radiology going down?

[mcatsucksss]

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so i was reading a bit on this forum and saw a bunch of posts from "nightflight" saying how radiology was going down the drain and that the lifestyle sucks (really long hours, endless amounts of reading when not working), the pay is getting cut bad etc etc... i am really confused about this because i always thought that radiologists were consistently among the highest paid and have very high job satisfaction.

could someone please explain to me if this is true or not? I'm only an M3 with very limited exposure to the field but i am interested because of the fact that it is so high tech and highly involved in so many other specialties.

 

[penguin24]

Let's say you don't go into radiology, what specialty will you go into. Let's assume that everything you said is correct.

 

[colbgw02]

obvious nightflight troll not obvious?

 

[Radonkulous]

You have to admit, there probably is some truth to some of his statements even if he is a troll.

 

[omarsaleh66]

nightflight might be right.

lets see, its sunday afternoon and Im currently moonlighting , getting paid 200/hr and watching NFL football (in 2 fantasy leagues) and Netflix instant stream (very necessary for the job, trying to finish season 2 of Friday Night Lights today).

Not a bad job. Im gonna do my job, Jamaal Charles better do his LOL

 

[PokerDoc]

nightflight might be right.

lets see, its sunday afternoon and Im currently moonlighting , getting paid 200/hr and watching NFL football (in 2 fantasy leagues) and Netflix instant stream (very necessary for the job, trying to finish season 2 of Friday Night Lights today).

Not a bad job. Im gonna do my job, Jamaal Charles better do his LOL

This might be the single greatest post in the history of SDN.

Don't worry about Charles btw, last year i had him, AP and Foster on the same team (crazy I know, foster didn't even get drafted last year!) in a 12 team league. Needless to say I won that league.. this year I'm more worried. I'm counting on Josh Freeman as my QB....

edit: uh oh.. charles just got hurt

 

[Radonkulous]

I asked the following in the Allo forum to a current rads resident and soon to be fellow:

What's your take on the DR job market present and future (I like rads a lot but not enough if I don't have a job)? Appreciate all the insight.

It is pretty bad right now. I have a lot of friends who can't find jobs. I don't really expect it to improve much with all the reform coming through.

I don't think you can completely disregard the fact the job market is really bad.

 

[PokerDoc]

I asked the following in the Allo forum to a current rads resident and soon to be fellow:





I don't think you can completely disregard the fact the job market is really bad.

To be fair, you would probably have to go on the medicine and surgery forums and ask them too. In a vacuum, I don't think anyone is disagreeing that the job market for Radiology is worse than it was 5 years ago. But I would disagree that Radiology is the only field where this is true.

I think another point to consider is that there will be a mass increase in the need for physicians (under the new health care plan, whether or not there are bad components to the plan) due to the increase of patients in the system. Couple that with the impending mass retirement of baby boomer physicians, I am confident the job market will rebound in due time.

I'm not an expert on economics, but I think predicting certain doom is pushing it a little too far.

 

[DrBowtie]

I asked the following in the Allo forum to a current rads resident and soon to be fellow:





I don't think you can completely disregard the fact the job market is really bad.

Whats your other options?
As I told nightflight, I'd rather be unemployed or "reading mamms in the boonies" rather than playing social worker or working 100 hours.

Only other option would be Rad Onc but I'm not too keen on all day clinic.

 

[Radonkulous]

To be fair, you would probably have to go on the medicine and surgery forums and ask them too. In a vacuum, I don't think anyone is disagreeing that the job market for Radiology is worse than it was 5 years ago. But I would disagree that Radiology is the only field where this is true.

I think another point to consider is that there will be a mass increase in the need for physicians (under the new health care plan, whether or not there are bad components to the plan) due to the increase of patients in the system. Couple that with the impending mass retirement of baby boomer physicians, I am confident the job market will rebound in due time.

I'm not an expert on economics, but I think predicting certain doom is pushing it a little too far.

True, but you don't hear of other residents in other specialties saying they can't find jobs, except for pathology which is the worst. Cards fellows might not find their ideal job in a tight market, but they still get a decent job.

I only hear this "I'm a fellow and I can't find a job except in the boonies" sentiment from rads and path docs unless these guys are exaggerating the state of the job market.

To the last poster, M3 will probably answer that question for me. Unsure right now.

 

[DrBowtie]

Seriously though, I'm doing Rads because its what I like to do. Who knows what the job market, salary, etc. will hold in the next 6 years much less 20 years from now.

Cards/Rads/insert procedural specialties have been "getting the axe" for years. The great thing about Rads is that there is pretty much an unlimited amount of scans to read to compensate for whatever amount you want to make and time you want to put in.

The outpatient clinic is going to have a hard time filling their 11pm timeslots.

