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Concerns about health care costs may cause patients to delay treatment, including imaging studies that could result in life-saving care due to early screening. It’s no secret that concerns about the cost of health services are on the rise. But, some medical professionals are less aware that these concerns may lead patients to delaying medical treatment. Fifteen percent of all consumers are now enrolled in a Consumer Directed Health Plan (CDHP) according to 2015 research [anchor link]. It's also clear from this research that CDHP enrollees are demonstrating cost-conscious behavior (EBRI). We know that a very high percentage of DC Metro regional consumers not on high deductible plans (HDHP) or CDHPs in our region are using flex accounts for medical spending. The behavior that often accompanies this kind of consumer involvement can lead to delays in securing important health care services over cost concerns. There is broad agreement among groups that include the Center for Studying Health System Change (HSC), Families U.S.A., the Kaiser Family Foundation (KFF), the Commonwealth Fund, and the EBRI that health care delays result in patients having more advanced medical conditions at the time they are treated, leading to increased costs. http://www.archbright.com/news/211663/15-Percent-of-U.S.-population-now-enrolled-in-CDHPs-survey-shows.htm] as of 2015. There is an informal cost-benefit thought process going on in the minds of consumers as they consider health care choices. While they don't use actuarial studies or economic formulas, they are weighing the costs and value of medical treatment just the same. One in five U.S. households has postponed or cancelled medical care over the past year--up from 15.9 percent in 2006. Nearly one quarter of respondents report that cost was the primary reason. [link] Patients who have traditional health care plans report greater satisfaction with their health care, and much of that is due to the lower out-of-pocket costs. The level of deductible, "out of pocket" or "out of flex-plan" costs weighs heavy on the minds of patients as they consider health care. Efforts to manage and mitigate this pressure helps patients to make better choices about completing recommended care and seeking important screenings. RAF Efforts to Keep Imaging Affordable RAF has taken innovative steps to ensure that affordability and payment management are a priority throughout its approach to service. By providing a single bill for imaging studies, and the opportunity for payment plans, RAF has given patients greater peace of mind and control over their health care costs. "Throughout its history, RAF has sought to deliver the highest value and quality while finding ways to help patients manage costs. We believe that quality matched with affordability is imperative for the communities we serve in this region." Ed Swager, CEO Single Billing Reduces Complexity and Puts Patients in Control Medical imaging provided at the four outpatient locations of Medical Imaging of Fredericksburg (MIF) at Lee's Hill, Fredericksburg, the Imaging Center for Women, and Stafford is managed through a single patient bill. Unlike many traditional imaging providers--who send both a technology bill and a bill from the physician--RAF and MIF patients can expect to see all of their out-of-pocket expenses reflected in a single invoice. RAF believes that this approach mirrors the realities of financial management that most consumers already expect. No consumer wants to get two bills for anything, especially for expenses related to their health care. "Reducing the complexity of the billing process and ensuring that patients don't receive two separate invoices goes a long way towards increasing patient confidence and reducing negative anticipation. This approach requires internal strategic coordination, but it is well worth it when we consider the benefit it brings to the patient in terms of helping with cost management." Chris Snyder, Director of Technology Services Affordable Payment Plans Help Imaging Studies Fit the Budget The decision to delay important screening or diagnostic care can be avoided if we can help reduce anxiety about the potential of unexpected costs. By offering payment plans, patients can find the best fit for their budget. RAF has developed payment plans for all of its imaging services in the outpatient settings offered at their four regional MIF locations. Patients are made aware of these through our company website and at service counters in our facilities. "We want to work with patients to find an affordable solution for them: we discuss how the costs of the imaging they need can be paid over a period of months, with a minimal amount payable at the time of service. This approach takes all the mystery out of paying for their imaging services, and allows the patient to focus on what's really important - their health." Ed Swager, CEO Payment plans are worked out practically. We establish an amount to be paid at the time of service with the patient, and then set up payments that occur automatically over a three or four-month period after the service is provided. We can make these arrangements very quickly during the appointment process. Because payment plans form a routine part of our service offerings, patients don't feel that they are asking for some form of charity. Payment plans are a normal part of our service provision and we have the appropriate billing procedures and tools already in place. Patients should feel entirely at ease when discussing this option with staff from RAF or MIF. Patients can begin the payment plan discussion when they call our scheduling number, (540) 741-XRAY (9729) [clickable] and then meet with one of our service coordinators to confirm the details.

