Tri Hiremath | Jeffery Hogg | Bertan Ozgun | Aanshu Shah | Neha Choksi | Chad Ringger | Shalini Chabra | Geraldine McGinty | Haresh Naringrekar | Nikki Restauri
Tri Hiremath, MD
My ACR Rutherford-Lavanty Government Relations Fellowship Experience
The demanding nature of medical training leading up to a career in Radiology and the responsibilities on arrival, often leave us myopic to the complex regulatory processes constantly shaping and protecting our discipline at the local, state, and national level. This past June, the American College of Radiology provided me a unique opportunity to get a first-hand glimpse of this massive healthcare policy engine, as part of the 2019 ACR Rutherford-Levanty Government Relations Fellowship in Washington, DC.
Created in 1993 in honor of J.T. Rutherford and Donald F. Lavanty, the pioneers of radiology governmental advocacy for the ACR, this fellowship program provides radiology trainees exposure to the crucial work being done by the ACR Government Relations Office to promote Radiology, a chance for the trainees to inform legislators on the needs of their field drawing from their clinical experiences, and a primer on US health policy and the regulatory process.
I had an incredibly enlightening and humbling experience working alongside the talented and passionate members of the ACR Government Relations Office and the RADPAC team. The fast-paced week consisted of lunches, dinners, committee meetings, conferences, and fund-raising events for several members of Congress. Many of these were small group events co-hosted with other medical advocacy groups representing a range of specialties. It truly shed light on the importance of coalition efforts in fighting for the needs of physicians as a whole.
In addition to fundraising events, I was also excited to meet with legislative correspondents at the offices of Representative Mike Doyle, Senator Pat Toomey, and Senator Bob Casey to discuss some of the challenges facing the healthcare system in Pennsylvania noting the unique insurance models/organizations in place as well as the innovative initiatives underway on key topics such as the physician-patient relationship in ancillary departments like Radiology at many Pennsylvania hospital systems like UPMC in Pittsburgh. We also discussed the ACR’s support of the “Protecting Access to Lifesaving Screenings Act” (PALS) which would renew the moratorium on the USPSTF mammography screening guideline change thereby avoiding the detrimental outcomes and costs associated with delaying annual mammography screening.
One of the most exciting parts of this experience was meeting Congressmen who were former Physicians and thanking them for representing our profession on Capitol Hill and for their contributions to improving the lives of residents and practicing physicians. I had the wonderful opportunity to personally thank Representative Brian Babin (TX 36th District), a former Dentist, for his work on the “REDI Act,” which would provide interest-free deferment on student loans for trainees in medical or dental residency programs. I also had the fortune of sitting at an NRCC roundtable discussion that included Representative Larry Buchshon (IN 8th District), Representative Phil Roe (TN 1st District), and Representative Michael Burgess (TX 26th District), all former Physicians, on the hot-button healthcare issues like “Surprise Billing.” I had a chance to convey the important nuances of how ancillary physicians/providers like Radiologists are affected and the ACR’s support of inclusion of the arbitration clause in the final legislation, paramount for physician practices to stay market competitive.
The culmination point in my week was attending the legislative hearing, “No More Surprises: Protecting Patients from Surprise Medical Bills,” held by the Subcommittee on Health of the House Committee on Energy and Commerce. I heard testimonies from top leaders representing Physicians for Fair Coverage, Association of Air Medical Services, The ERISA Industry Committee, American Hospital Association, America's Health Insurance Plans, Families USA, and American College of Emergency Physicians. It was incredible to witness healthcare policy taking shape in real time as legislators fired crucial questions at and debated with industry and physician leaders to better understand the multifaceted problems associated with medical billing and compare different state models to appropriately tackle this pressing issue on a national level. Later that week, we crossed paths with Congressman Buschon again at a lunch event where he made it a point to recognize and thank the ACR for its support and attendance at the hearing. This really highlighted for me the impact of ACR’s advocacy work and the importance of actively contributing our ideas, opinions, and needs to the ACR, which ultimately provides legislators a better understanding of the crucial role of Radiology in our healthcare system.
