ICE February 2023

Training Program

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New

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for 2023! MRI Applications Training

FEATURES

DIRECTOR’S CUT

Children’s book lesson applicable to the imaging realm.

COVER STORY

Although communication is a fundamental skill in any working environment, choosing the right words to get your message across in a fast-paced, highstakes environment like health care can be complicated.

RISING STAR

Sonographer Candice Yee left the corporate world “to make more of a difference while still being able to utilize my core strengths and skills.”

IMAGING NEWS

Catch up on the latest news from around the diagnostic imaging world.

PRODUCT FOCUS

A look at imaging parts providers in North America.

EMOTIONAL INTELLIGENCE

When managers and leaders blur their lines of responsibilities, an organization probably won’t thrive.

WHAT’S INSIDE MATTERS

We deliver an inside advantage you can’t get elsewhere:

We deliver an inside advantage you can’t get elsewhere:

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• Int er nal su ppl y c hai n su ppo rti n g hund re ds of ul tras ound pro b es a nd MRI c oil s

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X-ray of GE C3-10-D

MORE R EAS ONS THAN E VER T O EVER T O INSIST ON INNOVATUS IMAGING IN SIDE! Visit us at the HTMA-OH and ICE this winter and get the Inside Advantage

customercare@innovatusimaging.com

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FOCUS IN

LAURIE MOTCH FROSS

UT Southwestern Medical Center Operations Manager of Imaging Systems and Services Laurie Motch Fross, MHA, and her twin sister both work in medical imaging. Her sister is U.S. Army Medical Center of Excellence Radiology Technologist Career Field Consultant Debra Schultz. We will learn more about her next month.

VA Puget Sound Health Care System Health Systems Specialist-Strategic Planner John Beall nominated the duo for the monthly In Focus feature article.

“They both joined the Army after 9/11 with one staying in and the other getting out and working the civilian route,” Beall wrote. “I just think it would be a cool, feel good story of a family duo serving the country while

also being part of our imaging community and two of the nicest people I have ever met.”

Fross said she chose imaging through the U.S. Army, and it grew on her as she completed her master’s degree in healthcare administration. She lists her greatest accomplishment as “serving my country and finishing my master’s degree.”

“I spent four years at Walter Reed Army Medical Center (now Walter Reed National Military Medical Center) providing care for service members, their families, and wounded service members coming back from Iraq and Afghanistan with diagnostic quality CT scans,” she shared. “While stationed at Walter Reed, I was a member of the Better Opportunity for Single Solders (BOSS) Program and served as president for one year. My next assignment was in Germany, supporting the Kleber Army Health Clinic in

Laurie Motch Fross is the operations manager of imaging systems and services at UT Southwestern Medical Center.

Kaiserslautern as the sole X-ray tech for the clinic. I was heavily involved in volunteering for the USO with time spent at the USO at Landstuhl Regional Medical Center, providing support for soldiers and wounded veterans in a comfortable atmosphere while away from home. While stationed in Germany, I deployed to Kosovo at Camp Bondsteel providing X-ray and CT support for all personnel.”

She described her current job as follows.

“I am an operations manager for outpatient imaging clinics at UT Southwestern Medical Center providing support to staff for day-to-day operational support for medical imaging including diagnostic X-ray, CT, ultrasound, bone densitometry (Dexa) and MRI. Coordination of patient flow throughout the imaging clinic ensuring patients are seen timely for imaging exams to get to a follow up appointment or next destination throughout their day. Overseeing patient volumes and key performance indicators along with leading and mentoring staff through day-to-day operations,” she said.

She loves her job because she gets “to combine the joy of patient care with the amazing leadership skills I gained through the military and professional roles I’ve held after my active-duty service.”

While she loves her job, she also says family is a priority and strives to achieve a work-life balance.

Looking into her crystal ball, Fross says the future of imaging will include “advancements in CT with a photon counting CT (PCCT) scanner. PET/MRI, combining positron emission tomography with magnetic resonance imaging.”

As an imaging leader, Fross strives to assist her team without micromanaging.

LAURIE MOTCH FROSS

“I approach leadership with a combination of value-based leadership and servant leadership, encouraging my teams to emulate shared core values while building on my aspiration of placing my team’s needs at the highest priority,” she explains.

She also enjoys serving as a mentor to others in the imaging field.

“UTSW has Business Resource Groups, we call them BRGs. I’ve had the opportunity to mentor a new health care leader in radiology through our women’s BRG,” Fross explains.

“Huddles are extremely important and provide teams with daily information. My teams are spread out through multiple sites,” she explained. “I send daily huddle notes about staffing, training requirements, schedules, supplies, etc., to allow open dialog in conversation and questions. Daily rounding and one-onone meetings are crucial for staff to know where they are performing, and any tools needed for improvement. I advocate for my staff and knowing imaging modalities helps me support them. I strive to listen to understand versus listening to respond and giving my staff the opportunity to suggest workflows and ideas, run with them, and revisit to see what worked well, and what didn’t. Employee recognition is very important to me. UTSW has a PACT (Problem Solving, Ability, Attitude, & Accountability, Communications & Compassion, and Teamwork) Program where patients and colleagues can recognize staff that make an ImPACT.”

When asked to nominate someone who she sees as being a great radiology director or leader she replied, “My twin sister.” •

UT Southwestern Medical Center Operations Manager

1. What is the last book you read? Or, what book are you reading currently? “Making Things Right at Work: Increase Teamwork, Resolve Conflict and Build Trust”

2. Favorite movie? “Dead Poets Society” And the quote, “Oh Captain, My Captain!”

3. What is something most of your coworkers don’t know about you? I played rugby through high school and college, ultimately being invited to the Women’s Select Rugby Team, U23.

4. What is one thing you do every morning to start your day? I take 15-20 minutes before everyone else, including the dogs, get up and reflect on the coming day.

5. Best advice you ever received? Be my authentic self.

6. Who has had the biggest influence on your life? My father

7. What would your superpower be? Photographic memory

8. What are your hobbies? Baking

9. What is your perfect meal? Grilled salmon, asparagus and a sweet potato

STAR RISING

CANDICE YEE

Candice Yee, RDMS, Abdomen and OB/GYN; RVT, is currently a sonographer at Stanford Health Care. Growing up in California’s Bay Area, Yee holds a master’s degree in industrial-organizational psychology after first earning a bachelor’s in psychology. She later earned an Associate of Occupational Science in Ultrasound Technology at Gurnick Academy.

“For many years, I had a successful career within a large corporate setting with absolutely no medical background or experience,” Yee explains. “It was only after being a patient myself, that it became clear how much of a powerful impact medical professionals have on people’s lives. Realizing this forced me to reflect upon my own purpose in life and inspired me to explore a new career in which I could positively impact people during, in many cases, a vulnerable time. This calling to make more of a difference while still being able to utilize my core strengths and skills led me to the study of sonography.”

ICE magazine found out more in a quick interview with this rising star.

Q: WHERE DID YOU RECEIVE YOUR IMAGING TRAINING/EDUCATION? WHAT DEGREES/CERTIFICATIONS DO YOU HAVE?

A: I received my didactic training at Gurnick Academy and my clinical training at Stanford Health Care. I’m a registered diagnostic medical sonographer (RDMS) in both abdomen and OB/ GYN and also a registered vascular technologist (RVT).

Candice Yee is a sonographer with a bright future.

Q: WHAT DO YOU LIKE MOST ABOUT YOUR POSITION?

A: I love that with sonography, I am continually learning and growing as a technician and always being challenged on my critical thinking skills. I enjoy the variety of scans I do on any given day, such as liver transplant dopplers, hepatoma surveys, appendicitis rule-outs, thyroids, DVT rule-outs, just to name a few. I also assist with procedures such as thyroid FNAs and renal transplant biopsies. I also value the high accountability sonographers have with being the “eyes” for the radiologist. Sonographers are storytellers – the images I capture and document for the reading radiologist are key to how they ultimately dictate and determine their reports for every patient. Where I work at Stanford Health Care, sonographers verbally present every case they scan to the reading radiologist or fellow before the patient is let go. This process facilitates a high standard of imaging quality amongst our sonography team as well as a strong partnership between the sonographers and radiologists.

Q: WHAT INTERESTS YOU THE MOST ABOUT THE IMAGING FIELD?

A: I am still amazed at just how much of our internal body we can image safely and at low-risk to the patient with just high-frequency sound waves. When the right imaging modality is utilized, many times unnecessary and, often risky, invasive surgeries can be averted. As the technology continues to advance, I can’t wait to see what else we’ll be able to do next for the patient.

Q: WHAT HAS BEEN YOUR GREATEST ACCOMPLISHMENT IN YOUR FIELD THUS FAR?

A: I consider my greatest accomplishment to be every day I am able to help a patient – whether it be images I took that were used to help diagnose, treat, and cure a disease or life threatening illnesses for a patient, or a comforting gesture given during an emotional moment for a patient. •

FUN FACTS

FAVORITE HOBBY: Trying new foods

FAVORITE SHOW: “Curb Your Enthusiasm”

FAVORITE FOOD: Spanish tapas

ONE THING YOUR BUCKET LIST:

To see and experience the Northern Lights and to spend a night in an ice hotel.

Clock Off THE KERNESHA

WEATHERLY

BY MATT SKOUFALOS

During the work week, Kernesha Weatherly is vice president of imaging at the New Orleans, Louisiana-headquartered Ochsner Health System, which spans 40 hospitals, 60 private care clinics, and even more freestanding centers throughout Louisiana, Mississippi and Alabama.

But even when she’s not in the office, the day doesn’t necessarily slow down. Two years ago, the Montgomery, Alabama native launched her own small business, Makena Prints; today, its sales have reached customers in every state of the contiguous United States.

The story of how Weatherly parlayed a knack for gift wrapping into a stationery boutique with a nationwide reach starts at her kitchen table, where the self-taught artist began experimenting with patterns and ideas for wrapping paper, tissue paper, gift bags and present tags featuring people of various ethnicities.

