2024 June Ebrief of the FRS & FRBMA

Edition: June 2024

Table of Contents

Letter from the Editor | FRS President's Message | FRBMA President's Message
Legislative Update | 2024 FRS & FRBMA Annual Meeting
Job Posting Opportunities | Become a PAC Member

FRS Membership
Dues

Please contact the American College of Radiology Membership Services at (800) 347-7748 to pay your 2024 Florida Radiological Society membership dues.

Meet Your 2023 - 2024 FRS Executive Committee


President Laura Vallow, MD	President Elect Juan Batlle, MD, FACR	Treasurer Andrew Bowman, MD, PhD


Secretary Edem Chen, MD	Past President Chintan Desai, MD, FACR	Radiation Oncology, Chair Jennifer Peterson, MD

Letter from the Editor
	Balancing Expertise: Navigating Simpson's Paradox in the Comparison of General and Subspecialty Radiologists for Informed Medical Decision-Making and Workforce Sustainability Simpson's Paradox, a well-known statistical phenomenon, occurs when trends that appear in different groups of data disappear or reverse when these groups are combined. This paradox can lead to misleading conclusions, particularly in the field of medical diagnostics, where comparing the performance of general radiologists and subspecialty radiologists might be critical for decision-making.
Understanding Simpson's Paradox Simpson's Paradox emerges when aggregated data masks underlying trends that are evident when the data is segmented. For instance, two distinct groups might show improvement over time when considered separately, but when their data is combined, it might suggest a decline or no improvement at all. This paradox emphasizes the importance of considering subgroup analyses in addition to overall analysis. The Role of Radiologists Radiologists play a crucial role in diagnosing and managing various medical conditions through imaging studies. General radiologists are trained to interpret a wide range of imaging studies across all areas of the body. In contrast, subspecialty radiologists have additional training in specific areas such as neuroradiology, musculoskeletal radiology, or pediatric radiology, allowing them to focus on a particular type of imaging or patient population.
Comparing General and Subspecialty Radiologists When comparing the diagnostic accuracy and efficiency of general radiologists versus subspecialty radiologists, Simpson's Paradox can significantly influence the conclusions drawn from the data. Consider a scenario where diagnostic accuracy is measured across different types of imaging studies (e.g., MRI, CT scans, X-rays). 1. Segmented Data Analysis: General Radiologists: MRI Accuracy: 85% CT Scan Accuracy: 80% X-ray Accuracy: 75% Subspecialty Radiologists: MRI Accuracy: 95% CT Scan Accuracy: 90% X-ray Accuracy: 88% 2. Aggregated Data Analysis: If the volume of X-ray studies is significantly higher than MRI and CT scans, the overall accuracy might be dominated by the X-ray accuracy, potentially leading to a misleading overall performance metric. For instance, if general radiologists interpret a higher proportion of X-rays compared to subspecialty radiologists, the aggregated accuracy for general radiologists might appear lower than that of subspecialty radiologists, even if their performance in MRI and CT scans is comparable or better.
An Illustrative Example Imagine a hospital dataset with the following distribution of cases and accuracies: General Radiologists: 300 X-rays with 75% accuracy 150 CT scans with 80% accuracy 50 MRIs with 85% accuracy Subspecialty Radiologists: 100 X-rays with 88% accuracy 150 CT scans with 90% accuracy 300 MRIs with 95% accuracy When segmented, the data shows that subspecialty radiologists outperform general radiologists in each category. However, when aggregated, the overall accuracy might suggest a different story if the proportion of X-ray cases (with lower accuracy) is higher for general radiologists.
Implications in Medical Decision-Making Understanding Simpson's Paradox is crucial in medical decision-making to avoid incorrect assumptions about the diagnostic capabilities of different types of radiologists. Hospitals and healthcare systems should consider the following: 1. Segmented Analysis Perform separate analyses for different types of imaging studies to accurately assess performance. Recognize the contexts and specific patient populations in which each type of radiologist excels. 2. Appropriate Staffing: Ensure the right mix of general and subspecialty radiologists based on the hospital's case mix and patient needs. Allocate cases strategically to maximize diagnostic accuracy and patient outcomes. 3. Continuous Training: Encourage continuous professional development for general radiologists to enhance their expertise in specific areas. Promote collaboration between general and subspecialty radiologists for knowledge sharing and improved diagnostic practices.
Weaponizing Simpson's Paradox Simpson's Paradox has occasionally been weaponized against individuals or groups to distort perceptions and support biased narratives. For example, in professional settings, aggregated data might be used to undermine the performance of a particular group by selectively presenting data that ignores important subgroup distinctions. This can be seen in cases where general radiologists' performance might be unfairly criticized by only presenting overall accuracy rates without acknowledging the higher proportion of challenging cases they handle. Similarly, subspecialty radiologists could be depicted as underperforming if data segmentation is manipulated to highlight their results in the few areas where their performance might be less impressive compared to their overall specialty. This misuse of statistics can lead to unjust consequences, such as skewed evaluations, biased policy decisions, and unwarranted professional repercussions. Unsustainability of High Degrees of Subspecialization Simpson's Paradox also highlights the potential unsustainability of an excessively high degree of subspecialization within the radiology workforce. While subspecialty radiologists bring valuable expertise in specific areas, an overemphasis on subspecialization can lead to inefficiencies and gaps in broader diagnostic coverage. In a healthcare system heavily skewed towards subspecialization, general radiologists may become undervalued despite their essential role in handling a diverse range of imaging studies. This imbalance can strain healthcare resources, as subspecialty radiologists might be overutilized for cases that general radiologists are fully capable of managing. Additionally, the training and maintenance of a highly subspecialized workforce are resource-intensive, potentially diverting funding and attention away from broader training programs. A balanced approach that appreciates the contributions of both general and subspecialty radiologists is essential for a sustainable and efficient healthcare system. Conclusion Simpson's Paradox serves as a reminder of the complexities involved in data analysis and the importance of context when interpreting statistical results. In comparing general radiologists and subspecialty radiologists, it is essential to look beyond aggregated data and consider the specific strengths and performance metrics in different imaging modalities. By doing so, healthcare providers can make more informed decisions, ultimately leading to better patient care and outcomes. Recognizing and guarding against the misuse of statistical phenomena like Simpson's Paradox is also crucial in ensuring fair and accurate evaluations in medical and other professional fields. Moreover, maintaining a sustainable balance between general and subspecialty radiologists is vital to optimizing healthcare resources and ensuring comprehensive diagnostic coverage. ChatGPT series#10
Edem Chen, MD Secretary, FRS

