A Message from the President of the CAR

Transformation takes vision and a lot of hard work

My first message to you as president of the CAR in 2011 included the following quotation by Charles Darwin, the English naturalist: “It is not the strongest of the species that survive, nor the most intelligent, but the one most responsive to change.” (en.proverbia.net)

With that in mind, the CAR undertook a strategic planning process to help us identify the most important issues around which we need to be responsive. The CAR created a 2012-2016 five-year strategic plan that revolves around four main strategic goals in the areas of: quality assurance and patient safety; advocacy; member engagement; and resilience.

In response to you, our members, indicating to us that the CAR needs to enhance its ability to advocate on behalf of our profession, we are currently working with a national public relations firm to unfold a national advocacy strategy. This also harkens back to a promise I made to you when I took on this role, to advocate on your behalf, both to government and to the public, and to work towards better communication and coordination with our provincial associations to meet the many challenges we are facing. Let me share some of what we’ve undertaken towards fulfilling that promise.

Although a renewal of a federal health accord such as the one implemented in 2004 is not on the horizon for 2014, all of the expert guidance we have received indicates that it is critical for national associations to continue to engage with the federal government on matters of healthcare as it is a national issue. Whether it’s working with the Canadian Medical Association (CMA), Wait Time Alliance (WTA), or the Health Action Lobby (HEAL), to name a few, we continue to build a strong presence on the pan-Canadian front.

We have endorsed such initiatives as the national Principles to Guide Health Care Transformation in Canada, partnered with other national organizations to hold a Canadian Clinical Practice Guidelines Summit, and provided input on medical imaging, through the WTA, to the Standing Senate Committee on Social Affairs, Science and Technology for its review of the progress of the 2004 Health Accord. In its report, Time for Transformative Change, the Senate committee recommended that “provinces and territories continue to develop strategies to address wait times in all areas of specialty care” and that “the federal government work with provinces, territories and relevant healthcare and research organizations to develop evidence-based pan-Canadian wait time benchmarks for all areas of specialty care that start when the patient first seeks medical help.” The CAR recently released its paper National Maximum Wait Time Access Targets for Medical Imaging (MRI and CT) in March 2013. Engagement at the federal level remains critical.

We are also extremely pleased with the strong collaborations we have had with our fellow medical imaging organizations. A high note has been establishing an annual Medical Imaging Team Day to bring attention to the team that works together in imaging care. Continuing to partner with us on this initiative are the Canadian Association of Medical Radiation Technologists (CAMRT), the Canadian Association of Nuclear Medicine (CANM), the Canadian Interventional Radiology Association (CIRA), the Canadian Organization of Medical Physicists (COMP), and the Canadian Society of Diagnostic Medical Sonographers (CSDMS). Our first event in 2012 included a press conference, meetings held at Parliament Hill and the release of a paper on appropriateness, with plans in 2013 to produce a highly sought-after resource for patients regarding medical imaging.

Internationally, we continue with strong working relations with the American College of Radiology, the Radiological Society of North America (read more about our work with the RSNA in this eNewsletter), the Royal College of Radiologists (U.K.), the Royal Australian and New Zealand College of Radiology, the Société Française de Radiologie, along with collaborations such as the International Radiology Quality Network.

A primary focus for me during my term as your president has been working with our fellow provincial associations. This is also a key component of our advocacy strategy. As I toured from coast-to-coast, it was clear that the issues facing some of us in one province inevitably affect us all. Questions around the quality of our expertise and the relative value of our services have unfairly singled us out, while technological advances have allowed what we do to become more accessible and under greater scrutiny than that of any other physician group. Recent approaches to healthcare negotiations that exclude the physician have left us feeling undervalued and, not surprisingly, concerned about the future of our profession. The CAR continues to offer support to provincial radiology associations as they navigate jurisdictional issues, such as our statement on how excluding physicians from healthcare reform is not a formula for success or coordinating national exchanges on important topics, such as peer review or point-of-care ultrasound, the latter for which the CAR is developing a position paper, in collaboration with other national bodies, to be completed in spring 2013.

There is no question that the models of healthcare reform most often proposed point towards more accountability on all levels. Whether it is the formation of provincial Health Quality Councils, the federal government unexpectedly distancing itself from healthcare direction, the Council of the Federation of Premiers initiating national strategies on clinical practice guidelines (CPGs) and appropriateness, or provincial governments making unprecedented decisions on funding, the system is transforming. However, we believe this transformation may not always represent the best way forward for Canadian patient care. Therefore, we need to determine our own destiny and not have others dictate it. We need to show governments that not only do we have the necessary solutions to provide the highest quality patient care, but that we can also ensure that they are spending their healthcare dollars appropriately. This is by no means easy, but we must be at those tables.

