May 21, 2024
Joseph Steiner, PhD DABR
Assistant Professor (Nuclear Medical Physicist)
Department of Radiology, Clinical Physics Division
The University of Chicago
Innovate. Illuminate.
These two words are the theme of the 2024 SNMMI Annual Meeting. They also were the theme to my experience as the 2024 SNMMI Henkin Fellow. Self-admittedly, I applied for the Henkin Fellowship because I knew nothing about nuclear medicine policy and governance except that it appeared to hinder the advancement of patient care. I could not understand why the US was often so slow in adopting nuclear medicine innovations that clearly would result in positive patient outcomes. I wanted to learn about the challenges associated with regulation and policy to better identify what I could do to move nuclear medicine forward.
The Henkin Fellowship provided that understanding and more; Doug Burrichter, Senior Manager of SNMMI Health Policy and Regulatory Affairs, correctly noted it was like drinking from a firehose. During my first day of fellowship, I joined three other champions of nuclear medicine, Nichole Ozinga (a CNMT from Corewell Health), Julia Bellinger (SNMMI Director of Government Affairs), and Dave Eckels (US Director of Sales at Hermes Medical Solutions); we purposely strode through Capitol Hill advocating to Congress the importance of the FIND Act, why NETs should be added to the DoD CDMRP report language, and the detrimental impact on patient care that would occur if the Nuclear Medicine Clarification Act came to pass.
As my fellowship progressed, I participated in the SNMMI Board of Directors governance meeting. It was enlightening to gain perspective on the inner workings of the SNMMI and humbling to be part of a group of internationally known leaders so dedicated to advancing nuclear medicine. I joined forces with the two Slosky Fellows, Dr. Remo George, a radiobiologist at the University of Alabama-Birmingham, and Dr. Bhasker Radaram, a radiochemist at GSK. Together, we visited and learned from many organizations dedicated to advancing nuclear medicine, ranging from patient advocacy groups to national not-for-profits to US regulatory agencies. These institutions had varied missions and institutional plans that all coalesced into improving patient care.
This fellowship was an illuminating experience that demonstrated what I and other nuclear medicine practitioners can do to advance policies aimed at improving patient outcomes. Interestingly, that “what” was much simpler than I previously envisioned and was most clearly identified during my visits to Capitol Hill.
When meeting with congressional staffers, we first asked them what type of understanding they had regarding nuclear medicine. Almost universally, the response was “I don’t know anything about nuclear medicine, but I am eager to learn.” This might seem surprising, as we were there with the dedicated purpose of discussing with them nuclear medicine specific legislation. Consider this – in the US ~12,000 people are diagnosed with neuroendocrine tumors annually (cancer.net). This disease newly presents in only 0.004% of the more than 300,000,000 individuals in the US each year. It became clear to me that many of the problems associated with nuclear medicine governance and policy are not an unwillingness to spend money or regulatory red tape; rather, the knowledge of nuclear medicine and how it can improve patient outcomes needs to be higher up on our policy maker’s docket. Although SNMMI does have congressional "champions" and supporters in both the House and the Senate, there are 535 members to educate about nuclear medicine and they appreciate hearing from their constituents. Many members of Congress, managing trillion-dollar budgets, navigating multiple wars, and working though hundreds of bills that impact every American are largely absent in the fight to advance nuclear medicine not because they are against it, but because they are not aware of it.
This idea formed in my thoughts like a lightbulb. As members of SNMMI we are the innovators of nuclear medicine. We know the science, we know the medicine, we know the incredible positive impact we can have on our patients. What I learned as a Henkin Fellow is that we cannot just be innovators. We cannot just work in the research lab or the hospital and expect nuclear medicine to advance through the halls of Congress so that it can reach our patients. We need to advocate for nuclear medicine to the movers and the shakers of governance. We need to inform our policy makers of the positive outcomes our patients will experience through improvements and advancements in nuclear medicine policy and regulation. We need to be the ones providing illumination to those who do not know what nuclear medicine is or the positive outcomes it can give our patients.