Working Together News

Utilizing Technology to Find Results:
Meet Our Imaging Directors

James Calliham

Medical Imaging Director
Saint Joseph Hospital

What's something we don’t know about your job?
I don’t think most people realize how dynamic and diverse the radiology department is. We have multiple imaging modalities (MRI, CT, X-Ray, Nuclear Medicine, PET/CT, etc.), employing a variety of technologies to determine specific diagnoses. Here at Saint Joseph, we perform about 100,000 diagnostic imaging exams each year, and while, first and foremost, we provide ancillary support to the ED and Inpatient Units, we also are a revenue-generating department expected to help drive new business opportunities. It’s a constantly changing environment, so it certainly keeps me engaged.

What is the most challenging part of your job?
I think the most challenging aspect of my job is the same that all healthcare leaders face in the current environment: How do we continue to improve the quality of care we deliver while reducing overall costs? In radiology, we’re expected to provide the highest quality imaging, utilizing the latest technology, performed by the best trained technologists. Imaging equipment can be among the most expensive capital purchases a hospital makes, and we would spend ourselves into insolvency if we tried to always have the absolute latest and greatest technology available. Striking the right balance between providing cutting-edge technology and being fiscally responsible requires good long-term capital planning and strong service line collaboration.
Where do you see this field in five years?
Things are changing so rapidly right now, but I believe the one area with the greatest potential to be a game-changer in radiology would have to be around the use of Artificial Intelligence (A.I.). I recently returned from the RSNA (Radiology Society of North America) annual meeting in Chicago where almost every vendor was presenting their version A.I. technology. We’ve been hearing for several years about how A.I. will revolutionize medical imaging, but this was the first time I really felt like we’re on the cusp of seeing A.I. used in real-world application.  While I don’t see A.I. replacing radiologists, I can definitely envision it being utilized as a complementary tool to more accurately identify and diagnose things like lesions and tumors that are undetectable to the human eye. It’s pretty impressive technology, and five years from now, I think we’ll see it at the forefront of image acquisition and interpretation.
What was your first job?
I grew up in a rural area in south Texas, and when I was 14 I worked at a little country general store/gas station/feed store that sold just about everything under the sun. One side of the store was set up to sell groceries, hardware supplies, fishing tackle, you name it. The other side was set up for old men who would come in to drink beer, play dominoes and tell stories. It was a unique experience, and it was my first opportunity to work in a position where I served the public. Many of the lessons I learned in that job have stayed with me over the years and, I believe, have served me well.
What is the best advice someone has given you?
My dad always told me “Education may be expensive, but it’s not nearly as expensive as ignorance.”

Will Cook

Director of Imaging
National Jewish Health

What's something we don't know about your job?
I provide oversight for the employee Clinical Radiation Dose monitoring program for National Jewish Health, which includes Imaging, the Minimally Invasive Diagnostic Center, Cardiology and the National Jewish Health South Denver outpatient clinic. I enroll clinical personnel that need Radiation Monitoring Badges through an outside radiation monitoring company. Radiation Monitoring Badges are collected monthly and are sent out to determine the monthly dose. I have the Medical Physicist review and sign off on the monthly radiation monitoring reports to make sure no one has received excessive Radiation.
What is the most challenging part of your job?
Making sure imaging is in compliance with the several accrediting agencies that exist, including The Joint Commission, ACR (American College of Radiology), CMS, FDA and the State of Colorado Radioactive Materials License Program. Making sure you meet the standards as written, however the interpretation of the standards are not always written clearly.  That said, the personnel that represent the various regulatory interpret the regulations with some degree of variability. The other aspect of regulatory agencies is there has been a lot of emphasis on radiation reduction practices and standards for all modalities that produce radiation such as CT Scans.      

Where do you see this field in five years?
Imaging will continue to play an active role in delivering high quality patient care services, but will be challenged by shrinking reimbursement rates. This is common in the Medical Field in which hospitals have standard charges for services rendered in which they can charge a reasonable fee, however Insurance companies or Medicare will pay you only  a percent of the charges, in many cases less than 50%. Example: It would be similar to (but not realistic) if your auto mechanic charges you $ 1,000 for work done on your car and you say I will just pay you $ 500.

What was your first job?
Most of my jobs as a kid was working for my father and helping him on the farm such as irrigating, driving a tractor etc. My first job was a Diagnostic Radiology Technologist at LaJunta Colorado Medical Center. It was a good experience and I was able to perform a wide variety of imaging procedures. At rural hospitals they do not have the depth in staffing for specialization so you have to learn it all.  The other aspect is I was “on call” a lot so getting up in middle of night was challenging.

What is the best advice someone has given you?
Good question. I’ve had several mentors in my career that have given me good advice, but I would say one of them advised me to get my Master’s Degree to advance my career. It helped me in that it provided me more knowledge, skills and confidence to pursue other jobs such as the one I have now.