is a staff Neuroradiologist, Department of Radiology,
Weill-Cornell Medical College/New York-Presbyterian Hospital, New
York, NY. He is also a member of the editorial board of this
I try to keep my small but modestly loyal readership in touch.
I'm moving from the land of Jefferson and going north to NYC. A bit
of a step, admittedly, but change is a good thing.
Last time we talked, I promised you that Mr. Know-a-Few-Things
(or Mr. KAFT) would answer your questions, and he's ready.
Why have reimbursements for radiology fallen so precipitously?
Doesn't anyone have a few softballs to start with? No important
memo is time-stamped 8:01 AM! I have to start sloooowly.
What possessed someone to flavor barium with strawberry? Why not
I have pondered this very question and I've come up a throwback.
What possessed someone to scent bathroom deodorizers with lemon?
That same person did the strawberry.
How can we be sure to get appropriate clinical information on
requests from the ED? We're really tired of "rule out disease."
A Glock 9 mm is an effective tool for obtaining good, if not always
reliable, data. Just kidding. Actually, the best way to get good
data on requests is to kick out the power cord for the computerized
entry system, so someone has to call to tell you why they want that
CT. On the phone. In person. Back to the future!
We've had difficulty communicating emergent results to clinical
staff. They often order urgent exams, and then disappear from the
face of the earth, and no one at their office will take
responsibility for informing them. How does Mr. KAFT deliver urgent
I like to have reports delivered telepathically. The documentation
is a bit tough, though.
How do you manage groins at the conclusion of an interventional
Oh, Mr. KAFT does not like sticking his fingers around the naughty
bits of strangers. The tried-and-true avoidance method is to be
paged right when it's time to compress, so you can leave it in the
hands of a resident who was a former linebacker for Penn State.
What advice do you have for those of us fighting turf battles for
medical imaging now?
Have no fear. As soon as the reimbursements reach the levels we
will see in the next year or so, we will finally get relief from
the turf wars. Admittedly, it will look a bit crazy to be the sole
clinical service to interpret a highly complex medical study
fraught with potential medicolegal hazards, which require our
services 24/7, for less than what our plumber charges to clear a
clogged toilet, but hey, Mr. KAFT can't make
Hey, I want to know why radiology reimbursements have fallen so
Sigh. . .. Well, I guess Mr. KAFT will have to answer this. It's
pretty simple, isn't it? Read the answer to Q6. We've negotiated
ourselves down to the lowest figure imaginable, to drive everyone
else out. See? Isn't that a great business model?!
Mr. Know-a-Few-Things will return later. Keep those burning
questions coming in, and we'll see if we can get you some answers.
Be careful what you ask, however. No bad intentions, or subtle,
tricky questions. I asked Mr. Know-a-Few-Things what the sound of
one hand clapping was, and he slapped me hard over the ear, and
laughed hysterically. Mahalo.