The word Makena is Swahili for “delighted,” and Weatherly picked it up on a trip to Kenya, where she heard it said quite frequently. It seemed fitting for the intention of her work, which is to connect with audiences who don’t always find themselves represented in the artwork that adorns most commercially available gift goods.

“I wanted people to be happy before they even received their gifts,” Weatherly said. “Trying to find wrapping papers that represented kids of different cultures or different ethnicities was challenging. I did a couple mock-ups, showed it to a few friends, and it went from there. It blossomed in Alabama, word got out, and it spread like wildfire.”

Today, Makena offers more than 22 different wrapping paper designs for every occasion: holidays, birthdays, graduations, baby showers, father’s and mother’s days, and more. Her designs showcase “an array of the different people in the

world,” and many of them are inspired by Weatherly’s own family photographs.

After a crash course at “the University of YouTube and the School of Google,” Weatherly learned how to digitize and modify images from her own photo album into computer graphics that could be developed into paper goods, and then worked to find stationery factories to produce them.

“I pull inspiration from my life and my background,” she said. “The birthday girl is a picture of me that I made into a cartoon; the boy is my little brother. Mrs. Claus is a picture of my grandmother. One picture is of me blowing out the candles on my birthday cake. Since I’m a nuclear medicine technologist by background, our white coats were the inspiration for one design with kids in lab coats.”

Then, just as Weatherly had the bones of the business lined up, the novel coronavirus (COVID-19) pandemic hit, and everything halted. Her original goal of a 2020 launch would be deferred until January 2021, and the business really ramped up in the 2021 holiday season.

Suddenly, Weatherly was speaking with vendors in multiple countries (and time zones), working to establish wholesale relationships (she’s up to seven), and positioning Makena for placement on Amazon.com. Throughout it all, she leaned on her experience as both a health care professional and a retail professional.

“It was a lot of long nights,” Weatherly said. “Even prior to getting into health care I worked in retail management for years, and was able to tap into some of that brain. I can truly say that my years of working helped prepare me for this even though I didn’t see it coming. Health care is health care, but it’s also customer service and retail, whether people believe it or not. Having conversations with customers in the retail space is no different than service recovery in the health care space. I was able to transition that into working with my business.”

Even as the business continues to develop, Weatherly said she’s consistently surprised to see how much the work

she’s done resonates with a variety of audiences. A friend who teaches in a rural area has repurposed some of her misprints into crafts for her students. Other children who see wrapping paper with faces that resemble their own on it “respond to it and are shocked,” she said, and adults who give gifts in Makena gift bags might be bold enough to try to take the bags back afterwards.

“I get a lot of feedback from people that tell me it has helped them with gift-giving,” Weatherly said. “A young lady found me because she wanted to wrap gifts for her staff, who were Black, and she shared with me their responses. Things like that are absolutely special. It’s beautiful to see people gift with intention. Something that someone may consider to be a relatively small gesture really changes a lot.”

Finding cultural representation in art is “absolutely powerful,” Weatherly said, and helped her to view differently her own position as a Black woman supervising a service line at Ochsner.

“For me, seeing the representation, and being out there, it allows people to be authentic within themselves,” Weatherly said. “You are seeing afros and braids and puffs, and seeing that you can still wear the white coat and be successful. Being at a point where you can authentically live out loud and be yourself, and be comfortable with that, is an absolutely beautiful feeling that I did not see growing up, nor in my transition moving up to leadership. You are one person in this space, and when you clock out, then you can take your mask off. It’s challenging to navigate.”

Today, Weatherly is working to grow Makena Prints for a broader audience and broader array of gift-giving occasions. Even in an age where many gifts are digital or plastic, she believes in the emotional response of a wrapped gift, and its ability to delight the recipient.

“For us, it is elevating the world of gift-giving,” she said. “There is something special about a wrapped gift. Listening to people talk about how it has helped them with gift-giving, it’s a beautiful thing to see.” •

Finding cultural representation in art is “absolutely powerful,” Weatherly said, and helped her to view differently her own position as a Black woman supervising a service line at Ochsner.

Rad idea

BY KRISSIE D. STICH, MBA, CRA, R.T. (R), AND MICHELLE DOSSA, PH.D., CRA, RT

OPTIMIZE MOBILE SERVICES

We have always valued our mobile imaging fleet for what it provides our patients, providers, local communities and organization. The mobile units are a great compliment to our existing stationary equipment and they allow us to navigate an ever-changing health care landscape full of access challenges. Challenges that we have encountered include financial constraints where failing equipment cannot be replaced, smaller imaging sites that are being closed due to an overall consolidation of our footprint but the need still exists to support our patients and providers, and staffing vacancies that reduce available imaging capacity where we may have existing equipment waiting to be utilized. Our mobile fleet allows us to bring services to our patients rather than our patient needing to travel to the next closest location for their imaging.

As our fleet continued to grow and offer different modalities, we recognized the need to standardize and optimize our mobile services. In late 2022, a dedicated mobile supervisor position with direct reporting to a regional hospital manager was developed. Our mobile supervisor is responsible for our entire mobile fleet that support nine counties. The supervisor oversees our fleet of five MRIs, one PET/CT, and one wellness van with screening mammography and point-of-care testing as well as the teams of technologists who support these mobiles.

The leadership structure that is now in place is aligning staffing and utilizing the equipment to its fullest potential. Real-time data is reviewed and drives our decision making in redirecting the mobile fleet to decrease outpatient back-logs/lead times.

This ensures we can provide an appropriate level of access to all of our patients regardless of their location. Having this dedicated mobile supervisor specifically allows for increased access to our communities that may not otherwise be available.

The use of mobile imaging equipment may be something you want to consider in the future and we recommend having a dedicated mobile supervisor to own this arm of your business.

Dedicated mobile oversight and supervision has many benefits:

• Ensures proper billing

• Provides consistent services and workflows

• Provides same quality imaging as stationary units

• Allows for staff to be more efficient in their travels

• Improves employee engagement with better communication and focus on their area of expertise

• Optimizes efficiency with the transport of the mobile units to decrease wear and tear costs

• Contributes to future growth strategies for additional mobile units and locations

• Ensures new construction includes mobile pads and cabling

• Increases shared resources

• Provides same positive patient experience

• Ensures seamless integration of mobile services and improves patient access •

Krissie D. Stich, MBA, CRA, R.T. (R), is the Radiology Director, East Market at University Hospitals. Michelle Dossa, Ph.D., CRA, RT, is Radiology Director, West Market at University Hospitals.

The Total Package

Hands-on technical training for all imaging modalities in Nashville, TN. Now offering an Apprentice program!

Service support for all major imaging manufacturers including GE, Philips, Siemens, Hologic and Toshiba/Canon.

SOLUTIONS

COMPANY SHOWCASE

Tri-Imaging Solutions is a fresh, innovative and ambitious company. Tri-Imaging began operations in 2013. The fast start resulted in a state-of-the-art facility to accommodate the company’s exponential growth.

Tri-Imaging Solutions is a medical imaging training institution, a full-service provider, and an industry-leading parts company.

So, how did the company come to be?

“It was a simple desire to do your own thing. I grew up in this industry and fell in love with the equipment and parts piece, mainly because it was constant change and learning. Josh Raines was the technical and support side of Tri-Imaging, which accelerated the growth of TIS,” explains President Eric Wright.

“In the first decade we have seen stages of growth. First, we started as GE CT equipment and parts company. Second, TIS added additional OEMs and modalities, specifically Siemens and Toshiba CT, X-ray, and introduced our training program. Third, we are very proud of our apprenticeship program which introduces new imaging engineers to the industry. As well as our Hologic mammography program and new Flex Service options,” Drew adds.

Success and growth often come together.

“The ability to adapt quickly and be flexible to meet customers’ needs. We are outside of the box thinkers and this really allows us to come up with strategic solutions both for TIS and our customers,” Wright says when asked how the company has grown and adapted to remain a leading provider in such a competitive industry.

MORE THAN PARTS

“Tri-Imaging Solutions is a diagnostic imaging support company providing replacement parts, equipment, service support and technical training,” Wright says.

“It is no surprise that statistically a large percentage of the current service engineers are close to retirement and will be leaving a large gap in the seasoned skills available to help guide those entering the profession. Our strategic approach grew from this and John Drew has been diligently working on rolling out a completely new way to train,” Wright adds.

“We stress the importance of continuing education and top-notch training,” says Vice President of Operations John Drew. “It goes back to our focus of ‘Empowering the Engineer!’ Providing quality imaging parts is just a portion of the value we want to offer, especially with all of the health care changes and uncertainty. We understand the best way to cut cost is to run efficiently. How better to do that than with your own team? Whether it is an inhouse hospital group or service company – we are able to provide support in areas to strengthen, grow and, most importantly, save them time and money!”

CUSTOMER CARE

Improving patient care and customer satisfaction is the goal. Each and every order is unique.

“It starts with the culture! This company was built on the premise of empowering the customer. By listening and looking intently at what the customer is asking and creating a strategic partnership and a unique solution. You get a sense for that in every interaction and when you walk through the facility. Everyone is aligned and committed to the same goal,” says Senior Vice President of Operational Excellence Rich Springer.

EXPERT INSIGHTS

“In the beginning of pandemic, the industry as a whole experienced challenges we had not seen, or at least in my 25 plus years, from our customers and suppliers. We were all adjusting to the ever-changing dynamic; employees working remote, supply chain delays and challenges getting engineers in and out of the facilities,” Senior Vice President of Business Development Wanda Legate explains. “We have seen improvements in a lot of these areas, but we still experience issues with supply chain and equipment delays.”

WHAT’S NEXT?

“Imaging service will continue to struggle as the lack of service engineers will be an issue for the foreseeable future. Our apprenticeship program was developed to help the industry meet this growing demand. Supply chain issues will continue through the end of 2023,” Drew says.

