Les turf wars? Absolument pas!

2013 02 05 12 11 07 698 Negotiation 70

The merits and achievements of the collaboration between imaging and cardiology in France will come under the spotlight again when the meeting of the societies of radiology (SFR) and cardiology (SFC) takes place in Paris on 14 and 15 February.

Joint presidents of the meeting, Dr. Louis Boyer, chair of the department of radiology at Hôpital Gabriel Montpied, University Hospital of Clermont Ferrand, and cardiologist Dr. Pascal Guéret, head of cardiology at the University Hospital of Henri-Mondor, Créteil, have high hopes for attendance and further progress to be made at the meeting, with its specific focus on state-of-the-art imaging.

Cardiologists and radiologists find strength in unity, according to Dr. Louis Boyer.Cardiologists and radiologists find strength in unity, according to Dr. Louis Boyer.
Cardiologists and radiologists find strength in unity, according to Dr. Louis Boyer.

"The two disciplines must continue to view the future together, rather than hold separate perspectives and eye each other with fear," Boyer told AuntMinnieEurope.com. "The collaboration existing in France concerns primarily CT and MRI, but not ultrasound or invasive angiography procedures, which in France remain the main domain of cardiologists."

The first session on Thursday, 14 February, will highlight new technologies such as dose reduction techniques in CT, 3-tesla MRI, MR-compatible material for pacemakers (both from a radiological and rhythmological point of view), and CT myocardiac perfusion imaging.

Thursday afternoon will also allow delegates the chance to hear clinical cases of myocardial infarctus from younger teams of cardiologists and radiologists, as well as lectures on emergency and nonemergency thoracic pain and the limitations of different stress test imaging techniques. Projects and ongoing work from the Cardiac Imaging Research Group (Groupe de Recherche en Imagerie Cardiaque, GRIC) will be presented during the evening.

Meanwhile on Friday, 15 February, sessions will cover difficult cardiomyopathies, right-side heart pathologies, aortic valve stenosis, and a video presentation about fusion imaging techniques. Again, the younger radiologists and cardiologists will jointly present clinical cases in the afternoon, this time about nonischemic cardiopathies.

Another key focus of the congress exhibition will be ongoing professional training available to practicing and student cardiologists and radiologists through the DIU (DiplĂ´me Inter-Universitaire). Twenty-three French universities are involved in the scheme that allows both qualified doctors -- and medical students of radiology and cardiology approaching the end of their studies -- to gain experience in the other discipline over two years with practical and academic training in "noninvasive" cardiac CT and MRI.

A turning point for a closer working alliance and a reduction in "turf battles" between the two disciplines came seven years ago through the signing of a good practice charter in September 2005 between the two societies, with this alliance supported by joint meetings every two years.

The societies of radiology and cardiology must lead by example, said Dr. Pascal Guéret.The societies of radiology and cardiology must lead by example, said Dr. Pascal Guéret.
The societies of radiology and cardiology must lead by example, said Dr. Pascal Guéret.

"The charter was intended to promote better caring for patients by the most competent doctors," Boyer said. "It specifies that the cardiologist decides on the indication for patients of a scan imaging procedure (CT or MRI), while technical realization of cardiac CT or MRI, as well as interpretation and reporting, is undertaken by a radiologist, before the patient's return to cardiology for management."

Challenges remain in the wider diffusion of knowledge and latest thinking in cardiac imaging and acceptance of multidisciplinary input to patient care, according to Guéret.

"There are teams which haven't really developed this collaboration. Neither the SFR nor the SFC can impose its ideas on hospital services. However, we can lead by example by providing concrete cases of joint clinical research and practice taking place across university hospitals in France," Guéret said.

One such example is the collaborative medicoeconomic Evascan study by radiologists and cardiologists about coronography validation that involved 40 mixed discipline teams.

Presentation of the study, published in the current edition of the American Journal of Cardiology (February 2013, Vol. 111:4, pp. 471-478), as well as an update on new regulations and cardiac imaging recommendations for 2013 will comprise the meeting's final session in what promises to be a lively and productive bidisciplinary congress.

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