While we address the critical issues facing our profession at a leadership level, the CAR has also progressed in the development of many practical tools and guides for medical imaging. Some of those produced  during my term as president of the CAR include: A Step-by-Step Guide to Maximizing the Effectiveness of Clinical Audits; The CAR Guide to Peer Review Systems; Medical Imaging Primer With a Focus on X-Ray Usage and Safety; updated 2012 CAR Diagnostic Imaging Referral Guidelines; six new practice guidelines in the past two years with the CAR Practice Guidelines and Technical Standards for Breast Imaging and Intervention and CAR Technical Standards for Bone Mineral Densitometry Reporting coming in the weeks ahead; National Maximum Wait Time Access Targets for Medical Imaging (MRI and CT) report released earlier this week; and lifecycle of equipment guidance coming in summer 2013.

We believe that any achievements we make require both the more seasoned of us as radiologists working alongside new radiologists and residents. It is with this in mind that the CAR continues to expand its outreach and programming for radiology residents. Read more on some of those efforts in this eNewsletter, and let’s encourage residents and new radiologists to become active in the CAR. In this important area of training, we also continue to work closely with national groups like the Canadian Heads of Academic Radiology (CHAR) and the Canadian Radiology Program Directors.

In regards to educational and networking opportunities, we have fine-tuned our focus on providing uniquely Canadian opportunities. Our Annual Scientific Meeting (ASM) has gotten bigger and better each year – with another exceptional one coming up next month with the theme of Quest for Quality: More Than Just an Image. For more information or to register online, click here. Our annual CAR Canadian Reception at the RSNA which takes place during the RSNA Annual Meeting each year also continues to get bigger and better, becoming a go-to event on many schedules, with between 350-400 attendees this past year.

Now, to return to the title of my message – transformation takes vision and a lot of hard work. We have a lot of both, vision and hard work in our organization. Thank you to our excellent CAR staff who work on our behalf each and every day, and to our more than two hundred incredible volunteers who are actively engaged in all areas of the CAR.

I am privileged to have been involved firsthand in all that we are doing for Canadian radiology through the CAR as your president these last two years. As I near the end of my final president’s eNewsletter message, I encourage you to sign up now for your 2013 CAR membership if you have not already done so. We are making a difference and I am excited about the direction we are taking. However, there is still much to do, which is why, when you see requests come through your email or when you get a call from a colleague in the months ahead seeking volunteers, please consider how you can contribute. I can assure you that the effort is worth it.

Finally, it is you who give me the confidence that we can achieve a successful future for Canadian radiology. Let’s continue this journey of transformation together.

Sincerely,

 

 

 

 

Dr. James Fraser
President, Canadian Association of Radiologists

Advocacy for Radiology

The CAR undertook a strategic planning process in 2011 and has developed a five-year strategic plan (2012-2016) around quality assurance/patient safety, advocacy, membership engagement and resilience. In addition, in early 2012, the CAR approved a body of work focussed on quality improvement (QI) which looked at how accreditation, radiation safety, guidelines, peer review, credentialing, and reporting all play roles in the continuous improvement of the radiology profession and our individual practices. The CAR intends to develop its focus into a white paper to share what we view as important directions for the future of Canadian radiology.

Here are just some of the other activities the CAR has been involved in or initiatives it has been developing to strengthen its position as an effective advocate for the profession of radiology:

CAR now a member of HEAL

The CAR is pleased to count itself among the 35 members of the Health Action Lobby (HEAL), a national coalition dedicated to sharing information across organizations, working on strategic issues of mutual importance, and working with external organizations to discuss issues that affect all of its members. It is also a group that is approached regularly by federal and provincial governments for consultation on various issues affecting healthcare.

The CAR took part in its first HEAL meeting in December 2012. Speakers at the event included Ms. Libby Davies, NDP Deputy Health Critic and Deputy Leader, Government of Canada, and The Honourable Fred Horne, Minister of Health, Government of Alberta.

Council of Federation

The Council of Federation (CoF) is an institution created by the provincial Premiers to address issues that affect all Canadians. One of those key issues is healthcare. Early in 2012, the CoF developed a Health Care Innovation Working Group (HCIWG) to drive a collaborative process for transformation and innovation to help ensure the sustainable delivery of healthcare services to all Canadians.

