Our Challenges in 2022

A Message from the President

The year that was, 2022, has conjured many challenges for the College, but it has also gifted us important achievements which demonstrate the capacity of our members and College staff to make progress in difficult times.

There's nothing like a pandemic to pressure-test a health system. And what a test it has been these last two years— it made organising a family gathering at Christmas look easy for a change. We continue to deal with the aftershocks of COVID-19, especially the deadly backlog of delayed investigations and procedures, but the silver lining in that dark cloud has been the revealing of serious weaknesses in our healthcare, aged care and disability insurance systems.

Thanks to the wake-up call from the pandemic, politicians of all persuasions are now falling over themselves to recognise the impact of chronic underfunding in public hospitals and offer big budget solutions. In the recent Victorian state election, Christmas came early for some as the major parties competed with each other to offer the most generous plan for new hospitals, hospital upgrades and scholarships for trainee nurses. The bidding war became so aggressive that it drew the ire of the Victorian Healthcare Association, which is rightly seeking a more transparent and orderly process to health funding.(1)

In a climate like this, if it is to last beyond the election cycles of our various governments, our political leaders need our help. Health commands a large slice of the available tax dollars and we can ill-afford to waste them.

Our College is among a number of respected voices advocating sensible, affordable policies in health care, each aimed at achieving high quality care with positive cost-benefits for patients and providers.

Not all solutions require big budgets. This year, at our ASM, the College collaborated with the National Imaging Facility to showcase research into new tools in artificial intelligence to enhance point-of-care medical imaging. A beneficiary of this research is the Australian Epilepsy Project, which is working to bring gold-standard diagnosis, advanced imaging and precision treatment options for epilepsy to the broad community. Even a small improvement in freedom from seizure would save or extend thousands of lives and save billions in lifetime healthcare costs and lost productivity for sufferers of this one condition.(2) Underpinning the application of this research is the policy work done by the College to help guide the regulation of AI in medicine and manage risks and opportunities presented by the new technology.(3)

Earlier, we ran a successful campaign for the deregulation of Medicare-funded MRI services in rural, regional and remote Australia, lowering out-of-pocket costs and improving outcomes for patients in these areas.(4) This coincided with the formalisation of our relationship with the Australian Indigenous Doctors' Association and the launch of a program jointly led by the College to increase numbers of non-GP specialist trainees among Aboriginal and Torres Strait Islander doctors.(5) We issued an action plan to help improve Māori, Aboriginal and Torres Strait Islander health over the next three years (6) and launched a video campaign aimed at increasing access to radiation therapy for patients subject to inequities in cancer care due to race, ethnicity, sexual orientation, gender, age and disability.

Our plan for formal specialty recognition for interventional radiology (IR) and interventional neuroradiology (INR) progressed another important step this year, with the issue in March of a position paper on the IR and INR range of practice, and then in October the first comprehensive set of standards for the preparation, delivery and follow-up of IR and INR services. These standards will help to reduce variability in service delivery in Australia and New Zealand and safeguard patient safety.

The College has been busy with housekeeping too, amending our articles of association to better represent our New Zealand members at Board and Faculty level and clarifying issues related to the ethical use of referrals in radiology, especially in regard to NZ practice models. This last topic generated much feedback from members with frankly divergent points of view and some dissatisfaction over the College's role. It is a challenge we will continue to address next year.

The other challenges of 2022 include issues both outside and within our control. In the former category, the critical shortage of iodinated contrast media agents. The College lead the way in managing this shortage, providing advice to government, members and the wider health community. I was very impressed to see other suppliers such as Guerbet swooping in to assist by seeking urgent TGA approvals to bring stock to Australia. As the situation normalised, Guerbet has been left with excess stock which cannot be used after February when their TGA approvals expire. Guerbet will be left with no choice but to destroy the contrast. They supported us in our hour of need, and I encourage members to reciprocate now by utilising Guerbet’s stock before the TGA deadline.

Among the challenges within our control is our financial management and the absolute need to increase College revenue to meet the higher costs of a new examination system. The changes brought by the Board, which have stung some members and trainees, were entirely necessary to ensure the College actually has a few more new years to look forward to.

Finally, on a personal level, 2022 has challenged me as your President in ways I had not fully anticipated as a former Dean of Faculty. The President has a demanding role, not just because she or he is the usual target of members' emails, but because the job requires a focus on both specialties, an awareness that their actions affect all members and, as a key member of the Board, a strong sense of responsibility for decisions that determine the College's strategic direction and long-term sustainability.

It has been a challenging job for me this year on top of my other challenging job as a clinician, but immensely satisfying. I try to do both in much the same way: listen and learn and do the best you can for those you serve.

If the festive season has special significance for you, have a joyous Christmas and Happy New Year; if it doesn't, have one anyway, because you probably deserve it.

References

1 https://www.theage.com.au/national/victoria/ call-for-transparency-on-merits-of-victorianelection-hospital-cash-splash-20220926p5bkyp.html

2 https://n.neurology.org/content/95/24/e3221

3 https://www.ranzcr.com/whats-on/newsmedia/570-ranzcr-position-paper-on-theregulation-of-artificial-intelligence-in-medicine

4 https://www.ranzcr.com/whats-on/newsmedia/551-ranzcr-applauds-the-deregulation-ofmri-services

5 https://aida.org.au/app/uploads/2022/03/ AIDA-RANZCR-STSP-FATES-funding-mediarelease-FINAL1.pdf

6 https://www.ranzcr.com/whats-on/newsmedia/550-action-plan-maori-aboriginal-torresstrait-islander-health