I realized that many in our field are unaware of the important relationships that the ACR has built over time with key legislators and partner medical advocacy groups to strengthen our message and have the physician perspective at the forefront of legislation. Their work ensures we get fair treatment to train and practice in a way that is effective, ethical, and economically beneficial for the patient and the sustainability of our healthcare system. None of us are exempt from the daily complaints pertaining to the wastes, injustices, and bottlenecks in our healthcare system that deters us from providing the ideal care that we pledged to impart when we took our oath. In the coming quality-based healthcare overhaul, it is imperative for Radiology to play a key role in shaping the future of healthcare and safe-guarding our field. We all have the capacity to actively participate by passing along our perspectives and feedback to the ACR on important healthcare issues to enact real, positive change.
The 2019 ACR Rutherford-Levanty Government Relations Fellowship afforded me an incredibly eye-opening, transformative experience, and I intend to fully utilize the resources, education, and mentorship it provided to accelerate my goals of being a thought leader in Radiology and driving impactful and innovative changes in healthcare for the betterment of society.
I want to sincerely thank Dr. Matt Heller and Dr. Marion Hughes, the former and current UPMC radiology program directors, for supporting my passions and providing me the dedicated time to pursue my interests in leadership and innovation during my residency tenure. I also want to thank my attending, Dr. William Delfyett, for advocating for me and connecting me with the Pennsylvania Radiological Society, which sponsored me with a scholarship to attend this prestigious fellowship. Currently, I am a Musculoskeletal Radiology Fellow at the Yale School of Medicine Department of Radiology and Biomedical Imaging. Following my clinical fellowship, I will be completing the Yale Department of Radiology Healthcare Leadership Program which includes an MBA at the Yale School of Management.
Jeffery Paul Hogg, MD
I finished my diagnostic Radiology Residency in 1987 as Chief resident, and then finished my Neuroradiology fellowship in 1989, both at the University of Pittsburgh. I sent my initial year after as a faculty member at West Virginia University School of Medicine, Department of Radiology. The next 3 years were at UPMC, then I went back to WVU (medical school alma mater) where I have been since, becoming Professor of Radiology in 2001.
While at WVU, I have been director of the diagnostic radiology residency program or the neuroradiology fellowship for 11 years. In 2012, I took a leave of absence from WVU for a planned 6 month fellowship in abdominal and chest imaging back at the University of Pittsburgh Department of Radiology to help me gain ground faster in my role as director of medical student education in radiology at WVU. I was made to feel very welcomed back at my academic home by Mitch Tublin and Carl Fuhrman who both facilitated my return to the role of a clinical fellow. The fellowship was cut short, but a good outcome was that one of my great Pitt friends and mentors, Carl Fuhrman, engaged me with a role working in Aquifer, which is a consortium of medical student educators that produce educational resources for medical students, largely at the clinical clerkship level.
I was able through Carl’s introduction to rise in the organization eventually to direct the online Aquifer Radiology course during a period of rapid growth and implementation, that currently is used in about 80 medical schools. Our course board collaboratively created flipped classroom workshop materials that helped make it easy for novice teachers (residents as well as faculty) to gain experience in teaching with emphasis on an active learning approach. Our group has been able to present work based on our Aquifer medical student education efforts in radiology at AUR for several years running, and most recently as an element of the initial training for 1st year radiology residents. I was humbled to be a co-author of a paper published in Academic Radiology in 2016 (along with UPMC colleague Dr. Vik Agarwal) that won the 2017 Herbert Stauffer for the Best Education manuscript that year. I remain active in the Aquifer organization as the assessment lead for the Radiology course, and one of the best benefits is regular opportunity to collaborate and visit with my good friends and superb educators like Carl Fuhrman.
It is because of the wonderful support I have received always from my friends and colleagues at the University of Pittsburgh for my career, at all its stages, that I choose to regularly give back to the University of Pittsburgh Department of Radiology in the form of philanthropic support. It is a big department, but I can think few other organizations that have maintained a more personal and lasting engagement with me. This department certainly is worthy of my annual investment in ongoing success!!
