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Letters from AAMD President
Dear Medical Dosimetrist,
The AAMD continues to participate in the Alliance for Quality Medical Imaging and Radiation Therapy (AQMIRT), most recently joining the group in Las Vegas, NV earlier this month. With your help, the Alliance has made great strides in getting the CARE bill in the front of our national congressional representatives. This legislation aims to establish federal standards of education and credentialing for all non-physician medical imaging and radiation therapy personnel. In addition to us, t h is includes: all radiologic imaging, magnetic resonance, nuclear medicine and interventional technologists, radiation therapists, medical physicists, medical sonographers, and radiology assistants. The Consistency, Accuracy, Responsibility and Excellence in Medical Imaging and Radiation Therapy (CARE bill) House version of the bill is H.R. 583 and the Senate version of the bill is S.1042. The bills introduced into both Houses of Congress, this session, are of identical wording which when passed will go directly to the President for signing. We urge you to become familiar with the bills and again make a concerted effort to contact your Representatives and Senators for their support. There is now an increased urgency to push for the passing of these important bills. Congress will soon enter the re-election period and if the CARE bills are not passed by the end of the year they could fall victim to the 2009 or even the 2010 process. This is too important not to act!
The Alliance has agreed to conduct a collaborative focused "virtual march" on Capitol Hill during the week of November 5-9, 2007. We are trying to make the CARE bill one of the top five items that constituents are concerned about and by focusing our efforts to this one week, we can achieve this goal. Sample letters are included for you to use and can also be found on the AAMD website by clicking here; feel free to modify each as you would like. We strongly encourage you to invite your friends and family to also write letters of support. Personal visits to your congressional representatives during the Thanksgiving break would be of great asset, as the Alliance has shown increased congressional co-sponsorship after personal visits from constituents. It is very important to send emails, faxes or make personal calls, as letters will take up to three weeks and will not contribute to this important collaborative effort.
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 statute 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") and are working in the field. 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. 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 mean s that people currently striving to become medical dosimetrists can complete their education.
This legislation is of utmost importance in providing a safe culture for the American population receiving medical imaging and radiation therapy. With its passage, standards will be required for our profession as well as others represented by the members of the Alliance. This is imperative because without standards the American people cannot be assured of receiving proper medical care with respect to medical imaging and radiation treatment services. After all, our profession deserves education and credentialing standards. We hope you agree and show your support by contacting congressional representatives during the virtual march. Coordination over the week of November 5-9, 2007 is key to the success of this virtual march.
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
Paula Berner, CMD, President
Nishele Lenards, CMD, President-Elect
Rudi J. Betrand, CMD, Past President
Laura Earley, CMD, Region I Director
Juan Pena, 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, Co-Chair
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 Consistency, Accuracy, Responsibility and Excellence in Medical Imaging and Radiation Therapy (CARE) bill (H.R. 583) 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 techno l ogists; 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. o te 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 Consistency, Accuracy, Responsibility and Excellence in Medical Imaging and Radiation Therapy (CARE) bill (H.R. 583). 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 Consistency, Accuracy, Responsibility and Excellence in Medical Imaging and Radiation Therapy (CARE) 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 CARE bill (S.1042) 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 CARE 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 CARE 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 Consistency, Accuracy, Responsibility and Excellence in Medical Imaging and Radiation Therapy (CARE) 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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