Philip B. Kivitz, MD — a pioneer in modern breast imaging and breast health care — develops the Breast Evaluation Center/San Francisco (BEC/SF) in the 1980's. He revolutionizes the role of breast-imaging radiologists while creating a new breast healthcare experience for women of every age.
Clinical care
A radiologist's practice, redefined
- The radiologist accepts self-referred patients as well as those referred by physicians.
- The radiologist routinely performs clinical breast examination for women who had not recently been examined.
- The radiologist performs all necessary imaging and procedures the same day.
- The radiologist tells the patient her medical reports at the conclusion of the visit.
- The radiologist manages patient care for benign breast diseases — not generally available.
- When surgery is needed, patients are referred to vetted breast surgeons.
In short, Dr. Kivitz makes the breast radiologist's practice use imaging as part of a clinical practice, in the same way that cardiologists use the EKG and ultrasound imaging, and neurologists and neurosurgeons use EEG.
He moves breast imaging radiologists out of the dark reading room to personally see women. This is the first time that women have a face-to-face interchange with the radiologist.
Imaging & MQSA
Dr. K's training as a technologist as well as radiologist informs his work ensuring quality images. On-site, supervised hands-on training of mammography technologists to attain optimal positioning and effective compression with patient comfort is a special interest.
The SFBEC is performing MQSA quality breast images years before 1992. The MQSA, which Congress passes in 1992 and implements in 1994, requires every mammography facility in the US to be accredited by the FDA. The American College of Radiology (ACR) conducts the examinations and advises the FDA on a facility's qualifications.
As an ACR senior reviewer and inspector for the FDA-administered MQSA since its inception, Dr. Kivitz has reviewed thousands of images submitted for accreditation, visited hundreds of mammography facilities, and trained over a thousand technologists throughout the US. The training goal is always the same: to easily perform positioning and compression that meet MQSA standards — incorrect positioning and insufficient compression are the most common causes of MQSA failure.
Ultrasound
Dr. Kivitz develops the first ultrasound service for the hospital during his residency. Building on this experience, ultrasound becomes a significant part of his clinical practice. Completing his residency and certified as a Diplomate of the American Board of Radiology, he soon establishes what is believed to be the first non-hospital diagnostic ultrasound service in a San Francisco private office.
The first certification examination for ultrasound technologists is administered in San Francisco. Dr. Kivitz is one of the examiners, assisting in establishing early standards for ultrasound imaging.
With his extensive ultrasound experience, he recognizes the importance of the FDA-approved water-bath, automated, whole-breast ultrasound equipment. It becomes a building block for better breast disease diagnosis when the BEC/SF opens its doors in 1980.
Industry & innovation
Consulting for medical start-ups and established companies ranges from training neural networks and software development in the 1990's to innovative breast diagnostic hardware development. Dr. Kivitz, an original thinker, is an innovative force in the breast health space. Extensive clinical and academic experience informs his concepts for a user-friendly approach to product development.
Education for mammography technologists
Team building — on-site, at your facility
A unique opportunity for mammography technologists: receive supervised hands-on positioning and compression training in their own work space. This quality improvement (QI) project is designed to improve and maintain the technologist's skills for consistent mammography images that meet MQSA standards, stressing easier breast positioning and effective compression, and highlighting the most common causes for MQSA failure.
Thoroughly Modern Mammography
For several years during the 1990's, “Thoroughly Modern Mammography: Mammography Interpretation for the Technologist,” a two-day course approved for 15 CME credits (ASRT), is presented annually in 12–14 locations across the US. During these Friday/Saturday sessions, 15 hours of new material each year is presented by Dr. Kivitz — many technologists attend annually though they did not need the CME credits. If technologists know what changes radiologists need in the images to make a diagnosis, they will be better at their job. MQSA positioning standards, and techniques for accomplishing these images with ease and less fatigue, are prominent as well.