 

[bronx43]

nightflight might be right.

lets see, its sunday afternoon and Im currently moonlighting , getting paid 200/hr and watching NFL football (in 2 fantasy leagues) and Netflix instant stream (very necessary for the job, trying to finish season 2 of Friday Night Lights today).

Not a bad job. Im gonna do my job, Jamaal Charles better do his LOL

And ladies and gentlemen, this is the definition of sustainability. When something seems too good to be true, it probably is (or is true but won't be for long). Everything comes down to fundamentals.

 

[PokerDoc]

True, but you don't hear of other residents in other specialties saying they can't find jobs, except for pathology which is the worst. Cards fellows might not find their ideal job in a tight market, but they still get a decent job.

I only hear this "I'm a fellow and I can't find a job except in the boonies" sentiment from rads and path docs unless these guys are exaggerating the state of the job market.

To the last poster, M3 will probably answer that question for me. Unsure right now.

I really don't know how to answer this man. You've been in med school long enough that anecdotal stories shouldn't have this much of an effect on you. Find statistics, trends, real numbers. Then I'm happy to talk or share in concern with you. I'm just a little tired of the he said she said stuff about the job market. There are too many factors at play here to go on word of mouth. Job markets are struggling everywhere. The economy in 6 1/2 years when I finish fellowship will be different than it is now, just like it was different 5 years ago. I think it's pointless to worry about this. Do radiology if you truly love it and that's what you want to be, because if it isn't, you're going to be pretty miserable regardless of how much money you make.

 

[bronx43]

To be fair, you would probably have to go on the medicine and surgery forums and ask them too. In a vacuum, I don't think anyone is disagreeing that the job market for Radiology is worse than it was 5 years ago. But I would disagree that Radiology is the only field where this is true.

I think another point to consider is that there will be a mass increase in the need for physicians (under the new health care plan, whether or not there are bad components to the plan) due to the increase of patients in the system. Couple that with the impending mass retirement of baby boomer physicians, I am confident the job market will rebound in due time.

I'm not an expert on economics, but I think predicting certain doom is pushing it a little too far.

It depends on your definition of certain doom. In the scenario of heavy cost cutting (an inevitability at this point), radiology doesn't fare well.

 

[bronx43]

I really don't know how to answer this man. You've been in med school long enough that anecdotal stories shouldn't have this much of an effect on you. Find statistics, trends, real numbers. Then I'm happy to talk or share in concern with you. I'm just a little tired of the he said she said stuff about the job market. There are too many factors at play here to go on word of mouth. Job markets are struggling everywhere. The economy in 6 1/2 years when I finish fellowship will be different than it is now, just like it was different 5 years ago. I think it's pointless to worry about this. Do radiology if you truly love it and that's what you want to be, because if it isn't, you're going to be pretty miserable regardless of how much money you make.

The economy won't be rebounding. I don't want to go into specifics, but the American economic machine is closer to depression and/or financial collapse than a "recovery."

 

[Radonkulous]

I really don't know how to answer this man. You've been in med school long enough that anecdotal stories shouldn't have this much of an effect on you. Find statistics, trends, real numbers. Then I'm happy to talk or share in concern with you. I'm just a little tired of the he said she said stuff about the job market. There are too many factors at play here to go on word of mouth. Job markets are struggling everywhere. The economy in 6 1/2 years when I finish fellowship will be different than it is now, just like it was different 5 years ago. I think it's pointless to worry about this. Do radiology if you truly love it and that's what you want to be, because if it isn't, you're going to be pretty miserable regardless of how much money you make.

It'd be ok if it was 1, 2, or even 3 anecdotal stories. But after reading AM and SDN, this is a pervading sentiment among a lot of ppl. I agree the job market could be totally different a decade from now, but I think the sentiment that it is bound to turn around rests on hope more than anything else.

 

[DrBowtie]

It'd be ok if it was 1, 2, or even 3 anecdotal stories. But after reading AM and SDN, this is a pervading sentiment among a lot of ppl. I agree the job market could be totally different a decade from now, but I think the sentiment that it is bound to turn around rests on hope more than anything else.

At my institution alone, we are quite bimodal. We have about half out faculty <10 years out of residency and the other half of our faculty is >30 years of practice. Many just banking a little bit more to tank up their retirement.

 

[badasshairday]

Then don't go into Rads people. More spots for me. Thanks.

Expect to make 50% of what rads currently makes today, would you still be happy? If not, do something else, but to be honest 5-10 years from now you will be hard pressed to find any doctors making over 250-300 in any specialty. Do what you want to do and don't think about the cash. Also don't listen to these goobers who are jealous of rads. Listen to yourself and what you like.

 

[bronx43]

At my institution alone, we are quite bimodal. We have about half out faculty <10 years out of residency and the other half of our faculty is >30 years of practice. Many just banking a little bit more to tank up their retirement.

