“Now, even at the most ‘academic’ of medical schools, the clinical faculty are paid directly by health systems, their salaries depend on their ability to generate fees, not research papers, and their time is managed by service line administrators.”
– Baylor University cardiologist, Milton Packer MD, arguing that the traditional med school business model (making great MDs and producing great research) is now “dead,” replaced by the new goal of generating fees. Sounds a lot like college sports.
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Med’s Dead, Baby
Baylor University’s Milton Packer MD made waves across the medical and academic communities, declaring the med school business model “officially dead.” Grant-funded production of great doctors and great research, along with providing great patient care, may have been the med school model between the 1950s and 1980s. However, Packard argues that increases in healthcare funding made producing doctors and research much less important over the last 30-something years. All you have to do is follow the money, as “even at the most ‘academic’ of medical schools, the clinical faculty are often paid directly by health systems, their employment and salaries depend on their ability to generate fees, not research papers, and their time is managed by healthcare and service line administrators. . .” Meanwhile, the folks in academic leadership positions (deans, etc.) who don’t have authority over the health system or service lines have been relegated to “figureheads . . . relics of an obsolete structure, which has no funding and little decision-making capacity.” Healthcare Twitter seems to largely agree with Dr. Packard on this one.
Konica Minolta Gets Precise
Konica Minolta’s late 2017 acquisitions of Ambry Genetics (genetic testing) and Invicro (imaging CRO) have been widely viewed as moves to help the company enter the Precision Medicine arena and diversify beyond radiology. Although this perception isn’t incorrect, Konica Minolta’s RSNA booth revealed a much stronger connection between its two healthcare pillars than many in the industry may realize. One of the best examples of this connection is Ambry’s new C.A.R.E Program, which can integrate genetic cancer risk data into imaging center workflows, giving clinicians greater patient insights to support their image diagnosis and follow-up recommendations (e.g. additional scans or ongoing screening). Konica Minolta isn’t the first to tie radiology into precision medicine, but it’s RSNA messaging and recent acquisitions reveal a far greater (and more-balanced) focus on precision medicine than most of its imaging rivals.
German Students, Not Afraid of AI
Several weeks after a survey revealed that an incredibly-high 67.7% of Canadian radiology students (n=322) believe AI will reduce demand for radiologists, University of Cologne professor, Dr. Daniel Pinto dos Santos, took the stage at RSNA to highlight very different findings. His study revealed that 83% of students at three of Germany’s major med schools (n=233) did not believe radiologists would be replaced by AI, although the vast majority believed AI would revolutionize (77%) and improve (86%) radiology. It’s debatable whether AI “reducing demand for radiologists” and “replacing radiologists” are directly comparable (the German study didn’t go into demand), but it’s very possible that both sides are right.
The Non-Rad Imaging Business
Non-radiologist physicians, especially cardiologists, can make a lot of money from medical imaging. This is according to research performed by a team of radiologists (you guessed it…), who found that the 25 non-radiologists with the greatest medicare billings generated a greater share of reimbursements from imaging than other lower-earning non-rads. The highest-earning Cardiologists stood out, attributing a whopping 18.3% of their billings from imaging ($578,265 mean), followed by vascular surgery (11.6%, $364k), obstetrics and gynecology (10.9%), and orthopedic surgery (9.6%, $113k), while the most common non-rad imaging payments were from ultrasound (45%) and cardiac nuclear medicine (40%) studies.
AI for Imaging Cybersecurity
Combining two of 2018’s hottest medical imaging topics (cybersecurity and AI), researchers from Israel’s Ben-Gurion University introduced an AI-based security system that can identify if a CT scanner received a malicious command and then respond by notifying an operator or potentially stopping the CT system. The security system features various advanced machine learning and deep learning methods that are trained on actual CT commands, allowing it to spot any illegitimate commands. Makes sense. The researchers focused on CT systems given a CT hack’s ability to harm patients (by increasing radiation exposure or altering imaging results), although this approach could likely be used on many connected medical device types. It’s been an interesting few years for medical cybersecurity, driving increased awareness of potential threats and increased debate over who’s responsible for protecting devices, and although this solution may not make it onto imaging devices (at least in the near term), this team’s approach and the goal behind it have some potential.
