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President’s Message Dear Colleagues,

As the end of 2018 nears, it is time once again to reflect on the year’s efforts of the BCRS. Now having been your President for 18 months, I have a greater appreciation of the value this organization provides to the membership, recognizing that is not always obvious to the members. I am very pleased to report on the strategies, tactics, outputs and outcomes of the BCRS over the last year to illustrate the value of your membership. Going into 2018, the BCRS focused on three strategic objectives. First, the PMA. As we are heading into a Physician Master Agreement (PMA) negotiation for 2019, the primary objectives is for radiology to remain fee for service and within the PMA structure as managed through the Doctors of BC. The risk is legislation, taking radiology down the same path as pathology, which has been suggested in conversations with the Ministry of Health. Second, Radiology contracts. Any change to the medical (radiology) governance model should maintain radiologists as independent contractors. The BCRS has been predicting change to the governance and operational model for medical imaging in BC for a couple of years, anticipating that medical imaging will become a provincial program. Thirdly, to increase membership engagement, enhance awareness of issues and broaden member/group participation. The professional practice of radiology is under many pressures ranging from governance/funding reviews, increasing demands around hours and levels of services as well as implications of emerging technologies such as artificial intelligence. Given this, it is critical that all members get engaged and stay engaged taking a hands-on approach in managing the future direction of the profession. Of course, there are always unexpected issues that surface, keeping the BCRS particularly busy in 2018. So to recap: Focus on Physician Master Agreement: § Multiple meeting with the Doctors of BC

o Strategies and discussions on staying within PMA o Preparation for PMA negotiations

• Expected outcome: Section of Radiology to stay within PMA

• Overhead Review o Radiologist member on review committee o Managed survey expectations from Doctors of BC and MNP o Engaged radiologists and community imaging clinics on data collection

• Expected outcome: Little to no impact on current overhead allocation

President’s Letter – continued on page 2…

October to December Q4 2018

BCRS News

Individual Highlights:

President’s Message 1 Treasurer’s Report 3 Women’s Imaging 3

Programs 3

Communications 4 UBC Radiology Update 5 Did You Know… 6

Educational Opportunities 6

MAILING ADDRESS: 230 - 1210 Summit Drive,

Unit 128 Kamloops, BC

V2C 6M1

PHONE: 1.877.465.2277

FAX:

250.377.4028

E-MAIL: bcrs@bcrs.bc.ca

EXEC DIR:

1.604.353.5233

WEB: bcradiologicalsociety.com

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SAVE THE

DATE

SATURDAY Apr. 27, 2019

BCRS Prostate MRI Workshop

+

BCRS Luncheon General Meeting

River Rock Casino Resort Richmond, BC

See Programs Committee for

details

President’s Letter continued….

• MOCAP Review o Meetings with the Doctors of BC o Written submissions to the Review Committee o Several in-person presentations and discussions to the Review Committee

§ Expected outcome: Majority of radiology groups to stay at the same levels of MOCAP. Some groups may see some downgrading, which will require site specific data analysis to form appeal strategies.

Focus on Governance: • Cancellation of radiology group service contracts within the Lower Mainland

o Formation of BCRS Contract Working Group o Collaboration with the Doctors of BC o Multiple conversations with the Ministry of Health

§ Outcome: Imposed Health Authority deadline extended. Ongoing contract negotiations with a view to acceptable resolution with site-specific deliverables.

• Medical Imaging as a Provincial Program is being anticipated o Meeting with the Minister of Health Adrian Dix – Radiology as a trusted

partner o Formation of BCRS/Ministry working group around system efficiencies o Open up conversations with PHSA CEO o Awareness of other provincial models, e.g. Manitoba

§ Expected Outcome: Radiology part of the evolving medical imaging provincial service model.

Focus on Membership: • Need for continuous and improved communications by the BCRS

o Maintain quarterly newsletters & e-blasts on important, need-to-know information.

o Two general meetings per year plus quality CME events. o A refreshed and more user friendly BCRS website - launched in Q1 2019. o Assess a social media strategy for the BCRS in collaboration with the

CAR. o Continue face-to-face group meetings – 10 visits undertaken in 2018.

§ Outcome: 2018 sees the highest membership rate in the history of the BCRS.

