HealthCare Business News had a recent opportunity to speak with Dr. Bennett Greenspan to learn more about him, his goals as society president and some of the challenges and opportunities facing nuclear medicine, molecular imaging and SNMMI members.

HCB News: What inspired you to get involved in medicine?
BG: My father was an internist subspecializing in hematology and oncology, so I grew up with medicine in the house. In high school, he said I should go into medicine, as it offered so many opportunities. I resisted as a teenager, because that’s what teenagers do. In college, though, I studied microbiology with the aim to go into medicine. I focused on radiology and nuclear medicine in med school.

My father actually suggested nuclear medicine as a career while I was still in high school, but I didn’t know anything about it. In medical school, I looked into it. It didn’t click right away, but it did eventually make sense.

HCB News: How did you get involved and get to where you are today in SNMMI?
BG: Somewhere along the line I got involved in one or two committees. I liked it and was good at it, so I got more involved. I became a member of several committees and councils and the chair of the Academic Council. I was elected to the board of directors and served two terms. I ran for vice president- elect two years ago and was elected.

HCB News: What major initiative or initiatives do you plan to support during your time as president?
BG: There are a number. First, we’ll be presenting our value initiative from our board of directors at the annual meeting. It will support our revised strategic plan.

Second, promoting radionuclide therapy and theranostics. These have a lot of promise, especially with radionuclides that can function in both therapy and diagnostic studies.

Third, we’ll be promoting a reasonable approach to radiation safety. The linear nonthreshold hypothesis that’s used for radiation protection isn’t even correct.

Fourth, we’ll be supporting development of Appropriate Use Criteria (AUC) and updating our procedure standards. In its role as a qualified provider-led entity (PLE) under the Medicare AUC program for advanced diagnostic imaging, SNMMI is developing a series of new AUCs for some of the most commonly used nuclear medicine procedures. These AUCs are intended to assist referring physicians and ordering professionals in fulfilling the requirements of the 2014 Protecting Access to Medicare Act.

Fifth, we plan to reinstate the future leadership academy. It’s important for the future of the society to engage young talent and encourage them to be active participants.

And finally, I want to support the development of medical physicists who specialize in nuclear medicine physics by supporting increasing the number of medical physics residencies. I would also like to support mid-level opportunities for nuclear medicine technologists.

HCB News: As president, what unique experience and perspectives do you bring to the table?
BG: I’ve been heavily involved in committees for many years and have a broad range of experience in that respect. I have worked with scientists, technologists, radiologists and nuclear medicine physicians. I also have training in radiology and nuclear medicine, and am certified in both.

HCB News: What are the biggest challenges facing SNMMI today?
BG: There are three main challenges. The first is handling regulations and reimbursement. Second is raising awareness among clinicians about the value of nuclear medicine. The third is the concern about a shortage of Technetium-99m. There is no domestic supply of Mo-99. The Canadian reactor shut down routine production of Mo-99 in 2016, and backup emergency support will cease in 2018.

However, the good news is that a study by OECD’s Nuclear Energy Agency stated that the supply chain capacity should be sufficient to manage an unplanned outage of a reactor or a processor until 2021. Also, the High Flux Reactor in Petten has undergone upgrades, and has significantly increased production of Mo-99, and ANSTO has ramped up Mo-99 production at its OPAL reactor in Australia. Companies working in partnership with the U.S. Department of Energy’s National Nuclear Security Administration on non-high energy uranium production of Mo-99 will also soon be part of the supply chain.

HCB News: What are the biggest opportunities?
BG: It goes back to the value initiative of nuclear medicine and radionuclide therapy that is key to advances in the field, especially in cancer therapy. There are also new radiopharmaceuticals which have been or will be receiving FDA approval that are very promising.

HCB News: Did the introduction of the ACA have any significant impact on your members?
BG: I don’t have numbers, but I think in general, more patients could afford to get tests, so it did probably increase the volume of tests being done.

HCB News: Are there any concerns about repeal/replacement?
BG: Doing the right study for the right patient helps them get the care they need. PET studies can determine if they have cancer and at what stage, so it can prevent unneeded surgeries. By providing the right information, it lowers costs by directing physicians toward the most promising therapy. So cutting reimbursement or increasing copays reduces the chance of getting care when treatment could be more successful. Therefore, cutting reimbursement or increasing copays could lead to an increase in health care costs.

HCB News: What are you most excited about at the upcoming annual show and conference?
BG: I’m looking forward to seeing the data on the new agents to see how successful they are. Presenting our value initiative about how nuclear medicine provides value to patients and health care overall will also be exciting.

Our value initiative covers five domains:

• Quality of practice, which provides focus on improvement in quality of studies and interpretations, and use of diagnostics and therapeutics, to promote better patient outcomes.

• Research and development, to develop new radiopharmaceuticals in a wide range of diagnostic procedures, and new radiopharmaceuticals for radionuclide therapy.

• The workforce pipeline, to attract high quality candidates to nuclear medicine. Also to get radiology residents more interested in nuclear medicine.

• Advocacy, explaining to legislators, regulators and payors the value of nuclear medicine and molecular imaging.

• And outreach to referring clinicians, patients and the public.

The value initiative will help direct our development of the new strategic plan of the SNMMI for the next three to five years.