By Michael Mozdy
Two faculty anchors of our Head and Neck Imaging program here at University of Utah Health have been recognized nationally by being elected fellows of the American College of Radiology (ACR). This is one of the highest honors bestowed on ACR members; only 15% of members achieve this status, conferred on members who have been approved and elected by the ACR Board of Chancellors.
The ACR is an accreditation body for radiology practices around the country and also publishes Appropriateness Criteria to guide physicians in ordering the appropriate imaging for patients. This type of work and other clinical decision support tools play an essential part in uniting the American health care system around the most effective and efficient use of an incredible arsenal of imaging techniques: MRI, CT, PET, SPECT, X-ray, and evolving technologies.
Yoshimi Anzai received her MD from Chiba University School of Medicine in Japan. She pursued advanced training in radiology at UCLA and the University of Michigan, where she proceeded to take on a faculty position. She then joined the faculty at the University of Washington in Seattle, where she also received a Masters in Health Administration before coming to University of Utah Health. Dr. Anzai has held many leadership positions and currently serves as the Director of Value and Safety for IMAGER at U of U Health, the co-director of Women in Health, Medicine and the Sciences, and the Chair of the CMS Qualified Provider-Led Entity (a distinction she spearheaded for UofU Health). She has been awarded the Marie Curie Award by the American Association of Women in Radiology as well as several Honored Educator Awards from the Radiological Society of North America and is a fellow of the Association of University Radiologists. She served as the President of ASHNR and AUR in the past. She is internationally recognized for her work as a head and neck radiologist, high-value-oriented radiology and health policy, and advancing women's success, diversity, and inclusion in radiology.
Rick Wiggins received his MD from the University of Texas and pursued his advanced training in Head and Neck Imaging at the University of Florida and the University of Mississippi before doing a fellowship and joining the faculty at the University of Utah. Dr. Wiggins holds academic appointments in three departments: Radiology and Imaging Sciences, Biomedical Informatics, and Otolaryngology-Head and Neck Surgery. What's more, he currently serves as the Associate Dean of Continuing Medical Education for the School of Medicine. Dr. Wiggins is a nationally and internationally respected educator, both within the department where he has received several awards, around the country, and the world. Like Dr. Anzai, he participates extensively with professional organizations, taking on leadership in organizations like the Radiological Society of North America, the American Roentgen Ray Society, and the American Society of Neuroradiology. He is a fellow of the Society of Imaging Informatics in Medicine (SIIM). He also served as the President of ASHNR.
I had a chance to ask Anzai and Wiggins about their careers and what the FACR election means to them. Here are their responses:
What has been the most challenging aspect of your career as you’ve grown to be a respected clinician and leader in the field?
My challenge is that I have an interest in many things. I love clinical work and teaching trainees and students. I also enjoy research, writing papers, and grants in the late nights. Just thinking about grant ideas is fun. Last several years, on top of it, I have expanded my area of interest into Quality, Safety, comparative effectiveness, diversity& inclusion, and gender equality. I must say that I make myself too busy. However, it was not from a sense of obligation, but I have curiosity in many aspects of academic radiology. My philosophy is to follow own passion.
I think it is challenging to learn to focus on the critical aspects of head and neck imaging, and communicating them in the best way to the head and neck clinicians. Things like teaching, learning, and education are not taught in medical school, so that is something a lot of people need to learn themselves. I have also found it challenging to learn how to be an effective advisor, coach, and mentor to others, not only inside and outside of radiology department, but also inside and outside of our institution.
Can you say a few words about your professional passions outside of head and neck imaging?
As a teacher, my position with continuing education allows me to share best practices with others, in a “teach the teachers” position, throughout the health sciences center, not only with physicians, but nursing, PAs, pharmacists, social workers, dentists, etc. I have also had a great experience with the medical school executive team, dealing with issues from School of Medicine admissions to curriculum.
