From the June 2015 issue of HealthCare Business News magazine
Resolving the supply of Tc-99m is critical to the survival of nuclear medicine. It’s a big issue and it’s very complicated. The Tc-99m problem has been front and center since 2009. Here is where the SNMMI should take the leadership role. Someone needs to define what’s needed, chart the path, explain why we must go in a direction, and lead all the potential contributors to the solution.
Rather than take the lead, to date, what the SNMMI has done is applaud every group proposing a solution. That leaves the community with a piecemeal approach to the Tc-99m shortage and no way to determine if the pieces add up to a viable solution. Chalk River and other older reactors are definitely on a path to shut down. Dates aren’t always set in stone but it will happen.
Who, other than the SNMMI, is better prepared to lead the way in solving this raw material supply problem? The answer is: no one.
As the ACA matures, hospitals are forming local oligopolies as they acquire other hospitals, diagnostic imaging clinics, and practices. Cardiologists and radiologists are returning to the hospital and becoming employees. The expectation is that this will be a return to the old paradigm with diagnostic imaging placed back in the hospital.
What does this mean to nuclear medicine? I think it’s pretty straightforward. Nuclear medicine has to step up and take a lead in the way these imaging services are reintegrated into the ACA hospital model. If nuclear medicine stands by passively there will be an integration of nuclear imaging into the newly established diagnostic imaging service, with the very real risk that nuclear medicine will lose its identity.
Within this new ACA-integrated hospital model, nuclear medicine can carve out its own space by taking ownership of its future. That requires educating referring physicians about the importance of the service. It also requires developing a new set of bona fides. The ACA demands increased quality and lower costs for the provision of health care.
Nuclear medicine professionals are uniquely qualified to develop solutions that meet the ACA objectives. Every day they deal with decaying isotopes, on-demand imaging, and no inventory of consumables. Yet they image patients and keep the patient flow moving. Other modalities reach into the supply closet and use a non-decaying standing inventory for their consumables. Nuclear medicine professionals can lead the imaging department in the most cost-effective way of scheduling non-critical patients. Knowing how to schedule and make the most of every hour is what nuclear medicine does better than any other imaging modality.
PATTI MCLEAN
There are several companies leading the way
June 25, 2015 03:44
SHINE Medical Technologies will have its construction permit to build a Mo-99 facility in Janesville WI, hopefully by the end of the year. NorthStar Radioisotopes is in the process of FDA approval (at least 3 years behind SHINE). Both Midwest companies. There are many other companies about 5 years behind SHINE that are attempting to fill the void that NRU will produce.
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