“We expect to see continued industry consolidation

and the customer to seek innovative solutions to meet budget constraints and uptime requirements,” he adds. Wright shares her vision for coming years.

“We have been developing an extensive software solution to incorporate all aspects of our business. We believe this IT solution will change the way the industry evaluates and address their current challenges,” Wright says.

OUR MISSION

Tri-Imaging Solutions strives to live up to its name and be a Solution for its Customers while at the same time Empowering the Engineer.

The company’s mission statement reads as follows: “Impacting lives by creating individual, Customer-centric experiences based on a shared core belief in bettering patient care through personal accountability, integrity, and admiration.” •

For more information, visit triimaging.com.

Tri-Imaging Solutions is an industry-leading parts company located in Nashville, TN.

Imaging News

A LOOK AT WHAT’S HAPPENING IN THE IMAGING INDUSTRY

AHRA APPROVES ICE EDUCATION

The 2023 Imaging Conference & Expo (ICE) has been approved by AHRA: The Association for Medical Imaging Management for Category A ARRT continuing education credits. Also, for the first time ever, the exhibit hall is sold out.

Registration is open for ICE 2023. It is set for February 17-19 in Music City inside the recently renovated Renaissance Nashville Hotel. Registration – including free registration for hospital employees, students and active military – is available online at AttendICE.com. Walk-up registration will begin at noon on Friday, February 17, 2023, onsite at the Renaissance Nashville Hotel.

ICE is the only conference dedicated to imaging directors, radiology administrators and imaging engineers from hospital imaging departments, freestanding imaging centers and group practices. The first day of educational sessions kicks off on Saturday morning. Attendees can add to their knowledge while leading companies from throughout the nation set up their booths in the exhibit hall.

An ICE Break from noon to 1 p.m. gives everyone a chance to stretch their legs before the afternoon educational sessions followed by the Exhibit Hall Grand Opening and Welcome Reception at 4:30 p.m. On Sunday, the classes start a little earlier with the first sessions set for 9 a.m. followed by an 11 a.m. round of classes. The exhibit hall will be open for two hours beginning at 12:30 p.m. with a free lunch served inside the hall.

Super Sessions cap off the educational offerings. The

90-minute presentations begin at 2:30 p.m. Everyone is invited to attend the Finale Party after the Super Sessions. This is an opportunity to celebrate the industry, catch up with friends and colleagues while also making new connections. ICE offers valuable CE credits and, keeping in line with successful conferences in the past, offers comprehensive educational opportunities for attendees.

Whether it’s invaluable continuing education, productive networking or the exclusive exhibit hall, attendees will have the perfect opportunity to enhance their careers and spend time with colleagues. As an added incentive, ICE conference admission is complimentary for all health care professionals, active members of the military and students.

ICE 2023 also features a CRES Study Group and Prep Class for an additional fee. The first session is Friday, August 17 from 1-5 p.m. The second session is slated for Saturday, February 18 from 8 a.m. to noon. •

For more information, visit AttendICE.com.

GE announced that it has completed the separation of its health care business, launching GE HealthCare Technologies Inc. (GE HealthCare). Starting January 4, 2023, GE HealthCare will trade on Nasdaq under the ticker symbol “GEHC.”

H. Lawrence Culp Jr., Chairman and CEO, GE and CEO, GE Aerospace, said, “The successful spin-off of GE HealthCare marks a pivotal moment in our transformation into three independent companies focused on critical, growing sectors. I am tremendously proud of the GE and GE HealthCare teams for their work to prepare this great business to stand on its own as an industry-leading, investment grade company focused on Precision Care.”

Culp continued, “We’re on track and confident in our plans to unleash the potential of GE Aerospace and GE Vernova as separate companies in early 2024. These two global leaders are creating a

smarter, more efficient future of flight and driving decarbonization to address the energy transition. With lean and innovation at our core, we could not be more excited about the future.”

Holders of GE common stock received one share of GE HealthCare common stock for every three shares of GE common stock held. The distribution was part of a tax-free spin-off, resulting in tax efficiency for GE shareholders in the United States.

GE is retaining approximately 19.9 percent of the shares of GE HealthCare common stock. Culp will serve as non-executive chairman of GE HealthCare.

Paul, Weiss, Rifkind, Wharton & Garrison LLP acted as legal counsel. Evercore, Morgan Stanley, and PJT Partners were the lead financial advisors to GE on the transaction. GE also received legal advice from Gibson, Dunn & Crutcher LLP and DLA Piper and financial advice from BofA Securities, Citibank, and Goldman Sachs. •

FDA LAUNCHES LIST OF AUGMENTED REALITY AND VIRTUAL REALITY MEDICAL DEVICES

The U.S. Food and Drug Administration (FDA) is sharing a list of augmented reality and virtual reality (AR/VR) medical devices legally marketed in the U.S. through 510(k) clearance, De Novo classification, or Premarket Application Approval. The Center for Devices and Radiological Health’s Digital Health Center of Excellence developed this list to increase transparency and access to information on AR/VR medical devices.

Although not a comprehensive list, the information provided by the FDA is in response to recommendations

received during the CDRH Patient Engagement Advisory Committee (PEAC) meeting held July 12-13, 2022, on the topic of AR/VR.

The list has information on AR/VR-based devices such as:

• Submission number

• Device and company name

• Date of marketing authorization of the device (510(k) clearance, granted De Novo request, or Premarket Approval) •

THE JOINT COMMISSION ANNOUNCES STANDARDS REDUCTION, FREEZES FEES

The Joint Commission is eliminating 168 standards (14%) and revising 14 other standards across its accreditation programs to streamline requirements and make them as efficient and impactful on patient safety, quality and equity as possible. Additionally, The Joint Commission is not raising its accreditation fees for domestic hospitals in 2023 in recognition of the many financial challenges hospitals and health systems continue to face.

The first tranche of standards deletions and revisions by program, effective Jan. 1, 2023, include:

• Hospital: 56 deleted and 4 revised

• Critical Access Hospital: 37 deleted and 4 revised

• Ambulatory Health Care: 20 deleted and 1 revised

• Behavioral Health Care and Human Services: 9 deleted and 1 revised

• Home Care: 10 deleted and 1 revised

• Laboratory Services: 6 deleted and 1 revised

• Nursing Care Center: 12 deleted and 1 revised

• Office-Based Surgery: 18 deleted and 1 revised

The standards reduction is the result of The Joint Commission’s comprehensive review that was announced in September 2022. The Joint Commission reviewed all its “above-and-beyond” requirements – those that go beyond regulatory requirements of the Centers for Medicare & Medicaid Services (CMS) Conditions of Participation (CoPs) and are not on crosswalks to the CoPs.

Specifically, The Joint Commission reviewed each standard to answer:

• Does the requirement still address an important quality and safety issue?

• Is the requirement redundant?

• Are the time and resources needed to comply with the requirement commensurate with the estimated benefit to patient care and health outcomes?

In addition to a direct review of each standard, The Joint

Commission conducted quantitative analyses of scoring patterns and tested for redundancy. Where necessary, it also led literature and field reviews and engaged experts within the field.

CMS approved the recommended discontinued standards after confirming they do not diminish any CMS regulatory requirements. Importantly, a second tranche of standards is under consideration for elimination or revision, and a second announcement of burden reduction is anticipated in approximately six months.

“The standards reduction will help streamline Joint Commission requirements, as well as provide some much-needed relief to health care professionals and organizations as they continue to recover from the pandemic,” said Jonathan B. Perlin, MD, Ph.D., MSHA, MACP, FACMI, president and chief executive officer, The Joint Commission. “Our goal is to eliminate any standard that no longer adds value. We want to have fewer, but more meaningful requirements that best support safer, higher-quality and more equitable health outcomes.”

To further provide relief to hospitals and health systems, The Joint Commission will not raise domestic hospital accreditation fees in 2023. As a result, some accreditation surveys will be conducted for less than cost.

“As with so many other organizations, we are experiencing inflation in several areas of our business, notably travel costs for surveys, however, we are steadfast in our decision not to raise domestic hospital accreditation fees. We believe this is the right thing to do and look forward to further supporting our accredited health care organizations in 2023,” added Perlin. •

For the full list of discontinued standards, visit www.jointcommission.org.

RS&A ACQUIRES SUMMIT IMAGING

RS&A LLC, an established medical device independent service provider for radiotherapy equipment, most notably external beam linear accelerators (LINACs), has announced its acquisition of Summit Imaging.

Founded in 2006, Summit Imaging is a tech-enabled provider of medical imaging equipment repair, refurbishment, and exchange services to health care facilities, independent service organizations and OEMs across North America, primarily focused on ultrasound and mammography. Summit’s deep industry expertise, technical capabilities and proprietary software solutions perfectly complement RSA’s existing service offering and will augment its collective ability to deliver critical support to its health care customers.

The combined entity will be a stronger, more diversified organization providing high-value services across multiple modalities resulting in a sustainable (eco-friendly) parts infrastructure, improved system performance, reduced costs relat -

ed to mission-critical health care equipment and expanded access to RT treatments.

“The entire Summit team and I are elated about our partnership with DJ and the RSA team,” said Larry Nguyen, the founder of Summit, and newly appointed CIO of RSA. “Our teams are fundamentally aligned in our cultural values, our commitment to our clients, and our desire to deliver the highest-quality services in direct support of health care providers, and the service community to improve patient care.”