Bertan Ozgun, MD
I did the Body Imaging Fellowship at Pitt in 1995/96 and learned a great deal under Drs. Federle and Barron among others. I remember it being a whirlwind year with getting to know a new city, having our second child and looking for my first job. The Body Imaging Fellowship gave the fellows a lot of responsibility and was very strong in imaging guided procedures so I felt well prepared to start my career. After fellowship, I accepted a job in Butler, PA where I worked for 5 years and gained a great deal of practical experience. I relocated to Maryland in 1991 and have been a partner with Advanced Radiology ever since. I am very involved in my practice and am currently the Chairman of Radiology at Carroll Hospital Center in Westminster, MD and I am Vice President and Chief of Operations for Advanced Radiology. I serve on the Advanced Radiology Board, the Carroll ACO Board and the Lifebridge Health Clinically Integrated Network Board. My wife, Mary Ann, and I have 3 wonderful children, but are now empty nesters. I learned a lot during my time at Pitt and I am a proud alumnus. We have been fortunate to have recruited a few superstar Pitt alumni to our practice as well.
Aanshu Shah, MD
I completed my Radiology residency at UPMC in the year 1999 and stayed on to finish my Fellowship in Women’s Imaging in 2000. I truly have amazing memories of my time there and could not have asked for a better foundation for my radiology career. Back then, I was the only fellow and we were still using standard analog films. Breast MRI and digital mammography were just being introduced. I was very fortunate to learn from this transition while training at Magee Women’s Hospital. After my fellowship was complete, with a two-year old and newborn in tow, I moved across the country and joined a private practice in Las Vegas, Nevada. I was the first fellowship-trained women’s imager and became the first female partner in my practice. I quickly transitioned our practice from Analog to digital mammography. We then became the first radiology facility in Las Vegas to introduce tomosynthesis. Over the years, I have made numerous site visits across the country including California, Florida, Kansas, Washington and even Milan, Italy as I try to keep our practice at the cutting edge.
In the last 18 years, as our company grew from 3 to 9 offices, I began getting active in community outreach. I have given talks and presentations throughout our community to educate our patients and referring physicians about the ever changing and technologically advancing field of women’s imaging. I have continued to stay in contact with the Pitt faculty for advice and it has been awesome to hear about all the changes at Magee over the years. As Director of Women’s imaging, I take a tremendous amount of pride in the leadership role and outstanding reputation our practice has provided our community. The training I received at UPMC could not have prepared me better for my career. This past October, I received the Inspired Excellence in Healthcare Award presented by the nonprofit organization, Las Vegas HEALS (Health, Education, Advocacy and Leadership in Southern Nevada). It was an incredible honor and I credit much of it to the strong foundation and education I received at UPMC. I am also fortunate to have the support of my husband, Tapan Shah, also a UPMC residency graduate in Ophthalmology and my two kids, both born at Magee Women’s Hospital. My daughter is currently attending a combined BS/MD program in college and my son will graduate from high school next year. In our free time we love to travel around the world, explore the amazing restaurants in Las Vegas and play lots of tennis!
Neha Choksi, MD
I graduated UPMC radiology residency in 2011 and stayed on at Pitt for a split fellowship in abdominal imaging and women’s imaging. Upon completion, I worked for a year at a community practice in Florida. A year later, our ties to Pittsburgh brought my husband and I back to the area.
I joined a community practice north of Pittsburgh and have been there since. I practice general radiology with a focus in my subspecislty training. My training at pitt was very well rounded and has empowered me to perform many different tasks of all radiology specialities each day.
When I look back at my residency and fellowship I am filled with many emotions alongside endless memories. Though there are innumerable experiences that shaped me into a radiologist, I have found that the daily case conferences in the mornings, afternoons, and in each reading room really stuck with me. When I’m faced with tough cases I always recall from the pearls of these lessons. To this day, I can visualize the cases and hear the discussions that went along with them. I also always hear one of my mentor’s voices telling me to “do the right thing”. Those simple words guide on many occasion in so many different ways. But most importantly to always put the patient first, no matter what the circumstance. I am forever grateful to all my attendings that have helped me become who I am today, and for the success of my career.