In an era where health screening resources are being scaled back as a cost-cutting measure, the new addition of Low Dose CT (LDCT) as a covered activity through Medicare allows more patients that are at risk for lung cancer to participate in annual screenings. High numbers of lung cancer deaths are attributed in part to the fact that lung cancer is often not detected until the late stages.   Early detection, when combined with prompt multi-specialty treatment, can increase lung cancer survival rates significantly over late-stage detection. Lung cancer causes more deaths than colorectal, breast, and prostate cancers combined. Nearly 160,000 Americans are expected to die from lung cancer in 2015, accounting for about 27 percent of all cancer deaths. Lung cancer is the third most common cancer and the leading cause of cancer death in the United States making the opportunity to identify and treat lung cancer earlier a significant development for our communities. (http://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/lung-cancer-screening#Pod5)   No Co-Pay and Affordability   Many people fail to follow through with recommended lung screenings because they have not been covered previously by insurance. Because of the significant life-saving value identified by the U.S. Preventive Service Task Force, both commercial insurers and Medicare began covering LDCT in February 2015. When patients fit the criteria they can have annual LDCT with no out-of-pocket expense. Patients who have private insurance receive our assistance in either pre-qualifying with their insurance or using our affordable payment options. For heavy smokers, who comprise 85% of all lung cancer patients, annual screening is an important step for continued health. http://www.lung.org/lung-disease/lung-cancer/resources/facts-figures/lung-cancer-fact-sheet.html   Helping lead this effort in the region is Dr. Stacy Moulton who completed his residency and fellowship at the Mayo Clinic.  He states that "the success of this approach has been demonstrated in highly credible studies. Greater participation in LDCT screening presents a huge health benefit for people in our communities. Doctors and health care professionals need to educate the public about the availability of no-cost LDCT screening for those who qualify."   High-Risk and Coverage Eligibility   Heavy smoking is the greatest risk factor for lung cancer. Medicare coverage for screening covers those with a 30 pack year smoking history [anchor link} that are currently smoking or who quit less than 15 years prior and who are between the ages of 55 and 77. Studies have shown that this high-risk population receives the greatest benefit from annual screenings. Heavy smoking means a smoking history of 30 pack years or more. A pack year is smoking an average of one pack of cigarettes per day for one year. For example, a person would have a 30 pack-year history by smoking one pack a day over 30 years or two packs a day over 15 years. A pack-year is defined as 20 cigarettes a day for one year. Someone who has smoked 40 cigarettes daily for 20 years has a 40 pack-year history. http://www.cancer.gov/types/lung/hp/lung-screening-pdq High Sensitivity Low Dose Scanning and False Positives with LDCT The LDCT has been shown to produce a high level of detail in detecting lung cancer. About 1-in-4 will have a positive finding, but more than 90% of that group will be identified as benign in a follow-up. Patients should view the screening as a part of an annual process, which may include a follow-up to rule out false positives.   Referring doctors provide a "shared decision making" appointment prior to referring patients for screening to explain the process and the potential for false positives and high percentage follow-up findings that are benign. LDCT is a specialized type of CT that allows for highly detailed lung scans with a radiation dose that is equivalent to 2 mammograms or 6 months of background radiation. The benefit for the high-risk group far outweighs radiation dose exposure at these minimal levels.   LDCT uses low doses of radiation because the lungs are comprised primarily of air, and do not require high levels of radiation to provide accurate images of lung tissue. Local Integrative Treatment Team   Radiology Associates of Fredericksburg (RAF) has facilitated the development of a local multi-disciplinary team of doctors ready to respond to cancer findings resulting from LDCT. The presence of a team prepared to work cooperatively and promptly with lung cancer findings is a best practice that should accompany lung cancer screenings to maximize the benefits of early detection. The availability of this team in our region completes the value of the early screening by providing for an appropriate response if a positive finding occurs. Adding RAF fellowship-trained radiologists to other specialties allows for a high-quality treatment regime to begin without losing additional time.   How Doctors Should Respond   The priority now is education. Reaching out to those who fit the heavy smoker and age profile to share about the opportunity for no-cost screening, pre-qualification assistance, or affordable payments for private pay. The RAF concierge can provide additional guidance to doctors regarding referrals and information about screening schedules. Call the Physician Concierge: 855-RAF-LINE for scheduling or information.

According to the American Cancer Society, breast cancer claims the lives of 40,000 women every year, however women who are regularly screened with a mammogram can reduce the mortality rate by 35%. Those numbers prove that through regular breast screenings, lives can be saved, and Radiology Associates of Fredericksburg has added a new tool to reduce those numbers even further. Tomosynthesis, or 3D mammography, takes multiple digital X-ray images of the breast, providing a three dimensional view that results in a more accurate screening. Catching Cancer Earlier Because 3D mammography takes multiple digital images as it sweeps over the breast, doctors get a more complete and detailed picture. During the exam which takes just a few seconds longer, approximately 11 images of each breast are taken, which provide the radiologist with an opportunity to spot smaller cancers. Catching cancers early (below one centimeter in size) is proven to give patients a 98-99% five year survival rate. “This is our chance to take the next step in imaging and catch those cancers early,” says Dr. Talukdar, Medical Director at the Imaging Center for Women, “but we find other benefits with tomosynthesis as well.” Accurate Results Reduce Callbacks The doctors at RAF have been following the evolution of tomosynthesis for a few years in order to ensure that the product that they offer fits their standards of excellence. After a large US study replicated results from the first European studies, they knew it was time to offer this advancement to their own patients. A careful process of reviewing research resulted in an important outcome -- RAF was able to secure the newest and best equipment available, to bring to the community. The 3D mammogram in our facility has the same radiation exposure as a regular 2D mammogram. “When 3D mammography is used, there is a 30-35% reduction in the number of patients who are called back for rescreening and for those who are called back, the cancer detection rate rises,” says Dr. Talukdar. In other words, tomosynthesis is more accurate in finding cancers than conventional screening and can lessen the number of patients who are called back to be rescreened for false positive results. Creating Benefit for All Women The newest data shows that 3D mammography is equally beneficial to everyone. “There is not a single woman who would not benefit from tomosynthesis,” says Dr.Talukdar. Currently, tomosynthesis is being used for screening mammograms, and patients can request it as an additional service when making their regular appointment. With the addition of this new service, the Imaging Center for Women is now the only place in our area to offer 3D mammography. “Screening is important, it saves lives,” says Dr. Talukdar. “Now we have the opportunity to save even more lives.” Call (540) 741-XRAY (9729) today and request this newest advancement in women’s health.

