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Letters from AAMD President
Dear Medical Dosimetrist,
As you may know, AAMD has been participating in a group called Alliance for Quality Medical Imaging and Radiation Therapy (AQMIRT) for the past six years. The main focus of this group, so far, has been to represent you and promote the profession in proposed legislation that aims to establish federal standards of education and credentialing for all non-physician medical imaging and radiation therapy personnel. In addition to us, this includes: all radiologic imaging, magnetic resonance, nuclear medicine and interventional technologists, radiation therapists, medical physicists, medical sonographers, and radiology assistants. The House version of the bill is H.R.1426 - Consumer Assurance of Radiologic Excellence Act (CARE Act) and, as of August 24, 2006, has 129 cosponsors. The Senate version of the bill is S.2322 — Consumer Assurance of Radiologic Excellence Act of 2006 (RadCARE Act) and, as of the same date, has 16 cosponsors. Many more cosponsors are needed for both bills.
The AAMD Board of Directors and Government Relations Committee are asking you to support this very important piece of legislation and, in turn, lobby your congressional representatives and senators to cosponsor these bills. Sample letters are available for you to use and can be found by clicking here; feel free to modify each as you would like. Invite your friends and family to also write letters.
If you are unfamiliar with the intent of these bills (which would amend title XIX of the Social Security Act), here is more detailed information. In 1981, the federal government set standards for the education of radiologic personnel (the Consumer-Patient Radiation Health and Safety Act of 1981) and gave the states a model stature for licensing radiologic technologists. Compliance with this law has never been enforced. As a result, only 41 states fully or partially license, regulate or register radiographers; 30 states license radiation therapists; 25 states license nuclear medicine technologists; 3 states license medical physicists; and 0 states license, regulate or register medical dosimetrists. What is pertinent to us is that we all know of situations where unqualified individuals have received "on-the-job training" ("OJT"). As our profession grows, the workplace expectations become more demanding. In recent years, we have all seen an exponential growth in complexity and this growth will continue into the future. Our profession has reached a turning point where the medical dosimetrists of the future need formal education and credentialing; OJT is no longer a reliable teaching method or appropriate avenue toward becoming a Medical Dosimetrist. For us, implementation will be far enough in the future to allow formal programs to develop to ensure the educational mechanisms are set into place. This occurred in the early 1970s with the radiation therapy bodies and we foresee the same thing happening for medical dosimetrists.
The two versions of the bill have similarities in that they seek ways for qualified individuals to perform the specified tasks. How this is accomplished is slightly different. The House bill looks to mandate state licensure and the Senate version ties credentialing to reimbursement. When these bills are approved by their respective houses, they will be reviewed and modified to become one bill. So, we currently have no way of knowing what the final product will be and, furthermore, what the final requirements will be. It is important to note that grandfathering will be included and that no one can be legislated out of a job. All current medical dosimetrists will be allowed to continue in their current jobs. There will also be a time period allowed before implementation. This means that people currently striving to become medical dosimetrists can complete their education or training.
This legislation is of utmost importance in moving our profession forward. With its passage, standards will be required for our profession. This is imperative because without standards we will not be taken seriously as a profession, and the future growth of Medical Dosimetry as a profession will be severely hindered. After all, what "profession" does not require an education or credentialing (as ours currently does not)? We hope you agree and show your support by contacting congressional representatives within the next two weeks.
To find your Congresspersons' names and snail or e-mail addresses, visit http://thomas.loc.gov/. The bills are also available from this site for you to review.
Sincerely,
AAMD Board of Directors:
Rudi J. Bertrand, CMD, President
Paula Berner, CMD, President-elect
Mark Reid, CMD, Past President
Nishele Lenards, CMD, Membership Secretary
Melanie Dempsey, CMD, Recording Secretary
Randall Merrill, CMD, Treasurer
Sandi Huston, CMD, Region I Director
John Peña, CMD, Region II Director
Jennifer Buskerud, CMD, Region III Director
Theresa Kwiatkowski, CMD, Region IV Director
Anjenette Milligan, CMD, Region V Director
Mary Jo Repasky, CMD, Region VI Director
AAMD Government Relations Committee:
Chris Gainer, CMD, Chair
Harold Tewksbury, CMD, Member
Keith Moore, CMD, Member
Mary Hare, CMD, AAMD Liaison to AQMIRT
Sample Letter to Representatives
Personalize your letter by describing your experience as a professional medical dosimetrist. Follow up your letter with a phone call, fax, email or personal visit.
Address your letters to:
The Honorable __________
U.S. House of Representatives
Washington, DC 20515
Dear Representative (Surname):
I am writing to ask you to cosponsor an important piece of patient-care legislation. The Consumer Assurance of Radiologic Excellence (CARE) bill (H.R. 1426) would establish basic educational and certification standards for non-physician health care personnel who perform and plan our nation's medical imaging and radiation therapy procedures. The CARE bill was introduced on March 17, 2005 by Representative Chip Pickering.
Most Americans take for granted that the person performing medical imaging or radiation therapy procedures is an educated allied health professional. The fact is, poorly trained individuals who have no formal education in these specified roles examine and treat patients in this country every day. This is because there are no mandated federal standards that these employees must meet.
