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Increase in imaging studies
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Washington, DC (March 9, 2009) – Medical radiation exposure of the U.S. population has increased more than seven-fold since 1980, according to a recent National Council on Radiation Protection and Measurement (NCRP) report. The report cites the dramatic increase in the use of imaging technology to diagnose and treat cancer, heart disease and other major illnesses as one of the leading causes of this increase. The American College of Cardiology (ACC) commends the NCRP for its focus on this important patient safety issue. Unfortunately, attempts have been made to link the report’s findings to ownership or leasing of imaging equipment by non-radiologist physicians.



“Medical radiation exposure is a concern of everyone who relies on imaging technology, which is why we spend considerable time and effort in our training programs ensuring that cardiologists are cognizant of the dangers of radiation exposure and know how to reduce it,” says ACC President Douglas Weaver, M.D., F.A.C.C. “The ACC has also worked with the American College of Radiology (ACR) to find ways to eliminate unnecessary and inappropriate procedures and ensure that patients receive the most ideal cardiac diagnostic and treatment procedures possible. The argument that someone other than the specialist caring for a patient will make a better decision about whether a test should be done is a thinly veiled attempt to protect ‘turf.’ Worse, it will neither lower utilization nor guarantee that patients are receiving the right test, in the right setting, at the right time.”

Medical technology has evolved to provide critical support to skilled patient care. Advanced technologies that did not exist a decade ago are now key tools in the prompt and efficient diagnosis and treatment of disease. The ACC is a leader in the formulation of health policy, standards and guidelines, and is a staunch supporter of cardiovascular research. The ACC has worked with ACR and other specialty societies to ensure the quality and safety of these technologies by developing an array of quality-improvement tools, such as:

  • Fellow Training Guidelines;
  • Clinical Use Guidelines;
  • Clinical Competency Statements;
  • Appropriate Use Criteria (AUC) for each cardiac imaging modality;
  • Physician Certification;
  • Laboratory Accreditation;
  • National Registries.

“We are taking a patient-centered approach to apply the best science at the point of care,” said Kim Allan Williams, M.D., F.A.C.C., chair of ACC’s Imaging Council. “Using the issue of radiation exposure to take a swipe at self-referral is unfortunately nothing more than a form of medical protectionism – more concerned with pocketbooks than with patients.”

The ACC is currently piloting the use of its AUC in practices and has committed to reducing inappropriate imaging by 15 percent. Past studies have shown that monitoring and education are the primary ways to ensure appropriate imaging, not limiting who performs the test.

“In 2007, 97 percent of CT scans were performed by radiologists and 0.6 percent by cardiologists,” says Weaver. “This appears to be an overall issue of utilization, not self-referral.”

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