FREDERICKSBURG, VA, March 25, 2015 – Dr. John D. Statler, a board-certified, fellowship-trained Interventional Radiologist with Virginia Interventional & Vascular Associates, is one of only 23 physicians nationwide selected this year as new Fellows in the Society of Interventional Radiology (SIR). The honor goes to SIR members who have demonstrated excellence in research and published works or teaching and leadership within the field of Interventional Radiology, the society announced at its recent convention in Atlanta. “Fewer than 10% of the society’s members are selected to receive this honor,” noted Dr. R. Donald Doherty, Jr., medical director of VIVA. “John is truly deserving of this recognition. He was selected based on his dedication to the education of medical residents as an associate professor of Radiology at the Uniformed Services University of the Health Sciences in Bethesda, Md., and also because of his many publications and his consistent leadership on SIR committees.” Interventional Radiologists provide minimally invasive, targeted treatments using medical imaging for guidance. As an Interventional Radiologist at VIVA, Dr. Statler primarily focuses on treatments that help patients who have cancer, Vascular malformations, or biliary conditions, or who require limb-saving therapies such as angioplasty, intravascular stenting, or atherectomy. Dr. Statler has lectured at several international medical conferences and has written over 20 articles for peer-reviewed medical publications. He earned his medical degree from Jefferson Medical College in Philadelphia, Pa., completed his Radiology residency training at Walter Reed Army Medical Center in Washington, D.C., and completed his Vascular and Interventional Radiology fellowship training at the Johns Hopkins Medical Institutions. Before joining VIVA in 2007, Dr. Statler was the Chief of both Diagnostic and Interventional Radiology at Madigan Army Medical Center in Tacoma, WA. He completed a combat tour in Afghanistan in 2002-2003. He is board-certified by the American Board of Radiology and earned the Certificate of Added Qualifications (CAQ) in Vascular and Interventional Radiology.   About VIVA VIVA, a part of Radiologic Associates of Fredericksburg, is the region’s only Interventional Radiology and Vascular Surgery practice. Treatments offered by VIVA physicians include minimally invasive procedures for uterine fibroids, varicose veins/spider veins, cancer, compression fractures caused by osteoporosis, chronic pain and many other conditions. VIVA physicians also provide the full range of Vascular Surgery care including catheter-based and open procedures. For more information, visit www.vivassociates.com or call (540) 654-9118.   Media Contacts: Jennifer Dawson, NP-C, director Virginia Interventional & Vascular Associates (540) 654-9118 This email address is being protected from spambots. You need JavaScript enabled to view it. Carla Young Harrington Susan Carol Associates (540) 479-7835 This email address is being protected from spambots. You need JavaScript enabled to view it.

Size enables 24/7 coverage and expertise in all major subspecialties FREDERICKSBURG, VA, JANUARY 6, 2015 - Radiologic Associates of Fredericksburg (RAF) ranks among the 100 largest privately owned radiology practices in the U.S., Radiology Business Journal announced in its December issue.  The journal’s “Radiology 100” ranking for 2014 named RAF the 85^th-largest privately owned radiology practice in the nation, based on the number of full-time equivalent radiologists: 29, explained Richard C. Pierson, a financial consultant for the practice.  RAF was one of seven practices in Virginia recognized in the ranking. Dr. David L. Glasser, president of RAF and a board-certified, fellowship-trained diagnostic radiologist, noted, “As a practice we have chosen to maintain the size necessary to ensure high-quality services to our patients, referring physicians, and health facilities. For example, we believe that our role as consultants to the physicians in our community does not end after normal office hours. Whenever a patient’s physician has a question or needs to discuss a case, 24/7, 365 days a year, one of our local radiologists is available for a consultation.” CEO Ed Swager added, “Radiologic Associates of Fredericksburg also is committed to providing subspecialized services in all major areas of radiology. Our physicians are all board certified and fellowship trained, with expertise in subspecialties including body imaging, cardiac imaging, interventional radiology, musculoskeletal imaging, neuroradiology, and nuclear medicine. Rather than having to travel to a major medical center, patients benefit from these services close to home.” Radiologic Associates of Fredericksburg is the largest provider of medical imaging services in the Fredericksburg, Virginia, region, including Spotsylvania and Stafford counties. The group’s 29 radiologists and two vascular surgeons serve patients at two hospitals (Mary Washington Hospital and Stafford Hospital), four imaging facilities (Medical Imaging of Fredericksburg, the Imaging Center for Women, Medical Imaging at Lee’s Hill, and Medical Imaging of North Stafford), and RAF’s interventional radiology practice, Virginia Interventional & Vascular Associates.  The practice’s radiologists also interpret all imaging studies for Stafford Hospital Imaging in Woodbridge. For more information, visit rafimaging.com.   Media Contacts: Ed Swager, Radiologic Associates of Fredericksburg (540) 361-1000 This email address is being protected from spambots. You need JavaScript enabled to view it., cc: This email address is being protected from spambots. You need JavaScript enabled to view it.   Carla Young Harrington Susan Carol Associates Public Relations (540) 479-7835 This email address is being protected from spambots. You need JavaScript enabled to view it.