Other efforts of the BCRS: • Doppler ultrasound at the community clinics • Pain management privileging dictionary • Moving to implement CT Trauma protocol and fee code development strategy • Breast clip fee code for high volume, Vancouver-based community imaging clinics

As always, we appreciate your feedback and welcome your participation in BCRS activities. Please feel free to contact me, other members of the executive team, Bob or Cheryl directly, for further information on how to become involved! ~Alison

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Treasurer’s Report Dr. Kristina Sharma The BCRS reached an all-time high in membership numbers in 2018 with 235 members in total. At the Annual General Meeting on November 3rd, the BCRS financials were presented to the members. The BCRS continues to run a fairly lean operation while holding contingency funds in place ($150K) outside of the general operating budget. This ensures that we have monies in place should a crisis arise and require a large sum of funds to be accessible in a short period of time. However, it was brought to the attention of the membership that relying on donations or sponsorship for CME events is somewhat unpredictable so annual budgeting must take this under consideration. Additionally, since the BCRS has now registered as a ‘member-funded society’ under the new Societies Act, public donations are restricted to $20,000 or 10% of gross income for the last two consecutive fiscal years. Dues for the 2019 calendar year remain unchanged from the past three years at $1,550.00 for regular members. The CAR dues have increased slightly (~3%) to $880.00 after holding steady for three years at $855.00. Total dues for the 2019 year for regular BCRS members will now be $2,430.00. Watch for the Notice of Annual Dues coming from the Doctors of BC to your inbox (and mail) soon. The BCRS is committed to promoting the value of the profession to key stakeholders and influencers, to be your advocate on important issues, to be diligent in matters of reimbursement, advance the profession through quality initiatives, with a focus on continuing medical education. At every stage of your career – from residency through to retirement – the BCRS is working hard for you. The BCRS would like to thank all our members for your continued support through 2018 and beyond. 2019 Resident Scholarship We are pleased to announce that we will be offering the BCRS Leadership in Radiology Resident Scholarship will again early in the new year. This award will allow one (1) radiology resident to attend the CAR Annual Scientific Meeting (April 26-29, 2018) in Montreal, Quebec. The award is intended to cover:

• Air travel, accommodation and meals associated with attending the Leadership course and CAR Annual Scientific Meeting (ASM)

• Cost of the CAR ASM registration

The Terms of Reference will be sent to all UBC Radiology residents before the end of 2018 with the deadline for submission in February. The successful recipient will be selected by in early March.

Women’s Imaging Dr. Zenobia Kotwall Update - Breast Clip Placement Following a revised proposal to the Tariff Committee on June 8, 2018 BCRS has received final approval for a New Fee Item Fund for Post Biopsy Radiological Marker (Clip) placement. The MoH agreed that this request represented standard of care and approved annual funding of approximately $200,000.

This fee item is restricted to two Vancouver Coastal CIC’s and will compensate them for the purchase cost of the clip itself.

Breast Density BC Cancer has recently mandated that women be notified of their breast density along with their screening mammography results. In order to increase awareness of this issue BCRS requested Dr Paula Gordon to present the latest information and research on this topic. Dr Gordon’s comprehensive article presents the breast density scoring system and then focuses on the diagnostic limitations that women with dense breasts experience despite their increased risk of breast cancer. She then discusses the advantages and limitations of newer technologies and provides information on supplemental screening that can facilitate early diagnosis for this subset of women. Her article is presented as a Special Supplement to the BCRS Q4 Newsletter. We thank Dr Gordon for this timely submission.

Programs Dr. Charlotte Yong-Hing The BCRS held another very successful CME event on November 3rd in conjunction with the AGM. The course, Pediatric Imaging Update: Pearls and Perils for the General Radiologist was well attended. Over 60 physicians including radiologists, fellows and residents participated in

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person and by webinar. We thank Dr. Heather Bray from BC Children's Hospital for organizing the speakers and planning the program based on feedback at BCCH. SAVE THE DATE BCRS Prostate MRI Conference April 27, 2019 – Vancouver, BC The BCRS is pleased to announce that we will host a hands-on Prostate MRI Simulation Workshop directed by Dr. Silvia Chang on Saturday, April 27, 2019, at the River Rock. Casino Resort. Keynote speakers include Drs. Larry Goldstein and Dan Margolis. Space is limited for this event so plan to register early! Pre-register here if you have not already done so. Communication Dr. Wan Wan Yap Re-developed BCRS Website The new BCRS website is currently under development. We have recently viewed a demo of the site and we are really excited to share it with our members. Additionally, we are undergoing a rebranding of the BCRS with a new logo and colour scheme. Our plan is to have one comprehensive site with a membership management system as well as a fully integrated learning management system where our members will have 'one stop shopping' for all things BCRS. Look for our launch in early 2019!

Update: Specialist Services Committee (SSC) Since its introduction in 2009, the SSC Fee Guide has not had a thorough edit in order to increase its usability and ensure that there is consistency throughout the guide. As of January 1, 2019 a revised SSC Fee Guide will be implemented. A high level summary of the updates SSC has made

in order to ensure that the guide is more user friendly. Specialist Symposium: Shaping the Future of Specialist Care in BC On January 18, 2019, the SSC and Specialists of BC and SSC will jointly host this event at the Sheraton Wall Centre, Vancouver BC, to discuss where specialists fit in the direction being take with BC's health care. The future is currently being defined and specialists can have a hand in shaping it. There is no cost to attend, but space is limited. Physicians attending will be supported through reimbursement of travel, accommodation and for non-salaried physicians, sessional time will be paid. To register, contact the SSC or the Specialists of BC. FMI: Contact Rhiannon Steele at the Doctors of BC, rsteele@doctorsofbc.ca