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FRS President's Message

Dear Members,
We are approaching our eagerly anticipated event of the year – the Annual Meeting of the Florida Radiological Society and Florida Radiology Business Management Association. Set to take place on July 19-21 at The Ritz-Carlton, Grande Lakes, Orlando, Florida, this promises to be a dynamic and enriching experience for all who attend.

The theme of the meeting is “Forging Ahead into the Brave New World of Radiology”. The meeting objectives include evaluating current socioeconomic issues facing the radiology and radiology-related specialties with an emphasis on preparing for change and understanding the technology and payment trends impacting the specialty over the next decade. There will be ample opportunities for networking and collaboration including a breakfast for the YPS, a Meet and Greet for Medical Students, and a Residency Program Job Fair. Not only a celebration of our society, but also an opportunity to reflect on our achievements and chart a course for the future.

Key Highlights:

Legislative Updates:
Join us in commemorating the milestones achieved by our medical community over the past year. From groundbreaking research to innovative healthcare initiatives, we have much to celebrate and acknowledge.

Educational Opportunities:
Engage in stimulating discussions and gain valuable insights through our diverse lineup of educational sessions. Explore emerging trends, best practices, and advancements, ensuring you stay at the forefront of your field.

Networking Opportunities:
Forge meaningful connections with fellow healthcare professionals from across the state. Exchange ideas, share experiences, and collaborate on ways to enhance patient care and address common challenges facing our industry.

Inspiring Keynote Speakers:
Prepare to be inspired by our lineup of distinguished keynote speakers, who will share their expertise.