During my free time I love just being a mom, and spending time with my husband and two wonderful boys.
Chad Ringger, MD
I completed my radiology residency at UPMC in 2011, and stayed for another year as a UPMC fellow, split between Abdominal Imaging and Women’s Imaging. Time has really flown by since I finished my training and returned to the Pacific Northwest (where I am originally from) to begin my career in Medford, Oregon. I joined a private practice group of about 20 radiologists, and immediately put my excellent UPMC training to good use. It has been rewarding use my subspecialty expertise in both abdominal and breast imaging in this medium sized community of about 200,000.
I have so many fond memories and experiences from my time in Pittsburgh. There was certainly a brief period of adjustment moving east, but soon my family and I fell in love with the city and entire region. My son is still a die hard Steelers fan, as his formative years were heavily black and yellow. Personally, I deeply appreciated all my impressive co-residents and fellows who always supported one another and inspired each other to succeed. I was always blown away by the excellent teaching of the attending radiologists in each division, and I use many of their tips, teaching pearls, and algorithms on a daily basis in my practice. My time at UPMC taught me to value each patient as if they were my family member, to go the extra step to provide excellent service to the ordering providers, and to value curiosity and continual learning. Those traits have helped make me the doctor I am today today, and have also helped me step outside my comfort zone to become a leader in my group and hospitals, serving on several committees and site directorships in the past few years.
In my free time, I enjoy raising my 4 children with my wife, Alisa, as well as much time spent volunteering with a local youth group. I dabble in all manner of sports and outdoor activities that living in Oregon offers (mounting biking, river rafting, skiing) but I’m most passionate about NBA basketball, backpacking, and travel - recently certifying in scuba and looking forward to an upcoming dive trip to Roatan, Honduras.
Shalini Chabra, MD
I graduated in 2008 from UPMC with Dr. Orons as the program director and did my fellowship in Abdominal Imaging under Dr. Mitchell Tublin.
I consider myself fortunate to have received excellent training and a strong foundation that has served as a strong backbone for my career throughout. Even after all these years, I can still hear the voice of my mentors when I use the phrases they used as descriptors in my dictations. I was fortunate to work with Dr Michael Federle to write chapters for the first edition of Diagnostic Imaging by Amirsys and later incorporating it into Statdx.
Right after my fellowship, I joined a private practice group east of Pittsburgh in Johnstown. The ultrasound training I received helped me become the head of ultrasound. I was making policy decisions including equipment purchasing decisions for the entire hospital system. Living in a small town and yet practicing high end radiology offered me the ability to balance family life and achieve professional success.
My husband’s job opportunity made us move to Las Vegas. Again, the great reputation of UPMC carries across the nation. I was able to find a new job quickly and gain the respect of my peers and referring physicians in a short time. I was working in a private practice group doing general radiology and a lot of procedures in a very high volume practice.
I moved to Tucson recently and am currently sub-specializing in Abdominal Radiology. Two senior partners in this practice are UPMC alumni. The kind of cases I read now most of the day reminds me of being in the UPMC Presbyterian reading room again.
It is always a pleasure to meet my fellow residents and attendings at conferences. The accomplishments of Pitt alumni inspire me.
In my free time, I like to maximize my vacation time by travelling to faraway places, by taking a lot of photographs and by trying new cuisines.
All this so far has only been possible due to the love and support of my kids, Om and Meera and my ever supportive husband, and an excellent Radiology training.
Geraldine McGinty, MD, MBA, FACR
John and I live in New York City's East Village, he is a tenured Professor of Genetics and Pediatrics at the Albert Einstein College of Medicine. We like to travel and occasionally manage to do that together although both of us are on the road a lot both for our "day jobs"
as well as serving on Boards for the Irish Government which takes us back to Ireland frequently. We love getting back "home"
to Pittsburgh and are delighted to see how cool the City has become although we thought it was pretty cool when we lived there.