I have three areas of professional passions. The first is neuro/head and neck radiology. I genuinely love Neuroradiology and Head and neck radiology. There are always discoveries either by understanding the pathophysiology of disease or adopting new technology. I have never regretted becoming a neuroradiologist. I am so grateful that I do things that I enjoy and get paid for it.
Second, advocating women in the STEM field. As the co-director of WiHMS, I have heard and witnessed that gender inequality is still pervasive in the STEM field, including medicine. Micro or macroaggression is very prevalent even now. There is the underlying societal stigma that women are not capable of sciences compared to men, or women are not well fit for leadership. I wanted to advocate for all women in the STEM field so that the next generation of women students and residents will have an easier path than I have experienced. It is what our senior women leaders like Dr. Osborn have done for us.
The third one is Quality and Safety. Some people may feel Quality and Safety is some kind of a mandate that is imposed upon us. However, when we think about the purpose of practicing medicine or radiology, the main reason is to help our patients. If we put patients in the center, Quality and Safety are perhaps a critical aspect of our radiology practice. Why not embrace it?
What does the American College of Radiology represent to you (and being a fellow)?
The American College of radiology is a critical society in the radiology profession, representing not only radiologists, but also radiation oncologists, nuclear medicine physicians, and medical physicists. This is a group focusing on leadership, integrity, quality, and innovation, so it is a huge honor to be recognized as a leader in our chosen field. While the ACR is best known for handling government relations and economic issues in radiology, there are also exciting and leading groups focusing on informatics, education, and research and innovation.
ACR provides accreditation of equipment and facility. They generate and update the practice parameters, set the standards for radiation protection, and disseminate Imaging focused white papers. However, the ACR's most significant role is its advocacy towards the Congressional Senators and Representatives at The United States Capitol in Washington, DC. They speak out for all of us to demonstrate the values that radiology and radiation oncology bring.
The ACR also creates multi-center research infrastructures, such as the ACRIN trials, Health Policy Research, and the ACR data science institutes. It is different from other investigational research that NIH will fund, but these health services and health policy research have become essential.
Another recent initiative of ACR is to support diversity and women. I was the upcoming AAWR President when AAWR was utterly out of funds. We had a very depressing AAWR board meeting to talk about declining membership and revenue and increasing administrative costs – simply stated, we run out of money. Julia Fielding and I flew over to the ACR headquarter and negotiated the management of AAWR under ACR. Under the collaboration with ACR, women's commission and general diversity were established, and AAWR has gained much-needed visibility. Dr. Fielding and I still discuss how proud we were to save the AAWR from extinction. Since then, the ACR has been a solid voice to embrace diversity and inclusion in radiology organizations.
I joined the ACR quite late. I was a full professor at the University of Washington and was not sure if I should join the ACR or not. Later, when I learned about the reimbursement cuts and quality metrics for radiology, I realized that the ACR's work is essential for our profession. I am so glad that I joined the ACR. I have served as a member of the ACR appropriateness methodology committee, the commission of women and general diversity, and now on the committee for medical students education. I am also a senior ACR member of the AAMC Council of Faculty and Academic Society (CFAS).
What are you most excited about as you consider the next 10 years in your profession?
I am most excited about the increase and growth of technology in education, as well as the potential for asynchronous learning in medical education, MedEdMorphosis, the reconfiguration of medical education, and the continued improvements in head and neck imaging of anatomy and pathology, and future innovations that will allow us to better care for our patients.
I have lived through incredible technological advancements in radiology - starting from CT scans in the ’70s, MRI in ’80s, and PET scans in ’90s. Ultrasound was not-so-exciting when I was a resident. But now, the US imaging is beautiful and offers such high resolution. I do not know if we will have another new imaging technology that changes the way we practice.
I am most excited about the future of radiology and the way we extract information and communicate it with clinical teams and patients. The way we dictate narrative reports has not changed for 100 years. We should have innovation in this space so that data can be minable and meaningful to everyone. Whether radiologists will participate in this endeavor or artificial intelligence will do it, it is up to us.