(Insert personal statement here)
The CARE bill would amend the Consumer-Patient Radiation Health and Safety Act of 1981, which set federal education and credentialing standards for non-physician radiologic personnel. Because compliance with the 1981 Act was voluntary, only 41 states have enacted licensure laws or regulate radiologic technologists; 30 states license radiation therapists; 25 states license nuclear medicine technologists; 3 states license medical physicists; and 0 states license or regulate medical dosimetrists, and many of those laws or regulations do not match the standards recommended by the federal government. The CARE bill would require states to develop education and credentialing standards for medical imaging and radiation therapy personnel that meet or exceed the federal standards. States that choose not to adopt standards would not be eligible for federal matching funds for imaging or therapy procedures reimbursed under Medicaid.
Establishing minimum educational criteria for health professionals is not a new or controversial idea. In the case of mammography, for example, Medicare will only pay for mammograms performed by an individual who: "is licensed by a state to perform radiological procedures, or is certified as qualified to perform radiological procedures by such an appropriate organization as the Secretary specifies in the regulation." The CARE bill would extend this concept to all other medical imaging and radiation therapy procedures while retaining the state's authority to license health care workers.
Thousands of individuals with limited education and no certification are performing medical imaging examinations and radiation therapy procedures on patients every day. Errors occur. In imaging, images can be unreadable by the physician who must order that the image be retaken in order to make an accurate diagnosis. In radiation therapy, patients can receive a higher or lower dose of radiation than what was prescribed by the physician, thereby delivering unacceptable treatment. Federal programs such as Medicare and Medicaid, along with private insurers or patients themselves pay for these mistakes. Improperly taken images or treatment planning and delivery not only result in unnecessary added health care costs, but in the most tragic cases, can lead to injury or harm to a patient.
Congress now has the opportunity to improve the quality of radiologic care by establishing education and credentialing standards for persons who perform needed imaging and treatment services. I urge you to voice your support for quality health care by contacting Mary Mills Ritchie in Rep. Pickering's office and cosponsoring the Consumer Assurance of Radiologic Excellence (CARE) bill (H.R. 1426). I look forward to hearing from you soon on this issue.
Sincerely,
Name and Credentials
Home Address
City, State, ZIP
Sample Letter to Senators
Personalize your letter by describing your experience as a professional medical dosimetrist. Follow up your letter with a phone call, fax, email or personal visit.
Address your letters to:
Senator __________
U.S. Senate
Washington, DC 20510
Dear Senator (Surname):
I am writing to ask you to cosponsor the Consumer Assurance of Radiologic Excellence (RadCARE) bill that was introduced by Senator Mike Enzi on February 17, 2006, as S. 2322. The purpose of this legislation is to establish minimum federal educational and credentialing standards for non-physician health care personnel who perform medical imaging, plan or deliver radiation therapy services.
Currently, only 41 states have enacted licensure laws or regulate radiologic technologists; 30 states license radiation therapists; 25 states license nuclear medicine technologists; 3 states license medical physicists; and 0 states license, regulate or register medical dosimetrists. Many of these state laws were enacted as a direct result of 1981 Consumer-Patient Radiation Health & Safety Act which set voluntary guidelines for states to follow in establishing education and credentialing standards radiologic personnel. While most states complied to some degree with the federal requirement, a wide disparity in standards from state to state was created; nine states and the District of Columbia still have no standards. In these states, individuals with as little as a few days of on-the-job training can perform medical imaging or radiation therapy procedures and their employers can submit claims to Medicare for reimbursement for those examinations or treatments. Errors occur. In imaging, images can be unreadable by the physician who must order that the image be retaken in order to make an accurate diagnosis. In radiation therapy, patients can receive a higher or lower dose of radiation than what was prescribed by the physician, thereby delivering unacceptable treatment.
(Insert personal statement here)
Simply put, the RadCARE bill would require the Secretary of HHS to set minimum education and credentialing standards for non-physician individuals who perform medical imaging and radiation therapy services and then ensure that all programs under the Secretary's authority adhere to those standards. The RadCARE bill does not require the states to change their laws but simply ensures that federal programs that pay for medical imaging or radiation therapy services will only pay for the procedure if it is provided by an individual who meets the minimum educational and credentialing criteria.
Establishing minimum educational criteria for health professionals in the absence of state standards as a condition of employment or reimbursement is not a new or controversial idea.
In the case of mammography for example, Medicare will only pay for mammograms performed by an individual who: "is licensed by a state to perform radiological procedures, or is certified as qualified to perform radiological procedures by such an appropriate organization as the Secretary specifies in the regulation." The RadCARE bill would extend this concept to all other medical imaging and radiation therapy procedures.
Congress now has the opportunity to improve the quality of radiologic care by establishing education and credentialing standards for non-physician health care workers who perform needed imaging and therapeutic services. I urge you to voice your support for quality health care by contacting Steve Northrup in Senator Enzi's office and cosponsoring the Consumer Assurance of Radiologic Excellence (RadCARE) bill.
I look forward to hearing from you soon on this issue.
Sincerely,
Name and Credentials
Home Address
City, State, ZIP
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