Jonathan A. Flug

A Picture of Burnout: Case Studies and Solutions Toward Improving Radiologists’ Well-being

This article uses case fictional case vignettes as a vehicle to discuss the complex way organizational and individual factors contribute to physician burnout. The article incorporates a review of the current literature on physician burnout focusing on work place inefficiency and ineffective leadership.

Mentorship in Radiology

Mentoring is an extremely important component of academic medicine, including radiology, yet it is not specifically emphasized in radiology training, and many academic radiology departments in the United States, Canada, and elsewhere do not have formal mentoring programs for medical students, residents, fellows, or junior faculty. The purpose of this article is to overview the current status of mentorship in radiology, to discuss the importance of mentorship at multiple levels and its potential benefits in particular, as well as how to conduct a successful mentor-mentee relationship. The literature on mentorship in radiology and in academic medicine in general is reviewed.

Lateral acetabular coverage as a predictor of femoroacetabular cartilage thickness

To investigate the correlation between femoroacetabular cartilage thickness and lateral acetabular coverage in patients undergoing hip arthroscopy for a variety of indications. Articular cartilage at the hip is hypothesized to undergo adaptive change secondary to unique patterns of pathomechanical loading which results in a direct relationship between acetabular coverage and femoroacetabular cartilage thickness. A cohort of 252 patients presenting to our dedicated hip preservation service between June 2013 and June 2015 were retrospectively analysed. Preoperative radiographs and MRI studies were obtained for all symptomatic hips and classified according to radiographic lateral center edge angle (LCEA) as follows: normal acetabular coverage (25–40°), acetabular overcoverage (≥40°), borderline dysplasia (20–24.9°) and frank dysplasia (<20°). Femoroacetabular cartilage thickness was measured on a preoperative MRI-scan at the fovea, middle sourcil, and lateral sourcil. In all groups, cartilage thickness was maximized at the lateral sourcil relative to the middle sourcil or fovea (P < 0.001). Furthermore, articular cartilage thickness was significantly increased when comparing one group to successive groups with diminished lateral acetabular coverage. Indeed, multivariate analyses confirmed LCEA to be the strongest determinant of femoroacetabular cartilage thickness compared with age, gender, body-mass index or presence of cam/pincer lesions. Patients with borderline and frank dysplasia exhibit increased values of femoroacetabular cartilage thickness in the weight-bearing zone, potentially indicating a compensatory reaction to the lack of bony coverage. Articular cartilage thickness may serve as an instability marker and inform clinical decision-making for patients with borderline dysplasia.

ACR 2016 Open-Microphone Session: ACR Membership 3.0-Moving From Member Volume to Value

This report of the 2016 ACR Council Open Microphone session reviews the discussion around interests and concerns of council members and state chapter leaders as to the perceived and real value of their ACR membership, and how the ACR might further enhance membership value and meaningful engagement with members.

Arthrographic Anatomy of the Biceps Tendon Sheath: Potential Implications for Selective Injection

The purpose of this investigation was to better define the anatomical features of the biceps tendon sheath, including the distance the sheath extends below the inferior margin of the subscapularis tendon and below the termination of the bony bicipital groove. A total of 110 magnetic resonance and computed tomography arthrograms performed during 1-year period at our institution were retrospectively reviewed, and the length of the biceps tendon sheath and distances from the inferior margin of the subscapularis tendon and from the termination of the bicipital groove to the inferior margin of the biceps tendon sheath were measured by 3 radiologists. The mean length of the biceps tendon sheath was 47.5mm. The mean distances from the inferior margin of the subscapularis tendon and from the inferior margin of the bicipital groove to the distal extent of the biceps tendon sheath were 24.5mm and 11.9mm, respectively. The relationships among these 3 anatomical measurements and biological confounders of sex and age were investigated while controlling for measurement variability. The anatomical relationships between the biceps tendon sheath and surrounding structures may have implications for needle placement when attempting to inject into the biceps tendon sheath for diagnostic or therapeutic purposes.

Launchpad for Onboarding New Faculty Into Academic Life

We developed a faculty professional development seminar series in order to facilitate the integration of our numerous new faculty into academics. The changing nature of the healthcare system, increasing clinical and administrative responsibility, and lack of access to senior mentors can hinder junior faculty productivity and possibly increase attrition. Given that no ready-made resources existed to address these issues we established a Professional Development Committee, developed a curriculum that covers relevant topics including promotion, mentorship, conflict management and feedback, and effective presentation of scientific data, and instituted changes iteratively based upon feedback. We used surveys from successive years of this seminar series to assess effectiveness, and our data demonstrate that our Professional Development Seminar Series was valued by its participants and that individual lectures improved from year to year. While it is too early to determine whether our efforts will lead to long-term changes in promotion success or faculty retention, our initial data are promising.

The Ethics of the Match.

—Potter Stewart Honesty and enthusiasm should go hand in hand when determining a future in the field one has chosen. However, the National Resident Matching Program (NRMP) match process is a stressful time during which candidates and programs struggle to balance enthusiasm and honesty with self-interest. The NRMP match first started in 1952 to create a uniform date to accept residency offers. After Sir William Osler started the first residency program in 1889, competition among hospitals for incoming residents led to increasingly early offers of internships to students. Hospitals had limited information about students’ performance, and applicants had to accept or reject positions without knowing which other offers might be forthcoming [1]. The match algorithm addressed students’ struggles with short deadlines and hospitals’ need to scramble for available students [2]. However, decades after its creation, issues still arise in the process. In particular, postinterview, prematch communication has caused frustration for both program directors and applicants alike, as presented in a previous letter to the editor in JACR [3]. In another survey, 94% of programdirectors felt that theNRMP process placed their programs in the position of having to be dishonest

Price Transparency In Medical Imaging

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