Ultrasound imaging is the most widely used medical imaging method during pregnancy.  Fetal ultrasound imaging provides real-time images of the fetus. Doppler fetal ultrasound heartbeat monitors are hand-held ultrasound devices that let you listen to the heartbeat of the fetus. Both are prescription devices designed to be used by trained health care professionals. They are not intended for over-the-counter (OTC) sale or use, and the FDA strongly discourages their use for creating fetal keepsake images and videos.  "Although there is a lack of evidence of any harm due to ultrasound imaging and heartbeat monitors, prudent use of these devices by trained health care providers is important," says Shahram Vaezy, Ph.D., an FDA biomedical engineer. "Ultrasound can heat tissues slightly, and in some cases, it can also produce very small bubbles (cavitation) in some tissues." The long-term effects of tissue heating and cavitation are not known. Therefore, ultrasound scans should be done only when there is a medical need, based on a prescription, and performed by appropriately-trained operators. Fetal keepsake videos are controversial because there is no medical benefit gained from exposing the fetus to ultrasound. FDA is aware of several enterprises in the U.S. that are commercializing ultrasonic imaging by making fetal keepsake videos. In some cases, the ultrasound machine may be used for as long as an hour to get a video of the fetus. While FDA recognizes that fetal imaging can promote bonding between the parents and the unborn baby, such opportunities are routinely provided during prenatal care. In creating fetal keepsake videos, there is no control on how long a single imaging session will last, how many sessions will take place, or whether the ultrasound systems will be operated properly. By contrast, Veazy says, “Proper use of ultrasound equipment pursuant to a prescription ensures that pregnant women will receive professional care that contributes to their health and to the health of their babies.”

Doppler Ultrasound Heartbeat Monitors

Similar concerns surround the OTC sale and use of Doppler ultrasound heartbeat monitors. These devices, which are used for listening to the heartbeat of a fetus, are legally marketed as "prescription devices," and should only be used by, or under the supervision of, a health care professional. "When the product is purchased over the counter and used without consultation with a health care professional taking care of the pregnant woman, there is no oversight of how the device is used. Also, there is little or no medical benefit expected from the exposure," Vaezy says. "Furthermore, the number of sessions or the length of a session in scanning a fetus is uncontrolled, and that increases the potential for harm to the fetus and eventually the mother." back to top This article appears on FDA's Consumer Updates page, which features the latest on all FDA-regulated products. Updated: December 16, 2014  

FREDERICKSBURG, VA, Oct. 14, 2014 -- Dr. Deepak Raghavan has joined Radiologic Associates of Fredericksburg (RAF) in response to the increasing volume of neuroradiology imaging studies handled by the practice, RAF CEO Ed Swager announced today.  Neuroradiology studies such as magnetic resonance imaging (MRI) and computed tomography (CT) scans of the brain, spine, head and neck assist in diagnosing conditions including tumors, stroke, trauma injuries and spinal degenerative disease. Dr. Raghavan completed his diagnostic neuroradiology fellowship at Brigham and Women’s Hospital, a teaching affiliate of Harvard Medical School in Boston, where he was appointed the chief fellow in neuroradiology. Board certified by the American Board of Radiology, he also was a radiologist for Cape Cod Hospital before joining the Fredericksburg practice. He has co-authored medical research articles for a number of publications, including the Journal of Neurological Surgery. Dr. Raghavan joins five other neuroradiology subspecialists among the practice’s 31 physicians: Dr. James D. Sprinkle Jr., immediate past physician director; Dr. James J. Schuster Jr.; Dr. Daryle L. Darden; Dr. Vishal Bindal; and Dr. Edward C. Hwang, section chief.  He provides neuroradiology and other diagnostic radiology services to patients at facilities served by RAF including Medical Imaging of Fredericksburg, Mary Washington Hospital, Medical Imaging of North Stafford, Stafford Hospital and Medical Imaging at Lee’s Hill. Medical careers run in the family for Dr. Raghavan, who originates from North Caldwell, NJ. His parents, Dr. Padma Raghavan and Dr. Vijay Raghavan, are primary care physicians at the Veterans Affairs New Jersey Health Care System medical center in East Orange, NJ. Dr. Raghavan’s wife, Dr. Darshana Alle, is an allergist and immunologist. Dr. Raghavan knew from an early age that he wanted to follow his parents into medicine. While volunteering at their hospital during high school, he was mentored by a radiologist, who instilled in him an appreciation for the specialty. “Radiologists play a significant role in diagnosing and supervising imaging procedures for a wide variety of diseases, from gastrointestinal conditions to neurological disorders. That variety and the ability to do something good drew me to the field,” Dr. Raghavan said. Dr. Raghavan received his undergraduate degree from New York University’s Stern School of Business and his medical degree from Robert Wood Johnson Medical School in Piscataway, NJ. He completed his transitional intern year at Saint Barnabas Medical Center in Livingston, NJ, and his diagnostic radiology residency at Brown University in Providence, RI. About Radiologic Associates of Fredericksburg Radiologic Associates of Fredericksburg is the largest provider of medical imaging services in the Fredericksburg, Virginia, region, including Spotsylvania and Stafford counties. The group’s 29 radiologists and two vascular surgeons serve two hospitals, four imaging facilities, and RAF’s interventional radiology practice, Virginia Interventional & Vascular Associates.  For more information, visit rafimaging.com. Media Contacts: Ed Swager, Radiologic Associates of Fredericksburg (540) 361-1000 This email address is being protected from spambots. You need JavaScript enabled to view it., cc: This email address is being protected from spambots. You need JavaScript enabled to view it.   Carla Young Harrington, Susan Carol Associates (540) 479-7835 This email address is being protected from spambots. You need JavaScript enabled to view it.