Oh yeah, I forgot. Radiology was officially discredited as a specialty from the 1980s to the early 2000s, therefore the job market as a whole is obviously bi-modal.
No, but seriously, the job market is only as cyclic as what external forces are acting on the market over time. In the status quo, natural business cycles aren't reflected in physician job markets, therefore, the idea that physician jobs are cyclic by nature is dubious.

 

[PokerDoc]

Then don't go into Rads people. More spots for me. Thanks.

Expect to make 50% of what rads currently makes today, would you still be happy? If not, do something else, but to be honest 5-10 years from now you will be hard pressed to find any doctors making over 250-300 in any specialty. Do what you want to do and don't think about the cash. Also don't listen to these goobers who are jealous of rads. Listen to yourself and what you like.

Amen

 

[DrBowtie]

Oh yeah, I forgot. Radiology was officially discredited as a specialty from the 1980s to the early 2000s, therefore the job market as a whole is obviously bi-modal.

O RLY? I think they're calling your name over in the IM forum.

 

[bronx43]

O RLY? I think they're calling your name over in the IM forum.

Uh... ok. They probably are, but what's your point?

 

[DrBowtie]

Uh... ok. They probably are, but what's your point?

We get it. You're bearish on Radiology, bearish on the economy, and bearish on America. You've been repeating the same stuff over the past few months, and we get it. There is no longer any useful dialogue to be had.

Everyone knows that Radiology isn't the land of unicorn and fairies where everyone gets a job paying 800k for working 40 hrs a week.

 

[bronx43]

We get it. You're bearish on Radiology, bearish on the economy, and bearish on America. You've been repeating the same stuff over the past few months, and we get it. There is no longer any useful dialogue to be had.

Everyone knows that Radiology isn't the land of unicorn and fairies where everyone gets a job paying 800k for working 40 hrs a week.

Heh, don't act like all these forums aren't just a big clusterfu** carousel. When's the last time ANYone here offered any new insight? The same questions will be asked year in and year out, and the same responses will be given year in and year out. We're all just static furniture of this digitized simulacrum.

If you don't like what I have to say, that's one thing. But, don't put the repetitive nature of internet forums on me. With the influx of new posters asking the same questions, my presence ensures the insertion of a certain perspective that no one else here is going to offer.

 

[jahbrony]

If you don't like what I have to say, that's one thing. But, don't put the repetitive nature of internet forums on me. With the influx of new posters asking the same questions, my presence ensures the insertion of a certain perspective that no one else here is going to offer.

Not a day goes by where I don't thank my lucky stars for having stumbled upon your enlightening posts, here within these radiology forums. Your insight into the field is no doubt unrivaled, and the sage advice you give inspires me to be a better person. Without you, I would feel lost in this disenchanted world.

I think I speak for everyone, when I say, thank you for the insurance of your keen insight into radiology. We're all better people for having read just one or two of your posts.

 

[colbgw02]

Not a day goes by where I don't thank my lucky stars for having stumbled upon your enlightening posts, here within these radiology forums. Your insight into the field is no doubt unrivaled, and the sage advice you give inspires me to be a better person. Without you, I would feel lost in this disenchanted world.

I think I speak for everyone, when I say, thank you for the insurance of your keen insight into radiology. We're all better people for having read just one or two of your posts.

 

[bronx43]

Not a day goes by where I don't thank my lucky stars for having stumbled upon your enlightening posts, here within these radiology forums. Your insight into the field is no doubt unrivaled, and the sage advice you give inspires me to be a better person. Without you, I would feel lost in this disenchanted world.

I think I speak for everyone, when I say, thank you for the insurance of your keen insight into radiology. We're all better people for having read just one or two of your posts.

Lol, that came out wrong. The point was that contrarian arguments provide different perspectives that aren't always present within a specialized group. Perhaps "my posts offer a different perspective that isn't always present in these forums."

 

[cowme]

Lol, that came out wrong. The point was that contrarian arguments provide different perspectives that aren't always present within a specialized group. Perhaps "my posts offer a different perspective that isn't always present in these forums."

Nope, we've had trolls on here before. As someone who has basically zero experience with the field, your "perspective" is virtually worthless.

 

[OHMAN0125]

Nope, we've had trolls on here before. As someone who has basically zero experience with the field, your "perspective" is virtually worthless.

I believe I've seen his doom and gloom posts regarding other specialties as well (rad onc and cards?). Anyways I personally think his posts are ok although I find them a bit jaded. They're his perspective and in reality med students, residents, etc should pay attention to the changing aspects of radiology and healthcare. If you realize what's going on you have a chance to adapt or choose certain paths which are "better".

