On the exhibition floor

Lopez: Unlike RSNA, you won't see as much equipment at these meetings. You might see more of the smaller vendors here and they actually have more visibility. At RSNA sometimes it's hard to crowd through and get to see the vendor and there's a lot more personal vendor-client interactions. We hear that from a lot of the vendors.


Member concerns

Lopez: In one of our most recent member surveys we heard over and over again -- and it's not going to surprise you -- that at the same time that they are being asked to cut costs, including personnel, they are also getting busier. Our members need to glean how to increase productivity while costs are going higher and reimbursements are going lower and they are asking, 'How do we balance all of that?'

Health care reform and reduced access

Olivi: I think that radiology will be the first 'ology in the hospital that will feel the access issues that are sure to come as health care reform and health insurance reform continue. At some point we will be among the leaders saying, 'I can't run that scanner that way anymore and now I won't meet those get-every-patient-within-24-hour goals,' and there will have to be access discussions at that point.

Cronin: And when there is talk about what would have to be cut, MRI is always the first word out of people's mouths.

Lopez: Nurses have bed ratios. They have to have x amount of nurses per y amount of patients, and if they don't have the staff they can't admit new patients, whereas in radiology we may only schedule half of the procedures that come to us. We have emergency department procedures coming and patient procedures, and we have to say, 'Okay, we'll do it all.' What ends up happening is you have to cut off access to those exams that you scheduled because you can't say, 'sorry but we're not doing orthopedic on Monday.' You have to keep allowing the walk-ins to walk in.

Equipment utilization

Olivi: I think what ties into all of that too are the new CMS rules that are coming out about scanner utilization, 'we're only going to pay if your scanner utilization is...[at a certain level]' and I don't know what the number they're finally going to settle on is--something like 93 percent utilized. I know Deb came from a busy hospital, and I'm at a busy hospital. I can show you my scanner utilization and I can explain to you why my ER CT scanner is utilized between 50 and 65 percent because I'm waiting for that big influx, and then my outpatient scanner should be at 90 percent; you should be moving those people right through.

While I understand the logic and the intent, I think there are a lot of issues on how to measure it. I don't have 24/7 staff, so I measure my utilization based on when I'm staffed. So then it gets into, 'well I can't staff you; there's no money.' At that point I won't ever get to that utilization because I need a technologist to run the scanner.

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