Radiologic Associates of Fredericksburg (RAF) has launched a Concierge Service for physicians who refer patients to medical facilities served by RAF, CEO Ed Swager announced today. The service makes it easier for referring physicians to track studies and locate the best subspecialist to discuss specific studies and results. RAF’s board-certified, fellowship-trained radiologists and vascular surgeons provide services to Mary Washington Hospital, Stafford Hospital, Medical Imaging of Fredericksburg, Imaging Center for Women, Medical Imaging at Lee’s Hill, Medical Imaging of North Stafford, and Virginia Interventional & Vascular Associates. Physicians who refer patients to these facilities can contact the RAF Concierge from 8:30 a.m. to 5:00 p.m., Monday through Friday, at 855-RAF-LINE or This email address is being protected from spambots. You need JavaScript enabled to view it.. The concierge can expedite communication between referring physicians in the community and the ideal subspecialized radiologists to coordinate the most beneficial imaging study, review findings, and discuss the status of a patient’s medical imaging procedure. Like most radiologists, RAF physicians rotate among several locations. Unlike most radiology practices, however, RAF also provides 24/7 “in-house” coverage, with the radiologists rotating between daytime, evening, nighttime and weekend hours. “Because of this mobility, and clinical hours of coverage, referring physicians have told us that it is difficult to find the best radiology subspecialist to answer their questions,” Swager explained. “A RAF physician committee identified the need for a Concierge Service that would provide a consistent pathway to reach our radiologists” He added that this service is not intended to replace current methods physicians may now use to communicate with RAF.   Swager said, “Referring physicians will continue to receive calls about critical results directly from Mary Washington Hospital and the medical facilities.  The phone number for scheduling imaging tests remains the same.”   About Radiologic Associates of Fredericksburg Radiologic Associates of Fredericksburg is the largest provider of medical imaging services in the Fredericksburg, Virginia, region, including Spotsylvania and Stafford counties. The group’s 28 radiologists and two vascular surgeons serve two hospitals, four imaging facilities, and RAF’s interventional radiology practice, Virginia Interventional & Vascular Associates.  For more information visit rafimaging.com.   Media Contacts: Ed Swager Radiologic Associates of Fredericksburg (540) 361-1000 This email address is being protected from spambots. You need JavaScript enabled to view it., cc: This email address is being protected from spambots. You need JavaScript enabled to view it. Carla Young Harrington Susan Carol Associates, for Radiologic Associates of Fredericksburg (540) 479-7835 This email address is being protected from spambots. You need JavaScript enabled to view it.

Love Your Limbs™ Campaign Highlights Peripheral Arterial Disease Older adults who experience leg cramping or heaviness when walking short distances may think it’s a normal part of aging, but these symptoms can signal a serious medical condition called peripheral arterial disease, according to healthcare providers with Virginia Interventional & Vascular Associates (VIVA). VIVA is helping raise awareness in the Fredericksburg region about symptoms, treatments, and prevention as part of the national Love Your Limbs™ campaign. Peripheral arterial disease (PAD) causes blockages in the legs or arms. If untreated, it significantly increases the risk for heart attacks, strokes, and amputations. “Adults of all ages should contact their physicians if they experience symptoms of PAD, but people who smoke, those with diabetes, and anyone over 50 years old should pay particular attention,” says Dr. R. Donald Doherty, Jr., a board certified and fellowship trained interventional radiologist with VIVA. “It is important to start treating PAD before it progresses to an even more dangerous condition, called critical limb ischemia.” Information on PAD is available on VIVA’s Website, http://vivassociates.com/services/peripheral-arterial-disease/.  The national campaign is sponsored by Bard Peripheral Vascular. VIVA professionals have been visiting local doctors’ offices to provide campaign materials for improved patient education. PAD Symptoms Can Include:

• Burning or aching in feet or toes while resting
• Painful leg cramping, especially while walking
• Numbness, weakness, or heaviness in the limbs
• A patch of skin on legs or feet that is cool to the touch
• Sores on feet in diabetics
• Loss of hair on legs or feet
• Chronic leg or arm sores that do not heal

Treatments Painless tests for diagnosing PAD include the ankle-brachial index (ABI) and CT scans. Physicians may also use MR angiograms or catheter angiograms. “Treatments vary depending upon the patient’s condition,” says Dr. Doherty. “Front-line treatments include surgical bypass, angioplasty and stenting, but we also have newer procedures that are minimally invasive, including laser atherectomy, -- and rotational atherectomy.” Prevention

• Stop smoking, the #1 risk factor for PAD
• Control diabetes
• Manage high blood pressure
• Maintain a healthy weight
• Improve diet
• Get cardiovascular exercise
• Care for your feet

About VIVA VIVA is the interventional radiology and vascular surgery practice of Radiologic Associates of Fredericksburg. For more information, visit www.vivassociates.com or call (540) 654-9118. Media Contacts: Jennifer Dawson, NP-C, practice administrator Virginia Interventional & Vascular Associates (540) 654-9118 This email address is being protected from spambots. You need JavaScript enabled to view it. Carla Young Harrington Susan Carol Associates (540) 479-7835 This email address is being protected from spambots. You need JavaScript enabled to view it.