In the summer of 2012, the HCIWG announced that they would be addressing the issue of appropriateness in diagnostic imaging in the next phase of its work. The CAR, with the support of its medical imaging team partner organizations and other organizations, has been working to provide guidance for this initiative. As President of the CAR, Dr. James Fraser says in his message in this eNewsletter, “We need to show governments that not only do we have the necessary solutions to provide the highest quality patient care, but that we can also ensure that they are spending their healthcare dollars appropriately. This is by no means easy, but we must be at those tables.”  

Future Scanning and Signposts Working Group

The CAR recognizes that changes are constantly taking place in the practice of radiology. In order to remain current on the potential changes and influences on medical imaging and the overall profession of radiology, the CAR has initiated a working group of individuals that provide input to the CAR Board of Directors on emerging technologies and national and global trends, imaging related and otherwise, what will be referred to as signposts of change. The perspectives provided by the Future Scanning and Signposts Working Group will be used by the CAR Board each year to reaffirm the direction of its strategic plan and help the CAR to re-adjust its direction or focus, if necessary, as it moves through its five year plan.

RSNA and CAR Continue Alliance for Education in Radiology

The Canadian Association of Radiologists (CAR) and the Radiological Society of North America (RSNA) have enhanced their long-standing relationship by expanding opportunities for continuing professional development. This includes a recent approval by the CAR through the Royal College of Physicians and Surgeons of Canada (RCPSC) for radiologists to earn credit hours for self-assessment modules (SAM) awarded through in-person attendance at the RSNA Scientific Assembly and Annual Meeting, the RSNA journal, RadioGraphics through November 2015, and the RSNA Online Self-Assessment Modules through August 2013.

The CAR Canadian Reception at the RSNA has also proven to be a lasting event at the RSNA Annual Meeting, garnering upwards of 350 attendees at last year’s reception. “Every year, I’m astounded at just how much this has become a go-to event for Canadian radiologists,” said Dr. James Fraser, President of the CAR. “It keeps getting bigger and better, and really marks the Canadian presence at the RSNA.”

“The relationship between the Radiological Society of North America and the Canadian Association of Radiologists has proven to be strong and benefit the members of both societies,” said Dr. Sarah S. Donaldson, RSNA 2013 President. “The value of this relationship was highlighted this year when my fellow board members and I were honored to announce Dr. James D. Fraser from Queen Elizabeth II HSC/NHI Site in Halifax, Canada as the RSNA 2012-13 Second Vice President.”As part of the continued relationship, Dr. Sarah S. Donaldson will attend and present at the CAR 76th Annual Scientific Meeting in Montreal in April 2013.

Among those in the forefront of the international radiology community, Canadians have significantly contributed to scientific research and advanced radiology education. This involvement was showcased at the 2012 RSNA Scientific Assembly and Annual Meeting where 189 speakers from Canada were selected to present and thirty-five companies participated in Canada’s Country Pavilion, located in the technical exhibit hall. Of the 1,080 Canadian Annual Meeting attendees, nearly 20% (203) were medical students, residents and fellows – the future of radiology.

As innovators in radiology research, RSNA awarded over $70,000 in research grants to six Canadian researchers in 2012. Five of the six grant recipients were medical students or residents. Additionally, ten honorees from Canada received the Roentgen Resident/Fellow Research Award, which recognizes and encourages outstanding young radiologic researchers.

Currently, 21 of the Society’s Canadian members serve as volunteers on 22 RSNA committees. Also, in 2012, a neuroradiology specialist from Canada traveled to El Salvador as part of the RSNA International Visiting Professor Program. This program supports small teams to lecture at national or regional radiology meetings of societies in or serving developing nations, as well as at selected host institutions with radiology residency training programs, in those countries.

Call for Volunteers

CAR working groups are composed of volunteers, mostly radiologist members and other medical specialists as required, who assist, guide, consult, create materials, research or advise as necessary to ensure that their assignments reflect the most accurate and professional results.

Many working groups are put in place to provide the CAR staff with advice/direction on very specific operations or programs run by the CAR office, such as the CAR’s Mammography Accreditation Program and each year’s Annual Scientific Meeting. Working Groups are also established to help the CAR formulate policies and timely guidance on very specific topics, such as position statements and advisories, or broad policies such as for finances, which are sent to the CAR Board of Directors for consideration and adoption. All Working Groups are task-specific and time limited, which can range from weeks to months or longer if required.