Recognition of Excellence:
Join us Saturday evening for the Gold Medal Reception and Award Ceremony as we honor those with outstanding achievements.

Exhibition Hall:
Explore the latest advancements in medical technology and healthcare services at our exhibition hall. Connect with leading industry vendors and discover innovative solutions to enhance your practice.

Registration Information:
Registration for the annual meeting is now open! Don't miss out on this unparalleled opportunity to connect with colleagues, expand your knowledge, and contribute to the advancement of healthcare in our state. Secure your spot today by visiting our website at:

FRS Meeting

FRBMA Meeting

Join Us in Shaping the Future of Healthcare:
As we come together for our annual meeting, let us reaffirm our commitment to advancing the health and well-being of our communities. By sharing knowledge, fostering collaboration, and embracing innovation, we can create a brighter future for healthcare in our state.

We look forward to welcoming you to the 2024 Annual Meeting of the FRS and FRBMA and celebrating our collective achievements.

Warm regards,

Laura Vallow, MD
President, Florida Radiological Society
Vallow.laura@mayo.edu

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FRBMA President's Message
		Leadership in 2024 Last month we highlighted the challenges of managing a radiology practice in today’s world. A look at “What Keeps You Up at Night” covered a broad range of industry challenges and stresses. The key to navigating these storms is deeply rooted in leadership. Who are the leaders within your group, your practice, your administration? What makes them leaders and what support do they need to create a culture of success for your business?
Who are your leaders? Many would define leaders as those within your organization that are aptly titled e.g. President, CEO, COO, Director, Manager. While those are the formal titles that indicate leadership, they don’t represent the full spectrum of leadership within your teams. Leaders are individuals that have influence on a group of other individuals. Simply stated, leaders are people who have followers. The importance of recognizing these key personnel within your workplace is critical to the establishment of your desired corporate culture, along with your ability to strategically grow and succeed. From the new junior partner with the ability to engage other physicians and foster collective consents, to the front office registrar who is quick to share the benefits of enhanced workflows with their peers, these are leaders who influence and create an impact on the ease of change. A good analogy for this concept is a crew team. If all members of the team are rowing in sync and communication allows them to adjust quickly, they will move through the water smoothly and swiftly. It only takes one off- member to slow the process down or change its course altogether. Knowing who the recognized leaders are allows you to incorporate them into the process early, anticipate trouble areas and gain acceptance and buy in prior to implementation. In essence, rowing in the same direction.
What makes a strong leader? What makes a leader successful? We already identified the need for “followers”, but what is it about a person that results in them having followers”. There are a myriad of books touting the steps to great leadership, written by authors much better qualified than me, however there are some main concepts that thread their way through them all.
Integrity: As a leader, the importance of being true to yourself plays a big role in the garnering of trust and believability of your actions. A leader does not need to know all or be all but does need to have a firm understanding of their own strengths and weaknesses, along with the ability to acknowledge them when appropriate.
Communication: Leaders are encouraged to communicate accurately and often. But how we communicate is just as important as its frequency. Every time you write an email or text, you are sending a message that can be interpreted in many ways by the receiver. Misunderstandings can occur if you are quick to respond without context and your message is viewed as negative or dismissive. With zoom and in-person meetings, your body language speaks volumes and things like reading emails or glancing at your cell phone can lead team members to interpret your involvement as disinterested or even disrespectful. We are in an age of constant immediate communication with cell phones, message apps, email, and social media, and we need to be mindful of the unintended messages we are sending. No communication is also a form of communication that can lead your physicians to question your engagement, commitment, and abilities. Keeping stakeholders in the loop and focusing on responsiveness can assist in preventing side chatter and jumping to conclusions.
Humility: You are a leader because of others’ trust and confidence in you. Without them, you are no longer a leader. You may be a manager or director, but being viewed as a leader is something you have earned through respecting and elevating your team members. Creating an environment where each member is valued for their contributions and feels safe to explore and grow with the team is the hallmark and goal of leadership.
How do we support our Leaders?
Clear expectations and goals: Without a target, it’s tough for a leader to take aim and hope to hit a bullseye. As an organization, strategic planning and prioritization is the key to assisting our leaders in focusing the energy of their teams. Plans need to include timelines and KPI (key performance indicators) so all are aware of what a successful achievement will be like for the company. It also manages expectations for those creating the plan.
Recognition: Building performance recognition into your culture is something that is often considered and more often forgotten. We all know the importance of highlighting individual achievements and contributions, but too many times our busy work lives distract us, and we miss opportunities to engage and fuel the leaders of our teams. Assigning a team or individual to keep recognition within the framework of our daily organizational tasks can go a long way in assisting leaders who do not naturally home in on this aspect of leadership.
It Takes a Village: A leader’s work life can be somewhat lonely as their peer group is relatively small and, depending on the size of the group, don’t always have a readily available sounding board for their ideas and initiatives. Mentorship, networking, and continued education are all imperative to the growth and development of current and future leaders. We are lucky to have our own robust associations through RBMA and FRS that provide every level of resources and support that both tenured and emerging leaders can access. I strongly encourage supporting your leaders through encouragement in their participation!
Lisa Adams, CEO, MBA President, FRBMA