Dr. Catherine D. Buhler, a board-certified radiologist who is fellowship trained in breast imaging, has joined Radiologic Associates of Fredericksburg (RAF). Dr. Buhler is serving patients at the Imaging Center for Women in Fredericksburg. As a new member of RAF, Dr. Buhler specializes in interpreting the images of mammograms, breast ultrasounds and breast magnetic resonance imaging (MRI) tests for signs of breast cancer, and she also performs breast biopsy studies.  She provides patients with compassionate and advanced care and follow-up. “As a breast imaging specialist, I feel like I am on the forefront of the breast cancer fight. Early detection can improve a patient’s treatment options and offers a better chance of a beneficial outcome,” said Dr. Buhler, who has experienced breast cancer in her own family. Dr. Buhler’s father – among the less than 1% of breast cancer patients who are men – was diagnosed in 2004 and is doing well. Dr. Buhler received her bachelor of art degree in biology from the University of Virginia. She earned her master of science degree in anatomy and her medical doctorate degree from Virginia Commonwealth University (VCU), where she also gained research and teaching experience. She completed her medical internship with the VCU Department of Internal Medicine and her medical residency with the VCU Department of Radiology, where she later completed her breast imaging fellowship. Dr. Buhler is board certified in diagnostic radiology. She is a native of Virginia.   About Radiologic Associates of Fredericksburg Radiologic Associates of Fredericksburg (RAF) is the largest provider of medical imaging services in the Fredericksburg, Virginia, region, including Spotsylvania and Stafford counties. The group’s 27 radiologists and 2 vascular surgeons serve Mary Washington Hospital, Stafford Hospital, Medical Imaging of Fredericksburg, the Imaging Center for Women, Medical Imaging at Lee’s Hill, Medical Imaging of North Stafford and Virginia Interventional & Vascular Associates. RAF’s board-certified, fellowship-trained physicians provide 24/7 on-site radiology coverage for referring physicians and patients, and are trained in all major radiology subspecialties. For more information, visit www.rafimaging.com or call (540) 361-1000. Media Contacts: Ed Swager, CEO Radiologic Associates of Fredericksburg (540) 361-1000 This email address is being protected from spambots. You need JavaScript enabled to view it., This email address is being protected from spambots. You need JavaScript enabled to view it. Carla Young Harrington, SCAPR (540) 479-7835 This email address is being protected from spambots. You need JavaScript enabled to view it.

Radiologic Associates of Fredericksburg’s Web site, 207.58.164.131/~rafimaging/wordpress/, has been redesigned for easier navigation, with added information of value to referring physicians, patients, and the community.

“We see our Web site as a continually evolving resource,” said Daryle L. Darden, MD, the radiologist leading the redesign. “Our redesign has enhanced navigation and content, and social network integration is coming soon.”

Vishal Bindal, MD, MBA, one of the radiologists involved in planning the new Web site, noted several key features.

• Useful information about what radiology is, and what radiologists do
• Descriptions of medical imaging tests and procedures
• Helpful contacts, including information on how to schedule an examination
• Maps of each location with links to directions
• Hours of operation at each location

The new Web site also makes it easier to search RAF’s board-certified, fellowship-trained physicians by name or by medical subspecialty. For example, a person clicking on “cardiac imaging” would find that the section chief is Neil Green, MD, and three other RAF radiologists are also subspecialty trained to interpret cardiac MRI, coronary artery CT, and aortic imaging. RAF’s interventional radiology and vascular surgery practice, Virginia Interventional & Vascular Associates, is currently working on a refresh of its Web site, www.vivassociates.com.

The new computer tablet check-in system at Virginia Interventional & Vascular Associates (VIVA), believed to be the first of its kind in the area, has received an overwhelmingly positive patient response since its introduction in late May, said Jennifer Dawson, NP-C, VIVA director. In August, the Phreesia™ check-in system was also rolled out at four imaging facilities that are part of Medical Imaging of Fredericksburg, a partnership between Mary Washington Healthcare and VIVA’s parent practice, Radiologic Associates of Fredericksburg. Instead of clipboards with pages of questions, patients are provided computer tablets that they can take back to their seats to answer questions electronically. Dawson estimated, based on customer surveys and anecdotal feedback, that 70–80% of VIVA patients now prefer computer tablet check-in over paper forms.

“It was so fast and efficient. I have eight children, and filling out documents all the time over and over is time consuming. It’s nice to be able to just click, click, click, and it’s done,” said Rhonda Smetek of Fredericksburg.

Kit Lowes of Spotsylvania noted that the computer tablet system makes it easier to correct and avoid mistakes. “It took the pressure off filling out forms. When I start typing in the medications I take, the right spelling comes up on the menu and I just click it,” Lowes explained. “It’s so easy and simplified. It’s self-explanatory.” She also appreciated the ability to pay by swiping her credit card through a port in the computer tablet. Debra Wilkey of Stafford said the system is more relaxing to use than paper forms, with a bonus. “I thought the display was easy to read, understand, and follow. I also like that you can click on interesting educational information about medical conditions after you are finished,” Wilkey added. All three patients say they have not seen computer tablet check-in systems at other doctors’ offices. Dawson said VIVA’s electronic medical records vendor, which serves many medical practices locally, believes VIVA is the first in the area to offer computer tablet patient check-in. She introduced the idea of the computer tablet check-in system to VIVA after seeing it demonstrated at a medical conference. VIVA’s system:

• Interfaces with electronic medical records for more complete patient charts
• Stores information in a secure, confidential manner
• Is designed to make check-in easy and intuitive for most users, with prompts to lead patients through the process
• Provides automatic insurance eligibility checks
• Accepts patient credit card/debit card payments
• Eliminates misunderstandings caused by illegible handwriting
• Offers educational content that patients can view after check-in to better understand their medical conditions

Patients who are uncomfortable with computers, usually elderly patients, are assisted by staff or given a paper option, Dawson added. VIVA is the interventional radiology and vascular surgery practice of Radiologic Associates of Fredericksburg. For more information, contact Jennifer Dawson at This email address is being protected from spambots. You need JavaScript enabled to view it./~rafimaging/wordpress/, phone (540) 654-9118, or visit www.vivassociates.com.

