It is that time of the year, and I do not refer to decorated evergreens or eight-branched candelabras. It is time to close the books on 2002, time to tally the gains, write off the losses, and set goals for 2003. In so doing, I polled the Decisions in Imaging Economics editorial advisory board to arrive at a list of unresolved business issues from 2002. Effectively, these items provide a blueprint for action in 2003:

1. The labor shortage persists, providing the most troublesome issue of all:

• The shortage of radiologists and increased demand are problems endangering the future of the specialty. - Alexander R. Margulis, MD
• From my perspective, the largest issue I have had to deal with this year is recruitment of technologists.It takes more than 6 months to recruit a technologist. We have created scholarship programs for students in all types of modalities, yet there are not enough students to fill the gaps. A related issue is the aging work force. It is a concern that most of us will be reaching retirement age around the same time and there are not the same numbers of staff coming in behind us. The Bureau of Labor Statistics predicted that the country will need 75,000 more radiologic technologists in 2010 than it did in 2000, in addition to 16,000 more sonographers, 8,000 more nuclear medicine technologists, and 7,000 more radiation therapists.Sheila M. Sferrella, MAS, RT(R), CRA

2. A continuing cause for concern in many states:

• The malpractice crisis sweeping the country. I suspect the worst is over as the Governor-elect has made this a priority in the state of Pennsylvania.Howard B. Kessler, MD

3. An issue that strikes at the heartand the pocketbookof radiology is the current confusion in the public mind regarding the effectiveness of mammography:

• We must undertake an educational program directed at the American public with regard to the benefits and limitations of mammography. Mammographically related missed or delayed diagnoses of breast cancer remain the leading cause of malpractice litigation against radiologists and non-radiological physicians alike. The huge indemnification payments and the frequency with which juries find for the plaintiffs in these cases regardless of reputable and good scientific testimony that a short delay did not harm the patient keeps increasing. At its annual meeting in September 2002, the councilors of the American College of Radiology (ACR)  passed a resolution sponsored by the Illinois and Georgia delegations calling for the ACR to undertake a campaign to better educate the public about the limitations of mammography. As I look toward to 2003, I hope the ACR will assume this duty enthusiastically and effectively.Leonard Berlin, MD

4. When the lame-duck Congress left Washington, it let stand the 4.4% cut in the 2003 physician fee schedule. Both the ACR and the American Society for Therapeutic Radiology and Oncology will undertake surveys aimed at determining the true cost of providing diagnostic and therapeutic services by the specialties. Your conscientious attention to those surveys will help effect:

• Restoration of the reimbursement on the technical component in radiology.Cherrill Farnsworth

5. To achieve maximum efficiency, health care must reassess its business models and practice patterns and design and adopt:

• Enterprise IT solutions based on computerized physician order entry (CPOE) to deliver knowledge at the point of care and enable the practice of evidence-based imaging. Embedding scheduling, billing, and image viewing tools within the same application will bring significant value to the health care enterprise by improving quality and efficiency.Ramin Khorasani, MD

That said, I would like to take a moment to acknowledge and express my gratitude to my editorial advisory board for its support throughout 2002. I also would like to wish our readers all of the joys and pleasures of the holiday season.

Cheryl Proval

cproval@medpubs.com