title: Effect of Health Care Financing Administration regulation on radiology fellowship training.
abstract: OBJECTIVE
  The purpose of this study was to assess the effect of Health Care Financing Administration (HCFA) regulations on radiology fellowship training.
  
  
  METHODS
  Surveys were sent to 157 fellowship program directors in body imaging and vascular/ interventional radiology. Questions addressed program accreditation status, faculty supervision of fellows, and any change in faculty supervision of fellows in response to HCFA's revised plan for Medicare Part B reimbursement.
  
  
  RESULTS
  Eighty of 157 (51%) surveys were returned. Thirty (37%) respondents indicated supervision of fellows had changed after institution of the new HCFA rules in July 1996. Vascular/interventional program directors (n = 25, 49%) were more likely to have changed their practice than body imaging program directors (n = 5, 17%). Nearly all respondents (29 of 30, 97%) indicating a change stated supervision had increased. Twenty-seven (33%) respondents also indicated faculty supervision was beyond that necessary for patient care and house staff education; most of these respondents (21 of 27, 78%) stated the new HCFA regulations were responsible. Many program directors also expressed concern the HCFA regulations might prevent fellows from obtaining sufficient experience to effectively learn independent clinical decision-making.
  
  
  CONCLUSIONS
  HCFA regulations intended to address attending physician billing practices at teaching institutions may have had the unintended effect of substantively altering the training of radiology fellows.
authors.affiliation: Department of Radiology, University of Virginia Health Sciences Center, Charlottesville, Va, USA.
authors.forename: J J
authors.initials: JJ
authors.lastname: Smith
authors.forename: S B
authors.initials: SB
authors.lastname: Gay
authors.forename: E J
authors.initials: EJ
authors.lastname: Maurer
authors.forename: A H
authors.initials: AH
authors.lastname: Matsumoto
mesh_terms: D014487:Centers for Medicare and Medicaid Services, U.S.; D005257:Fellowships and Scholarships; D006801:Humans; D007396:Internship and Residency; D011871:Radiology / Q000193:education*; D011795:Surveys and Questionnaires; D014481:United States