In a move that has more than doubled its space, Virginia Interventional & Vascular Associates (VIVA) has relocated to the Professional Plaza of Lee’s Hill. VIVA is the interventional radiology and vascular surgery practice of Radiologic Associates of Fredericksburg (RAF). VIVA’s new offices are located off US 1, near the I-95 Spotsylvania Exit, in the same building as Medical Imaging of Fredericksburg at Lee’s Hill and Mary Washington Healthcare’s Emergency & Outpatient Center - Lee’s Hill. The move in February was a necessity, as VIVA had long outgrown its offices in the Ambulatory Surgery Center near Mary Washington Hospital. RAF CEO Ed Swager explained that VIVA’s interventional radiologists and vascular surgeons evaluate and treat significantly more patients than they did when VIVA opened in 2007. Treatments offered by VIVA physicians include minimally invasive procedures for uterine fibroids, varicose veins/spider veins, cancer, compression fractures caused by osteoporosis, chronic pain, and many other conditions. VIVA physicians also provide the full range of vascular surgery care, including catheter-based and open procedures. Vascular ultrasound tests available through VIVA detect peripheral vascular disease, deep vein thrombosis, abdominal aortic aneurysm, and additional abnormalities. VIVA physicians include interventional radiologists Michael P. McDermott, MD, John J. McLaughlin, MD, R. Donald Doherty, Jr., MD, John D. Statler, MD, and John D. Gleason, MD, and vascular surgeons Victor J. D’Addio, MD, and Larry Koenig, MD. With 9,200 square feet, the new facility at Lee’s Hill not only accommodates VIVA’s growth with additional procedure rooms and exam rooms, but also offers: • Improved patient comfort • An accessible location • Faster scheduling • A supportive setting for clinical excellence “Moving to a new facility provided an opportunity to create a welcoming environment that is patient-centered and easy to navigate,” noted Dr. Doherty. Improved Patient Comfort “RAF and VIVA are cognizant of the healthcare expenses of our patients and the costs of third-party payers. The new VIVA facility has a pleasant design that is practical, not opulent,” Swager added. “It blends the positive aesthetic experience of the clinical environment with a facility that is not too sterile or too informal.” One major improvement is an office layout that reflects the workflow of patients and staff. For example, waiting areas for vascular surgery patients are located near the vascular surgeons, waiting areas for interventional radiology patients are located near the interventional radiologists, and waiting areas for patients needing both services are located equidistant between the two specialties. Irene Valentino, RAF director of administrative operations, noted that the spacious design better accommodates acute patients who are in wheelchairs or on stretchers. It is easier for acute patients to maneuver into and around the facility, and gives clinicians the flexibility of approaching patients on either side of stretchers. Accessible Location The Lee’s Hill location is near one of the few crossroads of US 1 and I-95, making it convenient to many patients throughout the region who are served by VIVA, Swager said. The location offers ample, easy parking for patients and staff. Faster Scheduling The new VIVA facility has more procedure rooms and exam rooms, which can be used or scaled back as needed based on volume. “We also have the space to add more clinicians by hiring additional nurses, physician’s assistants and radiology techs. These improvements should lead to faster scheduling of procedures,” Valentino added. A Supportive Setting for Clinical Excellence Swager commented that the new facility reflects the high quality and professionalism of VIVA staff. It is designed to comply with higher-end regulations and requirements such as accreditation criteria from the Accreditation Association for Ambulatory Health Care. It also offers the flexibility for VIVA to grow as it has historically, in a building with complementary support services such as medical imaging, lab, emergency services, and physical therapy.