“We could not be more excited to partner with Larry, and the entire team at Summit Imaging as we continue building RSA into a premier, national ISP,” adds RSA CEO DJ Conrad. “The acquisition meaningfully expands RSAs capabilities and reach. We will immediately be able to leverage Summit’s differentiated technical capabilities across our collective customer base to improve medical equipment uptime, performance and the overall delivery of care for our customers.” •

FUJIFILM TO ACQUIRE DIGITAL PATHOLOGY BUSINESS

FUJIFILM Corporation has entered into an asset purchase agreement to acquire the global digital pathology business of Tampa, Florida-based Inspirata, Inc. Upon completion of this agreement, Inspirata’s Dynamyx digital pathology technology, employees and customers will become part of Fujifilm. The addition of digital pathology will expand Fujifilm’s Synapse Enterprise Imaging offering to enable the integration of pathology images and data into a health care organization’s electronic health record system and help to streamline care delivery for oncology patients and provider teams.

Building off the success of its established partnership with Inspirata, this acquisition marks Fujifilm’s full-scale, global entry into the largely unpenetrated digital pathology market, where 85% of U.S., 86% of European, and 90% of Asian health care organizations are still running on analog.

“Acquiring Inspirata’s digital pathology business allows Fujifilm to be an even stronger health care partner – bridging a technological gap between pathology, radiology and oncology to facilitate a more collaborative approach to care delivery across the enterprise,” says Teiichi Goto, president and CEO, representative director, FUJIFILM Corporation. “We’re thrilled to welcome Inspirata’s digital pathology experts to Fujifilm’s growing medical informatics business, along with their renowned global customer base, as together we work to drive the digitization and advancement of health care.”

Dynamyx is an open, vendor-agnostic, end-toend digital pathology solution. Dynamyx’s software capabilities include using whole slide images from multiple scanning vendors to create an easier path for more pathology labs to digitize and realize the benefits of faster patient results, centralized imaging records and enterprise access to images for all clinicians. It is installed in medical facilities that handle large volumes of pathological images across multiple lab locations, allowing the use of their preferred mix of laboratory and diagnostic technologies with confidence of full compatibility. According to a recent DeciBio article, Dynamyx is shown to have one of the largest partnership networks in the digital pathology space.

It will become part of Fujifilm’s Synapse Enterprise Imaging portfolio. •

ACR, ASTRO COMMENT ON MEDICARE CONVERSION FACTOR ADJUSTMENT

The American College of Radiology (ACR) released the following statement in response to Congress’ year-end action in omnibus legislation that includes measures to reduce drastic Medicare physician pay cuts scheduled to take effect Jan. 1.

Despite continued advocacy efforts throughout the year from a united medical community to stop the cuts, Congress negotiated only a partial increase to the Medicare conversion factor of 2.5% for 2023 and a 1.25% adjustment for 2024, rather than providing the full 4.5% increase sought by providers.

This statement may be attributed to Jacqueline A. Bello, MD, FACR, chair of the ACR Board of Chancellors:

“At a still precarious time for practices coming off a pandemic, with increased inflation , and already declining reimbursement, we are disappointed Congress has not protected patient access to care by fully offsetting these added cuts. All of medicine must work with lawmakers in 2023 to enact Medicare payment reform that stabilizes the provider environment and safeguards patient access to lifesaving care in their communities.”

The American Society for Radiation Oncology (ASTRO) issued the following statement from ASTRO Board of Directors Chair Geraldine Jacobson, MD, MBA, MPH, FASTRO, in response to the Fiscal Year 2023 Omnibus Appropriations bill.

“On behalf of ASTRO’s 10,000 members who are physicians, nurses, biologists, physicists, radiation therapists, dosimetrists and other health care professionals who specialize in treating cancer patients with radiation therapy, ASTRO is disappointed that Congress failed to stop the full Medicare physician payment cuts for 2023, demonstrating that the Medicare physician payment system is broken. Radiation oncology has faced among the most significant cuts of any medical specialty, leaving community-based clinics at the breaking point. We urge the new Congress to immediately begin payment reform discussions, including working with ASTRO and the radiation oncology community to create a new, sustainable payment approach for radiation therapy services.

The omnibus package leaves all physicians with a 2% reduction in the Medicare physician payment conversion factor for 2023, and radiation oncology with an additional 1% decrease due to clinical labor price changes, at a time when patients are returning to clinics and facing more complex cancer care due to delays caused by the pandemic. Cancer clinics must also contend with a wide range of increasing overhead and staffing costs when determining their ability to provide care to Medicare beneficiaries. Payment relief in the omnibus bill is insufficient and could endanger some clinics’ ability to stay open and provide needed care to people with cancer.” •

For more information, visit tinyurl.com/mr2zb6dr.

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Market Report

IMAGING PARTS MARKET GROWTH EXPECTED

STAFF REPORT

Recent reports point to growth of the imaging parts market in coming years.

A recent ResearchAndMarkets.com report predicts that the medical imaging equipment market will exhibit dynamic growth globally in coming years.

The global medical imaging equipment market is projected to grow at a CAGR of 4.9%. It was valued at $35.9 billion in 2020 and is expected to reach $55 billion by 2030, according to the report

A PRNewswire report states, “In 2021, the global refurbished medical imaging equipment market size was worth $7.1 billion. The global market is likely to progress at 9.1% CAGR during the forecast period, from 2022 to 2031. By 2031, the global refurbished medical imaging equipment market is anticipated to touch value of $18.3 billion. Due to the rising need for imaging devices for the diagnosis of numerous illnesses, the global market for refurbished medical imaging equipment is anticipated to expand quickly in the coming years. With the exception of a few illnesses, medical imaging technology including MRI, X-ray, and CT scan scanners is widely utilized to identify practically every problem.”

The performance of refurbished medical imaging equipment is on par with that of brand-new equipment, which is expected to propel future market outlook for refurbished medical imaging equipment, the report adds.

“Around the world, an increase in illnesses is increasing demand for refurbished medical imaging equipment. Since they do not have to spend outrageous amounts of money on new equipment, many hospitals rely on refurbished medical imaging equipment. Market players are predicted to benefit economically from this,” it states.

North America accounted for over 37% of the global market in 2021 and is expected to account for the largest revenue share in the refurbished medical imaging equipment market. The region is anticipated to lead the global market

during the forecast period. In North America, OEMs and third-party refurbishers are becoming more prevalent, which is likely to drive the regional market.

According to the new market research report “Medical Equipment Maintenance Market by Product (Imaging (MRI, CT, PET-CT, ultrasound, X-ray), Endoscopes, Lasers, Ventilators, Dialysis, Monitors, Provider (OEM, ISO, In-house), Service (Preventive, Operational), User (Hospital, ASCs) - Forecast to 2026,” is projected to reach $74.2 billion by 2026 from $45.2 billion in 2021, at a CAGR of 10.4% during the forecast period.

Transparency Market Research reports that the global medical imaging equipment services market was valued at $16.2 billion in 2021. The global market is projected to expand at a CAGR of 6.1% from 2022 to 2031. The global medical imaging equipment services market is anticipated to reach $29.2 billion by the end of 2031.

The medical imaging equipment services market is witnessing ongoing changes in customer base and competitive landscape, as the rapid shift toward value-added service offerings has increased providers’ budgetary constraints. The medical imaging equipment services market is primarily divided between independent services organizations (ISOs) and original equipment manufacturers (OEMs), which differentiate from one another through imaging equipment serviced and other service offerings. In the past few years, prominent OEMs have captured the competitive landscape of the medical imaging equipment service industry, as majority of medical imaging was conducted in hospitals.

On the other hand, in response to the OEMs prominent position, ISOs have differentiated themselves in the industry through engineering experience, personalized service, and pricing. Moreover, several ISOs globally have started providing services on time and materials basis, and have eliminated pre-approval processing.

Additionally, notable transactions within the medical imaging equipment services sector drives the global market. •

Focus Product

Imaging Parts

CM PARTS PLUS Radio Frequency Power Amplifier (RFPA)

A major subcomponent of the magnetic resonance imaging (MRI) system is the Radio Frequency Power Amplifier (RFPA). Fundamentally, the RFPA takes a small RF signal and amplifies it to a level that enables the production of an MRI image. The amount of RF amplification needed to produce an image is relative to the magnetic field strength (Tesla) of the MRI system. Repairing the RFPA requires knowledge, experience, and specialized test equipment to simulate system operation of the amplifier. CM Parts Plus has decades of experience in repairing RFPAs along with dozens of other MRI and diagnostic imaging components.

RAYPAC X-ray Tube

Ray-Pac is 40 years strong in the X-ray tube industry. It provides overnight deliveries on most 3-inch and 4-inch tube replacements for GE, Siemens, Phillips, Varex, Dunlee, Toshiba, and Shimadzu, as well as other hard to find units. Ray-Pac prides itself on building customers the perfect tube quickly to ensure the client has minimal downtime. The company offers custom builds, repairs and technical support.

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GE HEALTHCARE PETtrace Solid Target Platform

The enablement of theranostics in prostate cancer care begins with the production of radioisotopes for use in diagnostic tracers – namely Gallium-68 PSMA-11 – which is administered to the patient, attaches to specific cancer cells, and releases radioactive emissions to provide detailed molecular information unique to each patient. However, growing demand for Gallium-68 and the limitations of generators have created serious challenges for clinicians and limited patient access. In response, GE Healthcare is proud to offer a new Solid Target Platform for its PETtrace cyclotron which – in combination with its FASTlab 2 New Edition platform – can produce 100x the amount of Gallium compared to a generator for increased theranostics capabilities and access in prostate cancer patient care¹.

¹ Svedjehed et al. “Demystifying solid targets: Simple and rapid distribution-scale production of [68Ga]GaCl3 and [68Ga]Ga-PSMA-11.”

Nuclear Medicine and Biology. Volumes 104–105, January–February 2022, Pages 1-10. https://doi.org/10.1016/j.nucmedbio.2021.10.002

INNOVATUS IMAGING

Ultrasound Probes & MRI Coils

Innovatus Imaging is an ISO-13485:2016 certified preferred provider for best-in-class repair services for medical imaging products. Expertise spans the entire device life cycle – from design, development, and manufacturing, to sales, distribution, and repair. With a legacy spanning 35-plus years and having repaired more than 175,000 ultrasound probes and 40,000 MRI coils, Innovatus has accumulated tremendous amounts of data which serves as a massive knowledge base for continual improvement. The company operates an FDA-registered site for the design and manufacturing of ultrasound transducers and related products. Headquartered in Pittsburgh, Innovatus also maintains Centers of Excellence in Tulsa, OK and Denver, CO.

