and, if so, what do they recommend to
ameliorate the issue?” was addressed in
this research predominantly through the
viewpoint of the radiology administrator
with little feedback from the other two
groups. The recommendations to ameliorate the issues stem from best practices that have been put into place: 49%
are using ACR appropriateness criteria,
29% are using FDA recommendations,
while 33% are doing nothing at this time.
However, no one strong recommendation came out of this study.
Of those who do have something in
place, the ACR guidelines are most prevalent, which may be due to more organizations becoming accredited by the
ACR which forces them to put some of
the ACR policies and practices into place.
FDA recommendations were also commonly used. Some of the more common
open-ended responses to the question of
what practices are in place to address the
issue included having radiologists more
involved in consultation for appropriate
exam to be performed, types of organizational guidelines on ordering, and decision support software.
Eighty four percent of respondents
who have a program in place did so because of concerns of radiation exposure
in CT. Fifty six percent did so because
of their concerns with healthcare costs.
Radiation exposure and healthcare costs
were prevalent in previous studies, as well.
The recognition of overutilization ex-
ists; however, many still have not put a
program in place to help with mitigation.
The original intent of this study was to
get a good sample from the three groups
mentioned (radiologists, radiology tech-
nologists, and radiology administrators).
Due to constraints on a means to suc-
cessfully reach radiologists and technolo-
gists, the survey population was heavily
weighted with the opinions of radiology
administrators. Suggestions for addi-
tional research would be: a survey to the
other two groups, as well as a survey to
referring physicians who frequently use
these imaging modalities. This would
be helpful in determining the reasons
for the increases in utilization. From the
literature review, ED physicians seem to
be the biggest users of these two modali-
ties. Targeting this group may be a good
place to start with understanding order-
ing practices. It would also be useful to
send this survey out in another five years
to the same group to see if practices have
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Joe Gonzales is a senior manager for clinical
operations in radiology at Kaiser Permanente, where
he is responsible for the operations of 21 outpatient
radiology departments. He has a master of science in
health services administration (MSHSA) from Regis
University, and a bachelor of science in medical
imaging management. Joe has worked in multiple
areas of radiology as a RIS administrator, CT
technologist, interventional technologist, and
multiple management positions. He can be contacted