Additional SBC Specialist Symposium

Saturday, January 19, 2019

The Specialists of BC will also be hosting an additional event the following morning on Saturday, January 19th, from 8:30am to 12:30pm. There will be two physician-led sessions, and presentations from specialists with on-the-ground experience, followed by group discussion and a motion to bring forward after the session:

• Specialist disparities: can they be measured? • The model office: theoretical and real-world

overhead considerations

This is also a free event however, while sessional and travel is available to eligible attendees on Friday, for Saturday, participants will receive breakfast, lunch and SBC membership is not required, ie. all specialists welcome! Email the Specialists of BC to register for Saturday (specialists@specialistsofbc.org)

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These events are free of charge to BC specialists, but you must sign up in advance! UBC Radiology Update – Dr. Bruce Forster UBC Radiology is delighted to welcome Arman Rahmim, PhD, as an Associate Professor and medical physicist specializing in PET-CT and radio-omics, after his stellar career at Johns Hopkins. We are also excited to announce that we are about to hire into a combined Faculty position with the School of Biomedical Engineering in minimally invasive therapies, concentrating on device innovation, drug delivery and cancer biology analytics. This is part of a strategy to align with the Faculty of Applied Science, SBME and other Faculties as we develop our program in evolving areas such as Artificial Intelligence. We also said goodbye to Helen Nadel as she left for an exciting career as Clinical Professor at Stanford, and Anna Celler, who retired as Professor Emeritus after a distinguished career in Nuclear Medicine. Our Program Directors, Drs. Cam Hague and Tony Sedlic, are leading the Dept in preparations for Competency by Design (CBD), a new RCPSC-mandated approach to learning and evaluation, which will require considerable input from Faculty---much more to come. Dr. Gerald Legiehn, Vice Chair of Quality, organized and hosted a remarkably successful Resident Quality Day on Dec 4th. All seven PGY-4 residents presented thoughtful, impactful clinical

audits, with prizes generously furnished by the Radiology Practice Groups at Royal Columbian, Surrey Memorial, and Lion’s Gate Hospital, in support of possible presentation at the National Audit Day in Ottawa in April 2019. UBC Radiology hosted its first reunion in many years at the RSNA, attended by 40 alumni. The Mexican theme was most appreciated given the cold Chicago weather! We are planning this to be an annual event. In September, UBC Radiology held a Communications Summit, featuring speeches by Dean Kelleher, Executive Associate Dean Parhar on social media, and three breakout groups on teaching millennials, how to get your program/research message out to public/government, and advice on conflict resolution. Fifty faculty, learners and staff attended, and evaluations were strong such that future events, with topics chosen from crowd sourcing Dept members, will be forthcoming. lease make sure to join us live or remotely for fully accredited Grand Rounds each Wed at 5 pm, and make sure to follow Dept news on Facebook or Twitter (@UBC_ Radiology). Finally, on behalf of UBC, my very best wishes to all BCRS members and their families for the holidays. UBC sincerely appreciates your support of our learners, conferences (next up is MSK Radiology at Whistler, March 16-19) and programs.

UBC Professor and Vice Chair Dr. Savvas Nicolaou received in December the highly prestigious ‘Specialist of the Year’ (Prix d’Excellence) award from the RCPSC, for his outstanding work in modelling excellence in patient care in Emergency/Trauma Radiology. The award was presented by Dr. Siavash Jafari,, RCPSC Region 1 Member-at-Large. Left to right: Drs. John Mayo, Siavash Jafari, Savvas Nicolaou and Bruce Forster. Photo credit: C. Zwirewich

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Did you know….there is a social media group called “Canadian Radiology Women” that now has 259 members in the Facebook group, 284 followers on Twitter and 124 followers on Instagram? Canadian Radiology Women is an online initiative with a Mission to promote application to Radiology, foster mentorship, and facilitate leadership training that will increase diversity in Canadian Radiology practices to improve patients. The Vision of Canadian Radiology Women is to encourage women medical students to choose Radiology, to support women throughout their training and practice, and to create a community of women radiologists in Canada. Follow on:

• Facebook Canadian Radiology Women • Instagram @canadianradiologywomen • Twitter @canadaradwomen

Educational Opportunities

SHOW – Symposium on Hepatic Oncology in Whistler February 2019 Fairmont Chateau Whistler, Whistler BC UBC / U of T MSK Imaging Course March 16-19, 2019 Four Seasons Whistler, Whistler BC The Canadian Association of Radiologists 82nd Annual Scientific Meeting April 11-14, 2019 Le Centre Sheraton, Montreal QC 2019 PrIMED – BCRS Prostate Intensive MRI Education Day April 27, 2019 River Rock Casino Resort, Richmond BC 20th Annual ASR CME Conference - Breast Imaging and Interventions May 3 to 5, 2019 Kananaskis Mountain Lodge Resort, Kananaskis, AB