First Call Parts has been providing customers with quality replacement imaging parts since 2009. We pride ourselves in developing a top-notch reputation in the imaging industry as delivering the best in diagnostic imaging replacement parts. We specialize in the sale of refurbished/tested and used, Philips, Siemens, and GE in the Cath/Angio, R/F, and RAD modalities.

At RENOVO, we value knowledge, reliability, and integrity in our employees. If you are interested in being a part of a team that is committed to making a difference in healthcare equipment maintenance and healthcare asset and technology management, we invite you to apply for one of the open positions. We are always looking for talented, passionate, hard-working people to join our team.

Imaging Field Service Engineer

The InterMed Group is a healthcare technology management company meeting the needs of our customers for over 20 years. InterMed sells and services medical equipment for our customers across the country and is growing quickly. As a result, InterMed is looking for an Imaging Field Service Engineer to perform repairs and preventive maintenance. This individual would be responsible for maintaining, inspecting and repairing imaging equipment for our accounts in the area and must be willing to travel for work.

Based in Houston, Texas, Isikel Clinical Equipment Technology is a startup clinical engineering service that will support T&M repairs to full service healthcare system projects & partnerships. With an emphasis on culture and people, Isikel is an ideal career path for those who want to build something special! We are striving to build the best team, and have the commitment to do so!

Canon Medical Systems USA, Inc., a world leader in diagnostic imaging, is in search of qualified candidates to fill our open positions. Canon Medical Systems offers a competitive salary and benefits package, we support a diverse workplace and are an equal opportunity employer. We invite you to join and become part of our Canon family.

Imaging Engineer II

Do you want to work at one of the Top 100 Hospitals in the nation? We are guided by our values of Love and Excellence and are passionate about delivering health, not just health care. Come join us at ChristianaCare! ChristianaCare, with Hospitals in Wilmington and Newark, DE, as well as Elkton, MD, is one of the largest health care providers in the Mid-Atlantic Region. Named one of “America’s Best Hospitals” by U.S. News & World Report.

Do you want to work in healthcare? Would you like to make a difference in the lives of patients and their families? Do you enjoy a new challenge every day? If you are skilled at servicing medical equipment in a clinical setting, we hope you will join our team!

Agiliti is a nationwide company of passionate medical equipment management experts who believe every interaction has the power to change a life. Our industry-leading commitment to quality and team of expert technicians helps ensure clinicians have access to patient-ready equipment needed for patient care. Make an impact in healthcare and grow your career with Team Agiliti!

Associated Imaging Services has been offering nuclear medicine and ultrasound solutions to our customers since 1990. We specialize in the sales and service of new and refurbished nuclear medicine cameras and ultrasound systems throughout Kansas, Oklahoma, Texas, and the surrounding areas.

Bridging Gap:

BY MATT SKOUFALOS

Although communication is a fundamental skill in any working environment, choosing the right words to get your message across in a fast-paced, high-stakes environment like health care, where the majority of experiences are streamlined and protocol-driven, can become complicated to the point of easily distorting a message. In the medical imaging space alone, the varied layers of messaging that can occur in the normal course of operations – patient to clinician, patient to technologist, technologist to technician, subordinate to director, etc. – present opportunities rife with potential misunderstandings. Honing an ability to get clear on communication, and developing the skills to do so, is a key to career longevity as well as a fundamental pillar of patient care.

Gregory Goll manages the Projects & Medical Imaging Services Department for the Marietta, Georgia-based WellStar Health System, which includes one of the 10 busiest emergency rooms in the country, and hospitals that stretch about as far as the Alabama state line. Managing the responsibilities of his position doesn’t always involve faceto-face communication, but Goll described “90 percent” of his professional communication as being verbal. Doing it successfully involves establishing rapport with a variety of different professionals, and one of the most fundamental

ways for interdepartmental professionals to establish common ground is to reconnect over why they’re there to begin with.

“We’re here for customer focus,” Goll said. “Once you lose that focus, maybe you should consider a different career. We joined this field for patient care; otherwise, we’d all be working somewhere else.”

“Even though I’m not touching the patient every day, we’re doing the best to meet our customers’ needs, which ultimately meet the needs of our patients,” he said. “When you don’t put your focus on keeping that equipment running, you can’t call your patients making that decision to take time off work for their procedure, and apologizing for the situation you’re in.”

Another common scenario Goll says he often encounters is how communication can be clouded by the nature of the problem versus how it’s being described from one party to another. Choosing to address an issue from the perspective of identifying the problem itself rather than whose fault it may be offers many more opportunities to resolve it than assigning blame.

“Sometimes people miss things not because it’s anything malicious, but they’re under a lot of duress, and you have to be in that person’s shoes to understand what’s going on,” Goll said. “In the imaging world, it could be that my MRI scanner took a dive, and now you’ve got 15 patients who are upset, and you need to recreate a schedule.”

Beyond the initial disappointment associated with the problem itself, avoiding presumptions that an issue is the result of incompetence, neglect, or worse, always helps to clean up an interaction. Goll recommends keeping interactions focused on returning to normal operations as seamlessly as possible, and then committing to pitching in to resolve the issue. Sometimes, disconnecting from the intensity of the moment can help clarify those needs as well.

“It’s a matter of addressing the problem and getting them help ASAP,” he said. “There’s been numerous times when I’ve come out of my office, and I’ll go up and see if there’s something I can do. Sometimes it’s something simple; other times, it’s someone wanting to know that you value them in a crisis. Their number one priority is the patient, and that’s where people lose

focus if they won’t separate themselves from the repair to think about what the repair impacts.”

Another key piece of any workplace interaction, particularly one involving a call for service, lies in acknowledging that such an incident has an innate emotional charge around it, simply because a piece of technology that’s supposed to function in a certain way isn’t, or isn’t working at all. Managing the moment involves understanding the initial consternation around the precipitating incident, and then working backwards from that information to calm things down and deliver the fix that’s needed. Many times, taking the emotional response out of the incident also helps clarify the moment in a way that’s useful to diagnosing the issue – particularly if people feel like the fix is the subject of the conversation, and not their individual behavior leading up to the system failure.

“If someone calls you up and says they have a problem with whatever the modality is, people should feel that you’re actually listening to them,” Goll said. “A lot of the communication is how you treat your customers, first and foremost. They know that you have a belief that they matter, and that you have their back.”

“If the person is already having a bad day, and they’re calling you for help, they’re looking for you to throw them a lifeline,” he said. “You have an opportunity of dealing with it a few ways. If you throw them a cinderblock, it forces them to go underwater, and the credibility for your whole department starts to go downhill.”

In situations where a fix might be overly technical, or has the potential to yield an explanation that might be more confusing or complicating than is helpful to defuse the moment, Goll also prizes clarity of communication. The efficacy of deriving a solution is accelerated by finding ways to make yourself understood in as simple a fashion as possible. For Goll, who was once told by a service engineer that he “translates ‘geek,’ ” getting critical information across calmly and clearly in a moment of intensity is a worthwhile skill to burnish.

“During the heat of the storm, our goal

is to calm the waters,” Goll said. “Sometimes it’s not the words you say, it’s how you say them. When writing emails, I learned that you don’t write paragraphs; you write short narratives: bullet points one, two, three, and here’s the solution.” Anybody can identify a problem, but if you know a problem is there, it’s immediately working on a solution.”

Consultant Brian Parsley, co-founder of The Constance Group, an international training organization that consults with employees across a variety of different industries, believes that one way to improve communication in any scenario is to unlearn a critical assumption with which many people were raised.

“The number-one mistake that we’ve been unfortunately taught since childhood is ‘talk to people the way you want to be talked to,’ ” Parsley said. “Unfortunately, this is really bad advice. The reality is, we talk to people the way they need to be talked to; we treat people the way they expect to be treated. When you have a misalignment of expectations, it breaks down communications.”

“It’s easy to put a label on someone: he’s aggressive, she’s unfriendly,” he said. “Most of the evidence is derived based on your bias; your experience. We think we know. And we believe it to be gospel, and it’s not. We only believe what’s true in our reality. I think the real secret to amazing communication lies in your ability to connect with the other person, and the only way to make that connection is to hear it the way they need to hear it.”

Parsley defines the five pillars to any relationship as: trust, respect, credibility, likeability and rapport. Based on social science studies that show people make arbitrary considerations about whether they like someone in less than a blink of an eye, he emphasizes some key shorthand strategies for building an immediate rapport.

“The best way to connect with someone is to be like them, and try to listen with a different perspective,” Parsley said. “A lot of times, depending upon our personality or behavioral style, people are misunderstood. If I happen to be someone who is very relationship-driven, very outgoing, like-

GREGORY GOLL WellStar Health System

BRIAN PARSLEY The Constance Group

NICOLE DHANRAJ

South Texas Associates of Radiology

able, and I’m talking to someone who is more clinical, more process-driven, more collected in their thoughts, I might see that as they don’t have an interest in me or they don’t like me, when in reality, they’re processing what I’m saying. Then I tend to overuse that one skill I have, connecting and talking, and that skill becomes a weakness.”

The bulk of communication, Parsley said, is non-verbal: things like body language, posture, tone of voice, speech cadence, and eye contact comprise much more of an interaction than the content of the words chosen, he said. Unfortunately, in a professional environment in which the bulk of communication is written, texted or disseminated without the contextual clues of those in-person interactions, it’s far easier to be misunderstood than it is to be comprehended clearly.