It may be the best-kept “secret” in North Stafford. Although many people in the region have not yet heard of Medical Imaging of North Stafford, the facility expects to treat nearly 15,000 patients in 2012. “I don’t know how many times we have spoken with patients and referring physicians who are surprised to learn that the imaging center exists,” says Ed Swager, CEO of Radiologic Associates of Fredericksburg (RAF). RAF partnered with Mary Washington Healthcare to open Medical Imaging of North Stafford in September 2007. Since then, the facility has added increasingly sophisticated imaging services, expanded its hours, and scored high in patient satisfaction surveys. George T. Sofis, MD, a North Stafford resident and RAF diagnostic radiologist serving the facility, believes it is also underutilized because of the misperception that advanced medical care is available only in metropolitan areas such as Washington, DC. “Our physicians are board certified, and fellowship trained at excellent programs including Harvard and the University of Virginia,” notes Dr. Sofis, who received his fellowship training in musculoskeletal radiology at Duke University. “Medical Imaging of Stafford also has state-of-the-art imaging equipment. This is a great resource for area residents.” The following are just a few facts about Medical Imaging of North Stafford. Commuter hours – The facility opens early in the morning, closes late at 7 p.m. Tuesdays and Thursdays, and sees patients 7 a.m. to noon on Saturdays. Swager says Medical Imaging of Stafford is considering extending late closings to five days a week, given that roughly half of its patients commute to work in Northern Virginia and Washington, DC. Dr. Sofis adds that same-day appointments are often available at the facility. Crossroads location – Medical Imaging of North Stafford is located at 125 Woodstream Boulevard, Suite 109, Stafford, VA 22556. The location is close to Garrisonville Road (VA-610), a major east-west corridor in the area, as well as Interstate 95 and US 1. Advanced tests – The facility offers comprehensive imaging services including diagnostic X-ray, new 3D/4D ultrasound, multi-slice computed tomography (CT), and 1.5 Tesla magnetic resonance imaging (MRI). High ratings – Medical Imaging of North Stafford scores in the 99th percentile in patient satisfaction surveys when compared with facilities of similar size in the US, Swager notes. He attributes the high ratings to the professionalism and caring of the facility’s staff. 24/7 coverage –Even after hours,referring physicians can speak with a qualified RAF radiologist or communicate online about patient reports because Medical Imaging of North Stafford is connected with RAF’s on-site radiologists at Mary Washington Hospital. Professional supervision –In addition to interpreting medical imaging studies, RAF’s board-certified radiologists supervise services and training at Medical Imaging of Stafford. They evaluate treatment options to determine the best test for each study and follow Image Gently™ and Image Wisely™ protocols to ensure that the lowest effective dose is used in patient imaging, Swager explains. Complementary relationships – Medical Imaging of North Stafford is one of four facilities that are part of Medical Imaging of Fredericksburg; the other centers are Medical Imaging of Fredericksburg on the Mary Washington Hospital campus, the Imaging Center for Women, and Medical Imaging at Lee’s Hill. These relationships enable easy comparison with prior imaging studies that may have been performed at any of the sister facilities, Mary Washington Hospital, or Stafford Hospital. For more information about Medical Imaging of North Stafford, visit https://rafimaging.com/locations/ or www.mifimaging.com.

Shortly after Dr. Michael J. Hewitt, a board-certified diagnostic radiologist, launched his career with Radiologic Associates of Fredericksburg (RAF) in 1982, he was advised of RAF’s belief in the “Five A’s” of best practices in radiology: accuracy, availability, accountability, affability, and affordability. Over his three decades of service with RAF, the Five A’s have continued to be unwavering guideposts and keys to his longevity with the group. Medicine runs in the family, three generations back. Dr. Hewitt’s great grandmother served as a midwife in the Catskill Mountains, and his great aunt was a nurse in WWII. He grew up in dairy country, in the Catskill Mountains of upstate New York. With initial plans to be a veterinarian, Dr. Hewitt followed his passion for science at the State University of New York (SUNY) in Oneonta. “At first, I was hesitant to be a human doctor,” Dr. Hewitt recalled. “I felt overwhelmed by the responsibilities involved. After some soul searching, I convinced myself that I could be as good a doctor as anyone if I worked hard and cared.” He went on to graduate from University of Rochester School of Medicine and Dentistry in 1978, and then attended Duke University to complete his internship and residency in diagnostic radiology. The seventh doctor to join RAF, Dr. Hewitt was asked to assume the role of physician director of ultrasound, taking over from the initial directorship of one of his senior associates, Donald Allen, MD. Dr. Hewitt held this post for 20 years. He then became physician director of OB/GYN imaging in 2002, passing this baton five years later to his new colleague, Neil Patil, MD. In his first 15 years with RAF, Dr. Hewitt served as a member of RAF’s interventional radiology team, directed by Ted Glass, MD. He has also held a variety of leadership positions, including president of the medical staff at Mary Washington Hospital, chairman of the hospital’s department of radiology, and president of RAF. Through the years, Dr. Hewitt has observed remarkable changes in the practice. “When I came on board in ‘82, we had one ultrasound machine and one technologist, at one site, Mary Washington Hospital,” he said. “Now, we have many machines at many sites, along with dozens of certified ultrasound technologists, who in many ways work like physicians assistants with RAF.” Also, the number of physicians in the group has grown more than six times over, from five to 33. Today, Dr. Hewitt spends two-thirds of his time interpreting images and caring for patients at the Imaging Center for Women, a partnership between RAF and Mary Washington Healthcare. Procedures range from diagnostic mammography and breast ultrasound and biopsy to pelvic sonography. The rest of his time is divided between other outpatient facilities and the department of radiology at Mary Washington Hospital, where he has full on-call responsibilities. Dr. Hewitt and his wife of 36 years, Barbara, are owners of Sweet Promise Farm in Stafford, where Barbara raises Morgan horses. “Barbara thought of the ‘Sweet Promise’ name when we were young,” Dr. Hewitt noted. “A line in her favorite hymn, ‘How Great Thou Art,’ mentions God having a promise for all of us. It spoke to our dream of having a farm together some day.” The couple has three grown children: Meghan, John, and Amanda, who live nearby. When he is not on the job or helping Barbara on the farm, Dr. Hewitt reads (historical novels, along with books about religion and philosophy), plays the piano, cooks, and “tools around or lumbers around, as the case may be” in one of a few antique vehicles he was given over the years. They include a 1934 John Deere tractor from his father and grandfather, and a 1931 Model A Ford Coupe from his uncle. Dr. Hewitt looks forward to his 30^th year with RAF and with Mary Washington Healthcare associates. “Learning never stops,” he said. “Nor does the satisfaction of calling on years of experience to assist referring doctors in helping their patients avoid disease, or conquer it.”