It's hard to believe it's almost 25 years since we finished residency, we don't run into too many of our former colleagues but it's always fun when we do. I generally manage to at least wave at a few people as we are rushing around at RSNA!
Dr. McGinty did her Medical training in Ireland at the National University and then came to the USA for residency at the University of Pittsburgh where she was Chief Resident. Her fellowship was in Women's Imaging at the Massachusetts General Hospital. While working at Montefiore Medical Center in the Bronx she completed an MBA at Columbia University.
She is an national and internationally recognized expert in imaging economics. She has served an advisor to the CPT Editorial Panel, the JCAHO and the National Quality Forum. She was Chair of the American College of Radiology's Commission on Economics and was the radiology member of the AMA’s Relative Value Update Committee from 2012-2016.
In May 2016 she was elected as the Vice Chair of the ACR's Board of Chancellors, the first woman to hold this office. She was until 2013 Managing Partner of a 70 physician multispecialty medical group on Long Island. In 2014 she joined the faculty at Weill Cornell Medicine (WCM) in New York City. As well as her clinical practice there she serves as Chief Strategy Officer and Chief Contracting Officer for the Weill Cornell Physician Organization’s more than 1400 members. Her role as lead negotiator for managed care contracts at Weill Cornell Medicine incorporates both traditional fee for service agreements as well as shared savings arrangements. She is also a member of WCM’s digital health strategy team.
Her published work has focused on payment models for imaging, most recently a bundled payment for breast cancer screening. In 2015 she was voted Radiology’s Most Effective Educator by the readers of Aunt Minnie, a radiology news site with more than 140,000
members. She has more than 7000
followers on Twitter
Haresh Naringrekar, MD
It has been three years since graduating residency at UPMC, I currently am an Abdominal Imaging attending at Einstein in Philadelphia. After having been through three different institutions over the past 7 years, I have to say without a doubt UPMC is one of the best radiology training institutions in the country. It not only has prepared me well to handle anything thrown at me from a radiologic perspective, but it has also given me the tools for communicating well with other physicians and giving added value in interpretation. I would argue the second part of the previous statement is becoming more and more important as healthcare continues to evolve, and was definitely emphasized throughout my training at UPMC. I still keep in touch with many folks from residency, and while the training was tough I only look on those four years in Pittsburgh with fondness.
I am really enjoying my career thus far in academic radiology, and love the teaching aspect of training residents. This was instilled in me from my experience at UPMC, as not only were the faculty excellent radiologists, but also excellent educators. In addition to pursuing my career in academic radiology, my wife and I love to travel and enjoy Philadelphia with our dog, Lance.
Nikki Restauri, MD
Eight years ago, I graduated from the University of Pittsburgh Diagnostic Residency Program and the excellent training I received provided a strong foundation allowing me to grow as an academic radiologist and educator. As a radiology resident and then fellow in Abdominal Imaging at UPMC, I worked hard and had a blast with many of my co-residents now lifelong friends. Although residency and fellowship were times of fatigue and challenge, they were also filled with laughter, teamwork and personal growth. As we used to say - and I now know to be true- the nights go by slow but the years fly by. In addition to learning how to interpret images, my mentors at UPMC taught me what it meant to be a doctor.
Today, I pass on advice to my residents that Dr. Mitchell Tublin imparted to all his trainees when he advised us to “Do the Right Thing”
when it came to patient care. This translated to being honest and always putting the patient first. I think one of the biggest gifts I have been given, and a trait that was cultivated during my training, is a sense of curiosity. A passion for teaching goes hand in hand with a love of learning and I have focused my academic career at the University of Colorado on medical student education. It is my mission to engender a sense of awe and wonder about the practice of medicine to students. I believe this is vital in an era where burnout is now epidemic. I live work and play in Denver, Colorado accompanied by my husband and 2 furry best friends, Nala and Honey Badger. Travel, photography, good food and good friends occupy my free time. I also believe in the art of doing nothing. One of my favorite past times involves sitting on the front porch watching the world go by – I learned this from my dogs. Oh yea, I also write both scientific articles and poems and have begun to publish in both arenas and have been learning how to play guitar for the last 4 years.