“To me, the biggest issue on the hospital side is it’s very easy to become transactional in our conversations, both internally and externally,” Parsley said. “We have to move away from that; we have to get back to having meaningful conversations with people. COVID has taught us that human interaction is the key to successful relationships.”

“The biggest mistake medical professionals make is confusing the word ‘patient’ with ‘customer,’ ” Parsley said. “Even in the imaging world, there are lots of people who do what you do at the same level or even better. The only thing that separates you is your ability to serve your customer.”

Parsley also believes that a handful of institutional behaviors can help communicate the value that any institution or business places on the people whose relationships it courts. Organizations cultivate those impulses through inclusive practices like VIP programs and incentives that communicate feelings of appreciation, value and importance.

“Everybody wants to feel important,” Parsley said; “people want to feel like they belong, or are valued; that they’re part of something bigger. Everyone craves appreciation. If all you do is focus those conversations on those things, you’re going to win every single time.

“The goal is to serve the best interest of your patient, your peer, your subordinate,” he said. “If you combine that with willingness, you’re never going to have an issue. You don’t have to be sophisticated, but it requires topof-mind awareness.”

In some circumstances, particularly leadership roles, the intensity of communication required – or expected – in a high-paced healthcare environment can fundamentally limit its effectiveness. Nicole Dhanraj, CEO of South Texas Associates of Radiology, business operations consultant, HND Consultancy, recalled prior experiences communicating as an imaging director as presenting an impossible bar to clear.

“I have been on two Zoom meetings at the same time, one on my computer and one on my phone, with someone from my office talking to me, and someone else trying to

get my attention,” Dhanraj said. “I could miss something, but, unfortunately, the expectation is that you are juggling all of it.”

Dhanraj spoke about managing the expectations of a leadership role with the realities of those responsibilities in practice. She’d be told that leaders can set their own schedules, but if her calendar showed her as unavailable, she would often find herself double- or even triple-booked for different meetings in which her participation was presumably expected. The result would be that she could be virtually attending a meeting, but practically, there would be very little chance of her participating, or absorbing the information being communicated therein.

“You can see in a lot of meetings that everybody’s distracted, or that their eyes are in their emails,” Dhanraj said. “Apparently, my presence was more important than my digesting the information. I think the expectation overall is that our attention is to be divided, and there is no leniency. It’s amplified in certain industries because we’re so short-handed, and doing more with less continuously.”

Dhanraj said that in such environments, she reaches people more effectively when she manages their expectations ahead of the interaction – and sometimes during it, as well as afterwards.

“It is challenging, but a lot of times, once you start understanding how other people are seeing it, then you preface the conversation,” she said: “ ‘I’ve only got 10 minutes,’ or, ‘Do you mind if I face the computer when we talk?’ ”

Another important aspect of communication in any health care environment involves understanding cultural differences, both interpersonally and inter-departmentally, Dhanraj said. Knowing where someone is from, or how they’re used to interacting, can lead to more productive experiences because aspects of both can contribute to building trust, which will make any interaction more successful.

“In some cultures, or with some people, you just can’t come across very direct,” Dhanraj said. “Some organizations are very task-oriented. In addition to culture, as we talk about integrating that into how you communicate, we have generational differences.”

Most importantly, she spoke the clarity that can be found when individuals take ownership of their half of a conversation, clarify their own needs and experiences, and work to build a bridge across their differences, rather than widening a gulf that might exist.

“I think when we start approaching conversations about how we feel, and how we would like to be communicated with, it’s just easier and more effective,” Dhanraj said. “If you understand how someone wants to be talked to, and you lay the expectation, then it’s going to help build that relationship.” •

BY BETH ALLEN DIRECTOR’S CUT

CHILDREN’S BOOK OFFERS GREAT ADVICE

Afew weeks before Christmas, a group of our leaders spent the morning volunteering at the Salvation Army in Phoenix at its annual Angel Tree toy drive for children. For a few of us, this was the second time we had this very rewarding opportunity. I was lucky enough to be one of the special “elves” that got to shop through the donated toys to fill a bag with items from each child’s special Christmas list.

In doing so, I came across the cutest children’s book. I used to love searching for those unique stories for our kids so I couldn’t pass up the chance to take a break from helping Santa to read this book that caught my eye. I figured Santa would cut me some slack. I am pretty sure all elves are allowed a couple minutes for a cookie and cocoa break.

“The Day the Crayons Quit” written by Drew Daywalt and illustrated by Oliver Jeffers, tells the story of Duncan who just wants to color. When he goes to his crayon box, he finds a pile of letters written by the crayons who each have concerns they would like him to address. The crayons are on strike! Gray is worn out because of Duncan’s love of elephants. And don’t even get him started on rhinos, hippos and humpback whales. Purple is a perfectionist and wants Duncan to stay inside the lines. Green just wants Duncan to know that yellow and orange are not speaking because they both think they are the color of the sun. Red is worn out from coloring fire engines, apples and strawberries. Red even works on holidays to color Santa’s suit and hearts on Valentine’s Day.

It reminds me of our team members. Each of them has specific priorities, opinions, needs and wants. Each of them sees the world from their own point of view and may not take into consideration what it may look like from where others are sitting. What about those priorities,

needs and wants for our patients and our business? How can we make everyone happy?

In order to keep harmony in the crayon box we call medical imaging, there must be a way for all of us to work together and use each color to its greatest potential. This takes communication and collaboration. No idea is a dumb idea. An inclusive community allows all of us to contribute to our success. If we can convince each team member, no matter what the role, to help identify how meeting their individual needs supports attaining our collective goals that is a win-win! There will be compromise but it is important to understand why. We need to clearly communicate the target and the reason for it.

Duncan had an idea. *SPOILER ALERT* He took each of the concerns to heart. He used his imagination to create a beautiful, colorful, unique picture that used everyone in the box. There was an orange whale, a black rainbow and he even made the often-ignored pink crayon happy by using it to draw a massive dinosaur rowing a boat. In the end, Duncan’s teacher gave him an A for coloring and an A+ for creativity.

What opportunities do we have to make sure everyone gets to be a part of the masterpiece in the way that makes them fulfilled, engaged and supported? Our leadership teams need to demonstrate this idea for everyone. High tide raises all boats. If we prioritize supporting and lifting others, in return we each will reap the benefits.

I recommend this book to all ages. It is funny, cute and inspiring. I hope the deserving kid I gifted it to likes it as much as I did. I really enjoyed my time volunteering at the Salvation Army and this discovery was just the icing on the Christmas cookie.

Let’s be creative.

Thanks for all you do. •

Beth Allen is the director of clinical operations for Banner Imaging.

COMPARING NEW, REFURBISHED, AND CERTIFIED RESTORED EQUIPMENT

BY AMANDA GENDRON

Purchasing medical equipment is a significant investment for any facility. Typically, the process begins with countless hours of research and ends with the hope that your purchase will meet your performance standards and budget requirements. At Avante Health Solutions, we believe you deserve more than the hope that your investment was worth it. You deserve the assurance that your equipment is quality-tested, patient-ready and value-based. In this article we review new, refurbished and Certified Restored equipment and the advantages and disadvantages of each, so that you can choose the best option for your facility.

NEW EQUIPMENT

There are many advantages to buying new equipment. New equipment is aesthetically pleasing, patient-ready, and is often accompanied by a warranty from the original equipment manufacturer (OEM). While these advantages are valuable, there are also disadvantages to consider.

New equipment can be cost-prohibitive.

In fact, it can cost up to 40% more than refurbished or Certified Restored equipment. Another disadvantage is the lack of service options. Although new equipment may not need service for some time, all will need preventative maintenance and repairs in their life cycles. Unfortunately, due to OEM restrictions, you will likely be required to use the OEM for repairs and services instead of your in-house engineers or third-party service providers. This can result in higher costs for parts and services, and it could also result in extended wait times for repairs.1 This will negatively impact your equipment uptime, patient care, and ROI.

REFURBISHED EQUIPMENT

Refurbished equipment, or equipment that has been repaired to working order, is another option to consider. Most refurbished equipment are popular brands with which your staff are already familiar, and which match your current fleet. Refurbished equipment should also be in like-new condition, at least functionally. This translates into patient-ready use upon installation, which positively impacts patient care and your ROI. Refurbished

Amanda Gendron is the product marketing manager at Avante Health Solutions. She graduated with her bachelor’s from the University of Maryland and soon after entered the medical device industry where she has worked for the past 10 years.

equipment is also cost-effective. These three advantages make refurbished equipment a great option to consider, but there are also several disadvantages discussed in detail below.

We previously stated that refurbished equipment should be in like-new condition, at least functionally. There are two disadvantages to address in this statement.

First, while many companies will refurbish a machine to its working order, they may not repair cosmetic issues including chipped paint, dents, holes and general wear and tear. These devices will not be as aesthetically pleasing as new or Certified Restored devices.

Second, the phrase “should be” suggests caution when considering refurbished equipment.

If equipment should be in like-new condition, that means that sometimes it isn’t. Some companies cannot guarantee the quality of refurbished equipment. They may attest to the quality in a sales pitch, but do they have the certifications and quality assurance processes in place to prove it? Most do not. We suggest researching a company’s commitment to quality before purchasing its products.2

CERTIFIED RESTORED EQUIPMENT

Avante’s Certified Restored equipment provides all the advantages of refurbished equipment with none of the disadvantages. Like refurbished equipment, our vast inventory of more than 200,000 parts and supplies offers a plethora of popular brands from which to choose. Our equipment is also cost-effective. You

can save up to 40% on Certified Restored equipment compared to an OEM. Additionally, Avante restores equipment both functionally and cosmetically to look and operate like a new machine.

As for quality, Avante’s Certified Restored equipment is unmatched. Avante’s dedication to quality products and services is depicted in its ISO 13485:2016 certification through NSF-ISR. As a recipient of an ISO 13485:2016 certification, Avante’s Quality Management System demonstrates the ability to consistently meet customer, ISO and regulatory requirements. Furthermore, Avante uses an internal quality assurance process which consists of multiple inspections. This process ensures that customers receive the highest quality products with which to serve their patients.

