Fact Check:

Dispelling MARCA
and RA Myths

ASRT is committed to clearing up misconceptions and false information about the role of RAs, the use of physician extenders in the radiology practice and the Medicare Access to Radiology Care Act, or MARCA.

What is a Radiologist Assistant?

Radiologist assistants work under the supervision of a radiologist. These advanced-practice radiologic technologists employ sophisticated clinical skills to help radiologists by taking responsibility for patient assessment, patient education and patient management. They also perform fluoroscopy and other medical imaging procedures and provide the radiologist with initial image observations. By assuming responsibility for these tasks, RAs improve productivity, increase patient access to radiologic services and enhance the overall quality of patient care.

What is MARCA?

The Medicare Access to Radiology Care Act is legislation that would ensure that, regardless of the setting in which the radiology service is performed — hospital, critical access hospital, ambulatory surgical center or any other facility setting — RA services supervised by a radiologist as part of a radiologist-led patient care team receive appropriate Medicare reimbursement.

Myth vs. Fact

ASRT has examined the claims of those who oppose MARCA legislation and found that there are a number of misconceptions about the bill, the role of RAs and the use of physician extenders in radiology practice. Let’s set the record straight.

MYTH
The RA role was never considered by radiologist organizations.
FACT
The use of RAs was developed and implemented collaboratively with the support of multiple radiology organizations including the American College of Radiology, American Society of Radiologic Technologists and American Registry of Radiologic Technologists.

Read the full consensus paper.
MYTH
RAs aren’t educated in medical imaging protocols and procedures.
FACT
RAs must be certified and registered with the ARRT in radiography, earn a minimum of a bachelor’s degree, complete an ARRT-approved radiologist assistant education program and a clinical preceptorship under the supervision of a radiologist. In addition, they must comply with RA licensure requirements in many states.
MYTH
Nurse practitioners or physician assistants would be better suited to assist radiologists.
FACT
Nurses and other types of physician extenders don't have extensive education and experience in radiation physics, patient positioning, radiation safety, equipment protocols and other imaging-critical RA skills.
MYTH
Centers for Medicare & Medicaid Services reimbursements would go directly to the RA.
FACT
Facilities or the radiologist would bill for the RA's services.
MYTH
If MARCA is adopted, RAs will take jobs from radiologists.
FACT
RAs, unlike nurse practitioners or physician assistants, are restricted from making diagnoses and MUST work under the direct supervision of a radiologist.
MYTH
Advanced-practice radiologic technologists are employed in Europe ... and have taken jobs from radiologists there.
FACT
In the United States, RAs aren’t permitted to interpret medical images and cannot legally make diagnoses.
MYTH
The RA path has never been supported by radiologist professional groups.
FACT
The ACR was one of the founding organizations that created the RA profession to meet the increased patient demand and shortage of radiologists. This is outlined in the initial consensus paper drafted in 2002 with support and input from the ACR.

Read the full consensus paper.
MYTH
Radiologists don’t need RAs.
FACT
In 2002, an advisory panel that included ACR representation articulated the need to create the RA profession: “The radiology community faces many challenges today, including increased patient demand, a growing shortage of radiologists and radiologic technologists, and the rapid expansion of new technology. In this fluctuating environment, it may be time for the radiology workplace to introduce a new type of radiologic technologist, a person whose advanced clinical skills can extend the role of the radiologist.”

Read the full consensus paper.
MYTH
Radiologists don’t need RAs in the current health care environment.
FACT
The workload of radiologists continues to be an issue for the profession. According to recent studies and articles (see links below), radiologists are at increased risk for burnout due to growing workloads and face forecasted labor shortages.

Since integrating RAs into our radiology practice, our efficiency has increased, as has our ability to provide even better and safer care to our patients by giving them access to a knowledgeable staff member who can provide them with additional education and the chance to ask questions. Wait times for procedures and for consultations have decreased.

Hedvig Hricak, M.D., Ph.D.
Chair, Department of Radiology, Memorial Sloan-Kettering Cancer Center