Face of Radiology Campaign

This paper outlines the efforts of the American College of Radiology to understand the public perception of radiologists and to effect change in that perception. Through focus groups, in-depth interviews with Capitol Hill staff members, and national telephone surveys, it was found that the public is unaware of the education and training radiologists receive and does not understand that radiologists are physicians and experts in medical imaging. An internal and external marketing campaign was carried out in test markets, and it was found that awareness and attitudes can be changed. The American College of Radiology has taken a leadership role in attempting to change the perception of radiology at the national level.

In recent years, there has been an exponential rise in imaging utilization, which has caught the attention of government, third-party payers, and health policy experts . Much of this growth has been based on significant advancements in imaging technology and our understanding of new techniques. However, some component of growth is due to non-radiologist specialists who have previously referred their imaging studies to radiologists but are now obtaining imaging equipment and performing studies in their offices. Responses to this appropriate as well as inappropriate utilization include the Deficit Reduction Act of 2005 and the recent Medicare Improvements for Patients and Providers Act of 2008.

Historically, radiologists interacted with clinical practitioners as their source for patients and, with the exception of a couple of subspecialties, such as interventional radiology and breast imaging, remained relatively anonymous to patients. This practice model provided for high-quality studies by radiologists and a relationship between radiologists and referring physicians that aided in appropriate utilization.

For a variety of reasons, some specialist physicians have become increasingly competitive with radiologists by performing imaging on a self-referral basis. This is one of the drivers of utilization increases that has become readily apparent . The absence of relationships with patients can now be viewed as a weakness in the classical business model of radiology practice. Anonymity is no longer a virtue. We must now consider a blended model in which classical referral patterns are maintained but, at the same time, patient relationships are developed, such that we become their imaging referrals of choice.

The Board of Chancellors of the American College of Radiology (ACR) has been concerned for some time with this anonymity and has from time to time undertaken various means to improve the situation. Most recently, the so-called Stella campaign of 2000 was an attempt to increase the public’s perception of radiologists. It primarily used print media and asked, “Do you know who is reading your imaging study?” The campaign failed to make a persuasive argument, however, that the individual reading one’s study should be a radiologist.

The ACR’s most recent response comprises a two-pronged approach, with an initial extensive survey and focus group testing to understand the current public perception, followed by a media campaign, summarized in this work. A public relations and communications firm was hired to conduct focus groups and in-depth interviews.

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Figure 1

Radiologist—your physician imaging expert.

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Table 1

Summary of Media Campaign Effects in Three Markets

Market Burlington, VT Washington, DC Miami Pretest First Post-test Second Post-test Pretest First Post-test Second Post-test Pretest First Post-test Second Post-test Metric ( n = 250) ( n = 401) ( n = 400) ( n = 300) ( n = 405) ( n = 400) ( n = 300) ( n = 400) ( n = 400) Advertising awareness Radiologist ad awareness 14% 21% ∗ 9% † 7% 28% ∗ 8% † 8% 17% ∗ 8% † Recall something specific (among those who said they did recall ads) 19% 58% ∗ 1% † 20% 73% ∗ 3% † 36% 72% ∗ 1% † Radiologists’ education ad awareness 6% 13% ∗ 3% † 2% 26% ∗ 6% † 6% 17% ∗ 10% † MyRadiologist.com ad awareness 2% 3% 1% † 1% 11% ∗ 3% † 2% 7% ∗ 3% † Attitudes Radiologist is a physician 50% 46% 55% † 64% 63% 65% 51% 51% 58% † Radiologist is an important part of the health care team (% total agree) 97% 95% 96% 93% 95% 94% 91% 91% 93% Radiologist is best equipped doctor to understand benefits and dangers (% total agree) 84% 83% 86% 74% 81% ∗ 82% 82% 83% 86% Anyone having an imaging exam should have it done by a radiologist (% total agree) 78% 80% 85% 68% 81% ∗ 80% 83% 82% 83% Radiologist is best equipped doctor to catch problems early (% total agree) 78% 78% 85% † 66% 77% ∗ 77% 77% 79% 83% Radiologist is best qualified to recognize, diagnose, and treat (% total agree) 65% 69% 66% 58% 69% ∗ 65% 61% 68% ∗ 67% Consideration Would choose radiologists to conduct their imaging exams 60% 51% ∗ 61% † 58% 61% 66% 51% 52% 54% Behavior Had an imaging exam in the past 6 mo 47% 44% 43% † 53% 51% 47% 54% 54% 62% † Don’t know who conducted (among those who had imaging exams in past 6 mo) 49% 31% ∗ 18% † 32% 42% ∗ 46% 50% 27% 26% Radiologist conducted (among those who had imaging exams in past 6 mo) 32% 54% ∗ 58% 55% 51% 51% 32% 46% 42%

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References

1. Bhargavan M., Sunshine J.H.: Utilization of radiology services in the United States: levels and trends in modalities, regions, and populations. Radiology 2005; 234: pp. 824-832.
2. Medicare Payment Advisory Commission : Table 2B-4: use of physician services per fee-for-service beneficiary continues to increase.Report to the Congress: Medicare Payment Policy.2008.Medicare Payment Advisory CommissionWashington, DC:pp. 93.
3. StrategyOne. American College of Radiology 6 month follow up to post-advertising survey wave 3. Presented at AUR Meeting, Seattle, WA, March 2008.

Face of Radiology Campaign

References

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