CONTACT AVANTE TODAY

While new and refurbished equipment each have their advantages, we suggest their weaknesses far outweigh their strengths. On the other hand, Avante’s Certified Restored equipment stands in a class of its own and is the perfect option for any facility. Contact an Avante representative today for more information on Certified Restored medical equipment and the positive impact it can have on your facility. Call 800-979-6142 or visit avantehs.com for more information. •

Avante Health Solutions is moving healthcare forward. We are an industry-leading provider of diagnostic imaging, medical-surgical, patient monitoring, and ultrasound equipment. As a comprehensive provider, we partner with our customers from consultation and installation to service, repair, and ongoing technical support.

FOOTNOTES:

1. Read about the Right to Repair at repair.org.

2. For more information, read “Choosing the Right Refurbished Medical Equipment for Your Facility” at avantehs.com/learn.

“Avante’s Certified Restored equipment stands in a class of its own and is the perfect option for any facility.”

CHATGPT AND HIGH SCHOOL

BY MARK WATTS PACS/IT/AI

Howard Wong was the Centennial High School valedictorian, number one in a class of 400 in my class. I recently reconnected with him on LinkedIn. He is living in Hong Kong building sustainable housing.

Our mutual high school class education environment has acted as a foundational launching point for growth. This common general education has led to career success for David K. in the entertainment business. Cal B. in a military career resulting in his flying four U.S. presidents on Air Force One. Ted F. is an Olympic sports medicine provider and renown lecturer. Greg D. was a driving force in the growth of Nike into a global brand. Stephanie and Cynthia have developed Realtor empires.

Artificial Intelligence has a new entrant that is going to disrupt our understanding of all these classmates’ lives – ChatGPT. This Foundational Model ChatGPT, sometimes referred to as Artificial General Intelligence (AGI), is equal to the average intelligence of a high schooler’s general knowledge in science, art, music and history.

When I asked ChatGPT, “How will ChatGPT transform health care?”

The reply was: “ChatGPT is a powerful artificial intelligence (AI) tool that has the potential to transform the health care industry in several ways. Here are just a few examples of how ChatGPT could be used to improve health care:

1. Improving patient care: ChatGPT could be used to assist health care providers in making more accurate diagnoses and treatment recommendations by providing real-time decision support. For example, a doctor could input a patient’s symptoms and ChatGPT could suggest a list of possible conditions and treatment options.

2. Enhancing communication: ChatGPT could be used to improve communication between health care providers and patients, especially in cases where language barriers are an issue. By using natural language processing (NLP) to understand

and respond to patient questions and concerns, ChatGPT could help to ensure that patients receive the information they need in a way that is easy for them to understand.

3. Reducing workload: ChatGPT could be used to automate routine tasks and processes, such as scheduling appointments or answering frequently asked questions. This could help to reduce the workload for health care providers, freeing them up to focus on more complex tasks that require their expertise.

4. Improving accessibility: ChatGPT could be used to improve access to health care for underserved populations, such as those in rural areas or those with disabilities. By providing virtual consultations and other remote services, ChatGPT could help to bridge the gap between patients and health care providers.”

In conclusion, ChatGPT has the potential to be a valuable tool for improving health care in several ways. By leveraging its powerful AI capabilities, health care providers can enhance patient care, improve communication, reduce workload and improve accessibility.

I then asked ChatGPT, ”How can ChatGPT improve the journey for patients with cancer?”

The reply was: “Here are a few ways in which ChatGPT can improve the journey for patients with a cancer diagnosis:

1. Providing information and support: ChatGPT can be used to provide patients with information about their cancer diagnosis and treatment options, as well as to answer questions and provide emotional support.

2. Facilitating communication with providers: ChatGPT can help patients to communicate more easily with their health care providers, allowing them to ask questions and get updates on their treatment progress without having to make in-person appointments.

3. Coordinating care: ChatGPT can be used to coordinate care among multiple providers, helping patients to navigate the complex health care system and ensure that they are re-

ceiving the right treatments at the right times.

4. Monitoring treatment adherence: ChatGPT can be used to monitor treatment adherence, reminding patients to take their medications, and providing support if they are having difficulty with their treatment regimen.

5. Providing personalized recommendations: ChatGPT can be used to provide patients with personalized recommendations for things like symptom management, nutrition and lifestyle changes based on their specific cancer diagnosis and treatment plan.”

This all seems a bit sophomoric in the reply.

Think about how much you learned from birth until you graduated from high school – body care, language, writing, reading, social norms. This is the new starting point for the development of artificial intelligence. These AGI will be the new general knowledge foundation for the development of specific AI layers on top.

AGI plus specific knowledge in layer for first-year law school, firstyear engineering, code writing and, yes, medicine.

AGI has the potential to drive down the cost of knowledge work and advance research by a hundredfold.

AI is trained currently from small data sets to solve small narrow problems. This is going to be big.

It will force me to re-evaluate my first article in ICE magazine, “AI Will Not Replace Radiologists.”

I see the development of an ecosystem that provides for pseudo radiologists like the current physician assistants model. Radiologist extenders.

I will go into detail in my next article.

Artists are skilled and yet here are some examples of AI I have generated beyond my training or skill.

AI plus Chest X-ray. •

Mark Watts is an experienced imaging professional who founded an AI company called Zenlike.ai.

BY MELODY W. MULAIK CODING/BILLING

AI AND CODING

Artificial intelligence (AI) has been around for many years in radiology. From a clinical to an efficiency perspective, it has and continues to be a hot topic for discussion. It is natural then that the question of reimbursement should enter into the conversation.

In the 2023 Edition of the CPT® Manual, the American Medical Association (AMA) added Appendix S: Artificial Intelligence Taxonomy for Medical Services and Procedures, which is new and dedicated to AI. This appendix provides guidance to classify AI applications into three categories with stated primary objectives:

(1) Assistive – detects clinically relevant data (e.g., CAD imaging), (2) Augmentative – analyzes and/or quantifies data in a clinically meaningful way (e.g., external processing of imaging data sets), and (3) Autonomous – interprets data and independently generates clinically meaningful conclusions (retinal imaging is currently the only recognized procedure by the CPT® code set). The inclusion of an appendix does not guarantee payment for AI codes and procedures but rather indicates a recognition of the need to address the technologies in a meaningful and productive way.

In radiology, for a number of years, there have been codes for AI technology either as stand-alone procedures or as part of a code definition. Computer-assisted detection (CAD) for mammogra -

phy is good example. Initially separate add-on codes were created but ultimately the mammography code definitions were changed to reflect the industry standard of utilizing CAD. A similar update was made for breast MRI as well though there are still code options that do not contemplate CAD.

The majority of current AI codes are Category III procedure codes. The AMA developed Category III CPT® procedure codes to track the utilization of emerging technologies, services and procedures. Category III codes are five digits as well, but the last digit is always a “T.” For example, 0042T (Cerebral perfusion analysis using computed tomography with contrast administration, including post-processing of parametric maps with determination of cerebral blood flow, cerebral blood volume, and mean transit time) is a Category III code. These codes are temporary codes intended for data collection to substantiate widespread usage or to provide documentation for the Food and Drug Administration (FDA) approval process. Their scheduled sunset date, which is typically 5 years after creation, is now listed in the CPT® Manual. These code descriptions do not establish a service or procedure as safe, effective or applicable to the clinical practice of medicine. Unlike Category I codes, which are released only once a year, Category III codes are released in January and July.

There are no assigned Relative Value Units (RVUs) or established payments for

Category III codes. They will typically be denied as not medically necessary by Medicare and commercial payers, unless a Local Coverage Decision (LCD) or coverage article specifically extending coverage to a particular Category III code has been published. Historically no Category III codes were assigned to an Ambulatory Payment Classification (APC) for outpatient hospital reimbursement; however, this changed for 2023. Two (2) of the new augmentative technologies, quantitative CT tissue characterization (0721T-0722T) and quantitative MRCP (0723T-0724T) were assigned to APCs (1508 and 1511 respectively) so hospitals should see reimbursement for these procedures if allowed by their local Medicare Administrative Contractor (MAC). This is a positive sign of potential things to come in terms of

reimbursement for AI procedures.

Coding and reimbursement for AI technologies will continue to be a growing area that we should all watch carefully. Make sure to obtain accurate information when performing return on investment (ROI) analysis on new technologies to ensure appropriate expectations are set for all stakeholders. Some technologies will become industry standard, like breast CAD, while others will appear and not survive in the market for any myriad of reasons. Stay tuned! •

When you need a partner who can confidently handle every aspect of your contrast injector program, look no further... Althea-US has you covered.

Melody W. Mulaik, MSHS, CRA, RCC, RCC-IR, CPC, COC, FAHRA, is the president of Revenue Cycle Coding Strategies LLC.

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Colin Construction Company’s extensive resume over the last four decades includes the design and renovation of more than 320 health care facilities. The dedicated team of 20-plus employees gives Colin Construction Company a small-business feel while its impressive diverse work portfolio offers a huge footprint in the industry.

Colin Construction Company was established in 1981 after Mark Colin recognized a need in his community. Medical construction requires expertise and precision, especially when dealing with various imaging modalities; some that weigh multiple tons and cost millions of dollars. Mark realized the benefits of establishing a knowledgeable team that specializes in remodeling for and installing such equipment. Since then, Colin Construction has been committed to designing and building effective health care environments in 10 western states and providing construction management in the lower 48 and Alaska.

Services offered include one-room or multi-phase construction and project management from concept to completion. Colin Construction is prepared to take on the overall planning, coordination and management of your next project.

