear” was changed to not worry the public, people would joke that NMR stood for “no more radiologists.” Again, they found out that there was a lot of information in that MR scan that could really benefit from a radiologist’s expertise. This is what makes our specialty so exciting. Instead of being a threat, AI might give us more time, for example, to talk to patients. It may help us prioritize which cases we should look at first. It may help us data mine the electronic medical record and give more focused imaging reports. AI is not going to replace radiologists — I’m not worried about that, I’m excited about it.

HCBN: Can you talk about the annual meeting and what to expect?
JB: The most obvious change is that the annual meeting will be virtual. We had the vision and foresight to initiate a virtual meeting several years ago. This year, the virtual meeting is free to members. We’ll still have our plenary, scientific and educational sessions. We have opportunities to interact with vendors virtually. The RSNA has had the benefit of learning from the meetings other associations had earlier this year. Having our meeting later has allowed us to learn what works well and what doesn’t.

The title of this year’s meeting is, “Human Insight and Visionary Medicine”. We’ve planned a sensational virtual format. It allows everyone to participate in our annual meeting from the comfort of their home or office and do it at their own convenience. We’ve extended the live meeting to seven days — November 29th through December 5th. So that includes two weekend days — Sunday at the beginning and Saturday at the end, to allow attendees to balance their meeting attendance with a full work schedule. We’re going to have on-demand programming through April 2021, so if people miss something, they can come back and take a look at it. We have some unique opportunities where we can offer all attendees a chance to pick up substantial CMEs. There will be 300 hours of instructional education with live Q & A for many of these sessions. The meeting includes 100 science sessions with additional digital posters and educational exhibits to view on demand. AI as you and I have talked about, continues to trend. There are also five hot-topic sessions related to COVID 19.

For more information on this year’s conference, visit RSNA.org