- Here’s another side of the med school business model story at the top of this issue. New research (n=47) from the University of Pittsburgh Medical Center found that radiology medical students using web-based radiology curriculum hosted on Radiopaedia.org achieved better mean knowledge scores (74%) than their peers who used traditional learning materials (68%).
- Shine Medical Technologies closed a $150 million financing commitment from healthcare investing firm Deerfield Management to fund the construction of Shine’s molybdenum-99 (Mo-99) manufacturing facility in Wisconsin and to support the company’s operations before it begins production in 2021. Shine expects to be able to support one third of global demand for the often-scarce imaging isotope once the facility reaches full capacity.
- Signify Research revealed that 2018 will be another strong year for the global ultrasound market with 6.6% global growth, driven by rising demand in China, as well big increases in India, Russia, Eastern Europe, and Brazil. The US will end 2018 up by a solid 5%, driven by strong demand for radiology, cardiology, and point-of-care ultrasound applications. Signify foresees more global ultrasound growth in 2019, although regional contributors to the modality’s growth will change (e.g. expecting more growth from W. Europe).
- A team of international researchers took the stage at RSNA with findings that MRI lung cancer screening is as effective as low-dose CT screening in terms of life years saved, while creating up to five-times fewer false-positives and related follow-ups than CT (significantly reducing financial and time costs). The researchers attributed MRI’s lung cancer screening advantage to its greater specificity for characterizing solid nodules.
- Guerbet announced the CE clearance of its OptiVantage multi-use, syringe-based CT injector, revealing plans for an EMEA launch in January and later expansions to Asia and Latin America. The new version expands the well-established OptiVantage injector system to a market segment responsible for over half of all worldwide CT procedures.
- MEDNAX continued its radiology practice acquisition spree, acquiring Boynton Beach, Florida-based Bethesda Radiology Associates, and integrating it with MEDNAX’s Radiology Associates of South Florida practice (was acquired by MEDNAX last year). This acquisition appears to have direct ties to the 2017 merger of Baptist Health South Florida (contracted with MEDNAX) and Bethesda Hospital (prev. contracted with Bethesda Radiology Associates), uniting the greater Baptist Health system under a single provider. It’s also another sign of MEDNAX’s increased acquisition focus, as five of the nine radiologist practice acquisitions in its history happened in the last 14 months.
- A recent study performed by Bayer HealthCare scientists found 38 to 69-times higher concentrations of linear gadolinium agents in rats’ brains (mean: 1.91/2.13/3.38 nmol/g) a year after administration than in rats subjected to macrocyclic GBCAs (mean: 0.04/0.07/0.08 nmol/g), with the macrocyclic rats showing concentrations comparable to rats in the study’s saline control group. Like most of its competitors, Bayer produces both linear and macrocyclic GBCAs, although this finding certainly helps support its popular macrocyclic Gadavist/Gadovist MR agent.
- GE Healthcare and the VA Puget Sound Health Care System signed a research partnership intended to reduce the time it takes for radiologists to create 3D-printed models and prosthetics “from hours to minutes.” GE Healthcare will provide its AW VolumeShare workstations with 3D printing software at five VA facilities, replacing 3D software that wasn’t designed for medical use. The VA facilities will develop new 3D printing approaches and provide GE with feedback to help advance the use of 3D.
- ScreenPoint Medical announced the FDA clearance of its AI-based Transpara software used to help radiologists detect breast cancer in mammograms, reaching the US after Transpara’s mammography and DBT versions gained CE clearance (DBT version still investigational in the US). ScreenPoint’s US expansion comes as part of the company’s new distribution agreement with breast imaging analytics company, Volpara, which will offer ScreenPoint’s AI solutions within the VolparaEnterprise AI cloud ecosystem to its global clients.
- Ambra Health announced the launch of the Ambra Health Cloud PACS solution for Google Cloud, which leverages Google Cloud’s Healthcare API, and allows healthcare researchers to access and then anonymize imaging data.
- Glassbeam announced a technical collaboration with healthcare CMMS company, EQ2. Through the partnership, EQ2 will integrate Glassbeam’s machine data analytics platform with its HEMS (Hospital Equipment Management System) CMMS product, giving its customers more analytics on device uptime/utilization and enhancing EQ2’s service management capabilities.
The Resource Wire
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