Health Services Research & Policy ■ Clinical Practice Management ■ Training & Education ■ Leadership
Health Services Research & Policy ■ Clinical Practice Management ■ Training & Education ■ Leadership
Health Services Research & Policy
■ Clinical Practice Management
■ Training & Education ■ Leadership

Gatekeeping: A Radiology Firing Line Podcast

Changing health care delivery systems are shifting gatekeeping roles and risks in unexpected ways.

A gatekeeper controls access to something. In medicine, an optimal gatekeeper minimizes wasteful, inappropriate care while allowing access to necessary, or at least appropriate, care. However, as physicians are not only health care providers but also consumers of health care, we know that the gate is broken and the gatekeeper is too often asleep on the job.

Join Radiology Firing Line host Saurabh (Harry) Jha, MD, as the podcast takes a slight detour from its typical collegial debate format. Dr. Jha interviews H. Benjamin Harvey, MD, JD, a neuroradiologist at Massachusetts General Hospital, who gives us a brief master class on the complex regulatory environment surrounding gatekeeping in medicine. He demystifies concepts such as utilization review and radiology benefits managers and then prognosticates about the impact of contemporary shared-risk contracts on health care systems, especially accountable care organizations.

Radiology Firing Line - Gatekeeping.mp3

Another definition of gatekeeping can be found in media communications, in which gatekeeping involves filtering information before public dissemination, i.e. controlling access to information. In the podcast, Dr. Harvey breaks through a heavily fortified communications gate, unlocking a well-guarded secret about the shifting of gatekeeper duties from insurers to health care systems. He exposes a lack of legal accountability with straightforward remedies for bad health outcomes that are attributable to gatekeeper errors. But he also explains how health care systems without federal protections are assuming more of the risk for those errors than federally protected insurers.

If you are interested in further exploring the topic of this podcast, here is suggested reading from the JACR and other sources:

From Gatekeeper to Steward: The Evolving Concept of Radiologist Accountability for Imaging Utilization

Image Sharing Technologies and Reduction of Imaging Utilization: A Systematic Review and Meta-Analysis

Imaging Decision Support Does Not Drive Out-of-Network Leakage of Referred Imaging

The Biggest Threat to ACOs? Increased Malpractice Liability

The Looming Threat of Liability for Accountable Care Organizations and What to Do About It

The Ephemeral Accountable Care Organization – An Unintended Consequence of the Medicare Shared Savings Program The 2009 ACR Forum: Health Care Payment Models

The 2009 ACR Forum: Health Care Payment Models

Radiology Firing Line - Gatekeeping
The Role of Radiologists in the Patient Experience


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Wednesday, 26 June 2019

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