Benefits of the Colin Construction experience include:

• Over 150 years of combined industry experience

• Spearheaded by a Management Team with over 80 years of industry experience

• Turnkey Certified General Contractor with all major medical equipment vendors

• Management of the entire construction process

• Specifying objective, scope, budget, schedule and performance criteria

• Managing proposal requests and evaluations of bidders

• Management of efficient use of client resources

• Developing strong lines of communication between all parties

Colin Construction specializes in “Progressive Design-Build” services. This option brings an innovative construction model that combines the owner, general contractor, architect, and

consultants into one team managed by Colin Construction. The owner/client issues only one contract that covers both the design and construction services. This model encourages a more efficient and collaborative process that allows the focus to return to what matters most – treating patients.

Benefits of a Design-Build approach include:

• A design team tailored to the specific needs of the client and the project with the client involved throughout the design, constructability reviews, and budget validations.

• Manages risk for the owner and assigns more risk to the Design/Builder

• Collaboration with key subcontractors to identify and implement cost-saving ideas

• Project management from design to final closeout

• Single point of contact throughout the entire process

• Immediate addressing and assessment of discovered conditions for the most cost-effective solution

“Patient experience remains important to us, and we maintain a high level of personal involvement to ensure our clients’ needs are met,” Colin said. “Every project is a collaborative effort between the owner, project designers, engineers, project managers, and superintendents that will be involved until completion.”

“Our repertoire includes a state-of-the-art Nuclear Medicine Caring Suite at Children’s Hospital Oakland, the installation of a 25-ton 7T MRI at Li Ka Shing Medical Center in Berkeley, and the design-build of a 7,671 square-foot shell space into a new Human Longevity facility” Colin added. “We have also recently completed a 25,000 square-foot, multi-million-dollar Cancer Center in Walnut Creek, CA for BASS Medical Group.”

Colin emphasizes that patient care and giving back to the community are high on the list of the company’s priorities.

“Through all this work, it is our goal to help better our communities. Because of this, we have given back over $1 million to local charities and hospital foundations since we first began four decades ago,” Colin said. •

For more information, visit colincc.com or call 530-272-3357.

VAST DIFFERENCES BETWEEN MANAGING AND LEADING

BY DANIEL BOBINSKI EMOTIONAL INTELLIGENCE

Stark differences exist among the assignments inherent to front-line workers, managers and leaders. Each level in an organization is supposed to have authority over different duties, and each area of responsibility requires different actions. That may seem like a no-brainer, but throughout every industry, some organizations exist in which people conflate the responsibilities of management and leadership. When people confuse those responsibilities, organizations are rarely as effective or efficient as they could be.

By way of review, effectiveness means moving in the best possible direction, and efficiency means doing things in a timely and cost-saving manner.

Said another way, when managers and leaders blur their lines of responsibilities, an organization may survive, but it probably won’t thrive.

THE LEADERSHIP VOID

The following illustration is true. The names and places have been changed to protect the innocent … and the guilty.

Alan has been at the helm of Widget Services Inc., a medium-sized company for nearly 20 years. The industry is stable and Alan’s company has seen consistent growth, but that growth is mostly due to Alan purchasing other, smaller companies. Most of the people on Alan’s leadership team have also been there a long time, with some working relationships going back 25 years.

One problem? They talk together to set goals, but plans to achieve those goals are rarely created. They hold meetings, but if a department head inquires about the status of projects in other departments, people whisper that the department head is becoming a micromanager.

Because nobody wants that label, there’s not much communication about various projects.

Additionally, Alan wants people to feel like they have input into what’s going on, so he invites 15 or more people to attend meetings when only four or five are needed.

If asked, nobody in management or leadership can recite the company’s vision and mission statements. Neither can they clearly differentiate the responsibilities of managers and leaders.

To make things worse, there’s a good ol’ boys club consisting of six key people, all of whom have worked at Widget Services for at least 15 years. Every summer that clique schedules a week-long hunting trip together. Nobody else from the company is ever invited, nor are any other off-site retreats ever held.

THE PERSON AT THE TOP

Everyone likes Alan. He doesn’t ruffle feathers, nor does he want any conflict on his teams. Over the years, Alan has surrounded himself with many like-minded people. Walk into their building and you’ll see everyone working dutifully on projects they believe are important, and once each year they do performance reviews where raises get doled out. Plainly stated, Alan’s organization was functional, but barely so.

ENTER THE NEW GUY

A few years ago, Alan’s company acquired XYZ Inc., a small specialty company. Kevin came with that acquisition. Kevin had been a leader in XYZ Inc., and he was an advocate of clearly defined roles for managers and leaders.

As you might imagine, Kevin’s style did not blend with the rest of Alan’s team. For example:

• Kevin thought leaders should think strategically and consider suggestions for making improvements.

• He thought leaders should share status updates with each other and discuss how to prevent potential threats from slowing them down – and that inquiring about such things was not micromanagement.

• He thought leaders should be creating deadlines for the goals they set and expecting everyone to know what their deliverables were, as well as when they should be delivered.

Kevin also had expectations for managers.

• He thought managers should know the strengths and blind spots of each person on their team and do things that increase esprit de corps.

• He thought managers should explore with others ways to speed up production without sacrificing quality or safety.

• He thought managers should be helping those on their teams understand the entire workflow process, not just laser-focus on the team’s assigned tasks.

BUMPS IN THE ROAD

If you’re guessing where all this is heading, you’d be correct if you surmised that the old-timers described Kevin as “difficult.” They were accustomed to a laid-back work ethic, so people complained to Alan that Kevin was “pushy.” And, because Kevin asked about the status of various projects, they also defined him as a micromanager.

Despite having 30 years in management and leadership positions with an exemplary track record, a year into the merger, Kevin was put on an Individual Improvement Plan.

DIAGNOSIS

Some might argue that because XYZ Inc. was subsumed into Widget Services, it was Kevin’s responsibility to “fit

in” with the Widget Services team. Normally, I’d say that approach should be part of an acquisition equation. However, Alan’s leadership style leads to poor communication and missed opportunities, while Kevin’s approach to management and leadership is pretty much textbook.

Widget Services Inc. might be surviving, but they are not thriving. So long as Alan continues with a lackadaisical leadership style, they are likely to remain that way.

PROGNOSIS

It’s rather sad that Kevin is the one being criticized in this situation. Thankfully, Alan is realizing he needs to make some principled changes. As for the rest of the team? The firmly ensconced good ol’ boy mentality needs to be modified and management and leadership responsibilities need to be clearly defined and assigned.

Also, Alan must realize that people will not do what he wants – they will do what he expects. He must learn to be firmer in establishing those expectations as well as be consistent in communicating them.

To accomplish this, Alan needs to institute the necessary training and then follow up so that these things can come to be. Why is this important? If the lines of management and leadership remain fuzzy, Alan’s company may survive, but it’s highly unlikely they will thrive. •

Daniel Bobinski, who has a doctorate in theology, is a best-selling author and a popular speaker at conferences and retreats. For more than 30 years he’s been working with teams and individuals (1:1 coaching) to help them achieve excellence. He was also teaching Emotional Intelligence since before it was a thing. Reach him by email at DanielBobinski@ protonmail.com or 208-375-7606.

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THE ROMAN REVIEW

YOUNG VS. OLD

Imeticulously accumulated notes to write this column a week ago. They were carefully commingled with all the other documents, papers, candy wrappers and such on my desk. The candy wrappers are still here. The notes went the way of the socks in the dryer.

To make matters worse, since the mind is the second or third thing to go, I don’t remember what the main topic was. Then, I realized that I am not going to worry about it. I can’t find the notes so move on to this new topic which is very appropriate to the issue.

When I was much younger, a long time ago, I did not worry about things much. My attitude was that things will work themselves out and if not, then that was the way they were meant to be. I believed that if you wait long enough, most things will diminish in importance and damage. Obviously some, but not all, items required attention, however.

Most thought I was just lazy and others thought I just did not care. This attitude drove many of those around me nuts. They misinterpreted my attitude. Then, I was drafted by Uncle Sam. Nothing like the threat of jail time to correct some of the previous ways of thoughts and actions. This attitude adjustment began with a drill sergeant who was fond of saying, “I’m trying to hep yah, sh**head.” The military has a way of providing the opportunity to obtain a good work ethic and stay out of jail.

After 10 years of successfully avoiding jail, I exited the military and entered the civilian world. So, in middle life I inherited a relatively foreign environment. I worried my butt off about things. I had trouble accepting that things were the way they were and that my influence on things was limited by the constraints and objectives placed upon

me. I wanted to be in “control of my destiny.” I worked hard at making things happen. I survived middle life and business relatively unscathed.

Interestingly, in middle life, I noticed that the young did not seem to worry about anything and I felt that they were lazy and did not care.

Now I am much older and arguably wiser. I just don’t worry about things that I have no control over. I believe that if you wait long enough, most things will diminish in importance and damage. Although some things will still need to be addressed in a timely manner their number is relatively small.

I subscribe to a couple of wise rules.

• “If things cannot be accepted, they must be changed. If things cannot be changed, they must be accepted.”

• “What is the worst that can happen?” If you can accept the worst, then maybe it is not so bad after all. Implementing the above two “rules” causes a wonderful calmness.

Why go around in life stabbing at things in an attempt to demonstrate activity? Work on the things that are important and urgent, while keeping an eye on the others. Isn’t it better to do a few right things correctly? Sleep on it to see if it is still as important tomorrow.

I mostly live by this rule now: “If something is not worth doing right, it may not be worth starting in the first place.”

Think about the great wisdom in this statement. Of course, people tend to misinterpret my attitude again. I am not lazy or uncaring. I’m conservative and frugal with my efforts. My story. I’m sticking with it. Can’t be changed. Accept it. •

Manny Roman, CRES, is association business operations manager at Association of Medical Service Providers.

MANNY ROMAN

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“A leader is best when people barely know he exists, when his work is done, his aim fulfilled, they will say: we did it ourselves.”

–Lao Tzu

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