The CAR currently relies on the generosity of over two hundred volunteers to help carry out vital work in the areas of quality assurance, continuing professional development, and accreditation. If you are interested in contributing to the advancement of your profession, the CAR is currently in need of motivated volunteers for the following working groups:

 

We encourage our members to participate on our working groups. There is great satisfaction in having an opportunity to shape the future of radiology. To volunteer for one of the CAR working groups, and to learn more about the above opportunities, please contact us.

CPD – Useful Information

As an accrediting agent of the Royal College of Physicians and Surgeons of Canada (RCPSC) for continuing professional development activities, the CAR takes pride in developing continuing professional development (CPD) courses of the highest standards and in keeping its members informed of radiology-focused CPD opportunities. The CAR also strives to keep its members informed of relevant and helpful information on CPD opportunities and RCPSC MOC credit regulations.

Working group members eligible for Section 2 RCPSC credits

Members of CAR practice and referral guideline development working groups are reminded that they are eligible to claim up to 20 Section 2 credits per year towards the Royal College of Physicians and Surgeons of Canada (RCPSC) Maintenance of Certification (MOC) Program. For more information, visit www.royalcollege.ca/portal/page/portal/rc/members/moc.

Claim RCPSC credit for AMA-accredited activities

Thanks to an agreement between the RCPSC and the American Medical Association (AMA), Canadian radiologists taking part in AMA-accredited courses can enter these on MAINPORT to claim RCPSC credit. For more information, visit the MOC Frequently Asked Questions section of the RCPSC website at www.royalcollege.ca/portal/page/portal/rc/members/moc.

Insights4Imaging available online

Radiologists are reminded that Insights4Imaging, the Canadian Association of Radiologists Journal (CARJ) self-assessment program, is now available online. To access Insights4Imaging and earn Section 3 RCPSC MOC credits, visit http://cpd.car.ca/.

RSNA and CAR Continue Alliance for Education in Radiology

The CAR and the Radiological Society of North America (RSNA) have enhanced their long-standing relationship by expanding opportunities for continuing professional development. This includes a recent approval by the CAR through the RCPSC for radiologists to earn credit hours for self-assessment modules (SAM) awarded through in-person attendance at the RSNA Scientific Assembly and Annual Meeting taking place in November 2013, the RSNA journal RadioGraphics through November 2015, and the RSNA online SAMs through August 2013.

CAR resources to be highlighted at MIIT conference

Two CAR resources, The CAR Guide to Peer Review Systems and the new Medical Imaging Primer With a Focus on X-Ray Usage and Safety, will be highlighted at the 9th edition of the Medical Imaging Informatics and Teleradiology conference. For more information on this conference and other high-quality educational opportunities, visit the Upcoming CME Events webpage on the CAR website.

2013 CAR Membership

If you haven’t already renewed you CAR membership for 2013, we urge you to do so today! It is increasingly critical that we lead Canadian radiology towards a bright future, by proactively taking charge of our profession and showing ourselves to be medical leaders. The CAR leads through its quality initiatives, which serve to sustain and protect the profession of radiology while advancing the best imaging care possible for patients.

The 2013 CAR membership fee for a full CAR member is $780.00. For more information on the different member dues and categories, click here.

The earlier you pay your dues, the easier it is for the CAR to plan for our many endeavours slated for 2013. Paying by March 31 ensures no interruption in the delivery of your CAR Journal and entitles full members to vote at our Annual General Meeting (AGM), taking place during the CAR 76th Annual Scientific Meeting on April 27, 2013. Voting at the AGM is a vital component of being a CAR member because the CAR works on your behalf. Have your voice heard and become a member in time to vote at the AGM.

You may select one of the following options to pay your 2013 CAR dues:

 

When renewing your membership, kindly consider making a donation to your Canadian Radiological Foundation (CRF). As a registered charity, the CRF undertakes critical research and educational projects which benefit Canadian radiology and help to establish radiologists as leaders on the international stage.

We look forward to your support in 2013!

ASM – Update!

The CAR 76th Annual Scientific Meeting is just around the corner! The meeting has grown tremendously over the years, and is sure to be better than ever! Taking place from April 25 to 28, 2013 at Le Centre Sheraton in Montreal, Quebec, the theme of the event is Quest for Quality: More Than Just an Image.

Featuring an impressive roster of national and international speakers, the comprehensive program will cover relevant topics for today’s radiologists and radiologists-in-training including oncological imaging, high-resolution chest CT, body MRI, cardiovascular imaging, obstetrical imaging, and a special MSK Live Ultrasound Simulation Workshop, to name a few.

The CAR has also planned some exciting social events including the CAR Annual Dinner and Awards Gala, an ultimate Canadian cocktail party, a reception for radiologists-in-training, and much more.

