Reston, Va. - Products or services become commoditized when there is no differentiation between how they are perceived and price becomes the determining factor in provider selection. In radiology, the threat of commoditization has increased in part due to teleradiology, increased information exchange, and the development of new technology, according to Bruce I. Reiner, M.D., and Eliot L. Siegel, M.D., authors of Decommoditizing Radiology, an article appearing in the March issue of the Journal of the American College of Radiology (JACR, www.jacr.org).

In order for radiology to avoid the commoditization trend, imaging services must be differentiated on the basis of qualitative measures - those that are reproducible and objective. Existing initiatives are in place; however, the authors offer several recommendations for expansion, as well as opportunities to tie them to economic incentives, such as pay for performance.

CT Pulmonary Angiography Examined
The time spent interpreting CT pulmonary angiographic studies is critical; death from an acute pulmonary embolism can occur in as little as one to two hours. The Effect of Teleradiology on Time to Interpretation for CT Pulmonary Angiographic Studies, by Scott Kennedy, M.D., et al., evaluates the results and implications of surveys completed by radiology administrators and emergency medicine physicians at Yale-New Haven Hospital. The surveys were used to establish target benchmarks for optimal interpretation time, and to assess the impact of adding off-hours interpretation to current practice.

The authors reported that adding only 40 hours of teleradiology coverage per week decreased turn-around time for preliminary written reports, suggesting that teleradiology can help meet quality improvement standards and ensure timely diagnosis of time-critical illnesses.

Subspecialization in Radiology and Radiation Oncology, by Geoffrey G. Smith, M.D., et al., is the result of a study commissioned in 2008 by past Chair of the ACR Board of Chancellors Arl Van Moore Jr., M.D. Responses were gathered from 1,095 professionally-active radiologist ACR members and 308 radiation oncologists.

While few radiologists reported their main subspecialty as general radiology (1.5 percent), it accounted for 18.5 percent of radiologists' work time. The most frequently cited subspecialties were neuroradiology (17.1 percent), breast imaging or mammography (15.8 percent), interventional/vascular radiology (15.8 percent), and body imaging (11 percent).

In radiation oncologists, 70 percent reported their main subspecialties as being in body parts or organ systems. Prostate (18.9 percent), breast (17.7 percent), and head and neck (17.1 percent) were the most frequently cited subspecialties. Among therapeutic modalities, 12 percent named radiosurgery as their main subspecialty.

The March issue of JACR is an important resource for radiology and nuclear medicine professionals as well as students seeking clinical and educational improvement.

For more information about JACR, please visit www.jacr.org.

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The ACR is a national professional organization serving more than 32,000 radiologists, radiation oncologists, interventional radiologists, nuclear medicine physicians and medical physicists with programs focusing on the practice of radiology and the delivery of comprehensive health care services.

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