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Legislative Update
	The Governor is still receiving bills to act on; but, unfortunately the one bill most anticipated “the budget” still has not made it to his desk. He has been traveling around the state holding press conferences on parts of the budget that he supports and plans to act favorably upon. The prediction amongst the Lobby Corps is that he will receive the budget the beginning of June and all anticipate the veto pen to be used heavily.
Campaign season is well underway and I am busy traveling around the state and seeing Florida like a local. Please email if you have any thoughts, questions, or suggestions regarding the races in your local areas. Best,
Alison Dudley, FRS Lobbyist AlisonDudley@dudleyandassociates.com

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2024 Annual Meeting of the
FRS & FRBMA

Please join the Florida Radiological Society and the Florida Radiology Business Management Association for the 2024 Annual Meeting at the Ritz-Carlton Orlando Grande Lakes, July 19-21, 2024. The meeting will focus on “Forging Ahead into the Brave New World of Radiology” and will feature lectures by faculty who are leaders in the practice of radiology. We look forward to seeing you in July.

FRS Meeting Registration

FRBMA Meeting Registration

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Attend a sample of the Learning to Lead Bootcamp
at the 2024 FRS Chapter Meeting. Check out the spring RLI Learning to
Lead Bootcamp at www.acr.org/LearningToLead for additional training
and tools to address early leadership challenges.

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SUBMIT AN
ARTICLE

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Job Posting Opportunities

Florida Radiological Society is pleased to introduce the opportunity for interested parties to advertise for potential jobs in our monthly FRS Ebrief bulletin.

Advertisement pricing is as follows:

Ebrief Job Posting pricing:

3 months ($100 monthly)
6 months ($90 monthly)
12 months ($80 monthly)

Please contact Lorraine Roger, our Society Administrator for further information on how to advertise in our monthly publication.

Phone: (813) 806-1070
Fax: (813) 806-1071
Email: lroger@flrad.org

We feel that this will provide a valuable service to both our members and our Florida community of Radiology.

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Become A PAC Member Today
Attention FRBMA Members! Please support the cause. We encourage you to be PAC members and supporters; you do not have to belong to the FRS. Donations can be made online through our PAC website www.FLRADPAC.org. Thank you for your donation. It is critical that we support both our Florida PAC and RADPAC in order to bolster our voice in Tallahassee and Washington, respectively. Please join FRS lobbyist Alison Dudley in her special appeal for all Florida radiologists to become Florida PAC members. If you would like to help FRS defend radiology against untoward legislation and introduce bills that have a positive impact on our practices, we need your financial support to re-elect our friends in the state House and Senate. The FRS can also show you simplified ways on how to sign up your radiology group. Contact Lorraine Roger or contact Alison Dudley for more information.

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Telephone (813) 806-1070
Fax (813) 806-1071

5620 W. Sligh Avenue
Tampa, Florida 33634

The E-Brief is an exclusive member benefit of Florida Radiological Society, delivering monthly member, chapter and industry news. Please do not reply to this automatic e-mail. For comments or questions about the E-Brief, please contact lroger@flrad.org.