Among the excellent speakers, this year's keynote speakers will be Dr. Ramin Khorasani from the Brigham and Women’s Hospital and Dr. Evan Siegelman from the Hospital of the University of Pennsylvania. For the full provisional meeting agenda, click here.

For more information, or to register for this event, click here.

Residents’ Corner

Are you looking for a great resident-focused learning opportunity and networking event all in one? There’s still time to register for the CAR 76th Annual Scientific Meeting, taking place in Montreal from April 25 to 28, 2013. As part of its comprehensive meeting programme, the CAR has developed nine Resident Review sessions, an opportunity to interactively interpret over 90 cases focusing on MSK, nuclear medicine, mammography, vascular and interventional radiology, and much more. This will be followed by Resident Hot Seat Sessions, an afternoon of small group sessions, requiring on-the-spot interpretations and followed by practical feedback from experts. To finish it off, an exclusive evening cocktail for radiologists-in-training will be hosted by the President of the CAR and will be attended by CAR executives and board members – a perfect opportunity to network and make new acquaintances in the field of radiology.

One of the resident attendees of a past ASM, Dr. Stefanie Lee, noted that, “It was my first time at this conference, and I quite enjoyed it. All the sessions were interesting and interactive, and I was impressed by how much of the programming was geared towards residents. The practice and feedback from the hot seats were especially valuable, as we can definitely benefit from more simulated orals earlier in our training. Thank you for all of your efforts in putting these together, and I'm looking forward to attending again in the future!”

To register for the meeting or for more details including the provisional agenda, click here.

Threshold for Eye Lens Lowered by the ICRP

The work of the International Commission on Radiological Protection (ICRP) helps to prevent cancer and other diseases and the effects associated with exposure to ionising radiation, and to protect the environment. Although issued just under two years ago, its recommendations regarding the threshold in absorbed dose for the lens of the eye may not yet be known to all Canadian radiologists.

According to a statement released in April 2011, the recommendations state that the threshold in absorbed dose for the lens of the eye is now considered to be 0.5 Gy. Additionally, for occupational exposure in planned exposure situations, the Commission now recommends an equivalent dose limit for the lens of the eye of 20 mSv in a year, averaged over defined periods of five years, with no single year exceeding 50 mSv.

For further details, please refer to the ICRP Statement on Tissue Reactions, available here. To access all ICRP publications, visit www.icrp.org/publications.asp.

CARJ Mobile Apps Are Here!

CAR members now have access to the Canadian Association of Radiologists Journal (CARJ) through free mobile apps – you will just need your username and password from the journal website in order to read journal articles on your iPad or smartphone.

If you have not yet set up your CARJ online account, you can do so easily by clicking here. Please note that you will need to enter your CAR member ID to set up your account. If you do not know or have forgotten your CAR member ID, contact the CAR at [email protected] or at 613 860-3111 ext. 0. On subsequent visits to the CARJ website, you will be able to read full journal articles using only the password you have selected.

Insights4Imaging available online

Radiologists are reminded that Insights4Imaging, the CARJ self-assessment program, is now available online. To access Insights4Imaging and earn Section 3 Royal College of Physicians and Surgeons of Canada (RCPSC) Maintenance of Certification (MOC) credits, visit http://cpd.car.ca/.

National Physician Survey – your input matters!

All physicians in Canada are invited to complete the National Physician Survey (NPS) between April 2 and May 31, 2013. The Canadian Association of Radiologists (CAR) has joined with Canadian health care leaders in support of this important initiative. Brief and confidential, the NPS is a unique opportunity to share your views and help shape the future of Canadian health care.

Add your voice to Canada’s largest physician workforce survey

The NPS is administered by the College of Family Physicians of Canada (CFPC), the Canadian Medical Association (CMA), and the Royal College of Physicians and Surgeons of Canada (RCPSC). An invitation with a personalized survey link will be emailed to you in the next weeks or you can visit the NPS website to find out how to take the survey. It will only take 10-15 minutes to complete, and you can earn CPD credits quickly and conveniently.

The NPS takes the pulse of Canada’s medical profession through input from Canadian physicians, residents and medical students. Your input helps identify priority issues and trends that will help influence health care planning, research, policy, curriculum development and advocacy.

Participate and you could win $1,000!

Taking the survey makes you eligible to win one of the two $1,000 prizes!

To learn more or examine past survey results, visit www.nationalphysiciansurvey.ca.

Publication of Results

Survey results will be available by fall of 2013, on the NPS website. The next physician iteration of the NPS is also scheduled for next year.