 

[PokerDoc]

I believe I've seen his doom and gloom posts regarding other specialties as well (rad onc and cards?). Anyways I personally think his posts are ok although I find them a bit jaded. They're his perspective and in reality med students, residents, etc should pay attention to the changing aspects of radiology and healthcare. If you realize what's going on you have a chance to adapt or choose certain paths which are "better".

I agree, I just think many of us are growing tired of negativity without substance greater than anecdotal stories. None of us have rose colored glasses on, and were all here because we love radiology, not because we love money. A decline in salary (which let's be honest, is too much right now) does nothing to sway the majority of us. Every single resident in my home program (10 total) found a great job in a desirable location. those who are scared should do something else. It's really quite simple IMHO.

 

[bronx43]

Nope, we've had trolls on here before. As someone who has basically zero experience with the field, your "perspective" is virtually worthless.

Sorry, but total red herring. I've addressed this before numerous times. Your statement is analogous to a real estate developer's response to economic critiques of the unsustainability of the property boom prior to the crash (and I've read plenty of those.) Having empiric experience in the actual industry at question doesn't offer you any more perspective with respect to its economic/financial situation within a larger, more complex system. The arguments I make have nothing to do with how radiology is actually practiced, therefore, said experience is a moot point.
If you wish, respond to the actual points made. Otherwise, these ad hominems are just laughable.

 

[bronx43]

I agree, I just think many of us are growing tired of negativity without substance greater than anecdotal stories. None of us have rose colored glasses on, and were all here because we love radiology, not because we love money. A decline in salary (which let's be honest, is too much right now) does nothing to sway the majority of us. Every single resident in my home program (10 total) found a great job in a desirable location. those who are scared should do something else. It's really quite simple IMHO.

Not sure if you're referring to me, but I don't use anecdotes in my arguments - not that anecdotes aren't sometimes useful in certain discussions.

 

[cowme]

I believe I've seen his doom and gloom posts regarding other specialties as well (rad onc and cards?). Anyways I personally think his posts are ok although I find them a bit jaded. They're his perspective and in reality med students, residents, etc should pay attention to the changing aspects of radiology and healthcare. If you realize what's going on you have a chance to adapt or choose certain paths which are "better".

All of us are aware of these changes. That doesn't make posters like bronx any less annoying on this site. I use this site to find current/future radiology news and to check in on this years group of applicants to see if I can lend any advice. I don't come on for weekly salary and job market updates.

I don't know how many of you are big sports fans, but I love to go on my favorite teams blogs/websites and talk about the latest issues. And it is annoying as hell when an opposing team's fan comes to talk smack for no better reason than to preach that they think your team sucks... Yes, I know my team has flaws, but I don't care if some third party thinks that my team isn't gonna make the playoffs. This is why posters like Bronx are annoying as hell. They contribute nothing relevant, and for some unknown reason seem to just want to get a rise out of future applicants.

Oh, well, I guess that's what the ignore function is for.

 

[bronx43]

I believe I've seen his doom and gloom posts regarding other specialties as well (rad onc and cards?). Anyways I personally think his posts are ok although I find them a bit jaded. They're his perspective and in reality med students, residents, etc should pay attention to the changing aspects of radiology and healthcare. If you realize what's going on you have a chance to adapt or choose certain paths which are "better".

This is exactly right. 👍

And if you think I'm gloom and doom, you should visit the anesthesia forum sometimes. And no, I'm not talking about theads about the CRNA debacle. Some of those guys know their finance and economics (not sure if it's an anesthesia thing or just a handful of people who just happen to be anesthesia), and they realize that there's no other endgame in sight.

 

[bronx43]

All of us are aware of these changes. That doesn't make posters like bronx any less annoying on this site. I use this site to find current/future radiology news and to check in on this years group of applicants to see if I can lend any advice. I don't come on for weekly salary and job market updates.

I don't know how many of you are big sports fans, but I love to go on my favorite teams blogs/websites and talk about the latest issues. And it is annoying as hell when an opposing team's fan comes to talk smack for no better reason than to preach that they think your team sucks... Yes, I know my team has flaws, but I don't care if some third party thinks that my team isn't gonna make the playoffs. This is why posters like Bronx are annoying as hell. They contribute nothing relevant, and for some unknown reason seem to just want to get a rise out of future applicants.

Oh, well, I guess that's what the ignore function is for.

Nothing relevant? Jesus christ, man. Are you frickin' serious? I can't think of anything MORE relevant than the future of your career. If you wanna just sit there with your eyes closed and ears plugged, then be my guest. If I were a radiology resident, I would be researching everything I can about how healthcare and radiology is going to fit into a debt-laden nation with sluggish manufacturing and a debased currency. Then, I would do everything I can to protect my assets and expand my skillset to hedge against these risks.
Just sitting there and hoping for the best doesn't do jack sh**, dude.

 

[DrBowtie]

This is exactly right. 👍

And if you think I'm gloom and doom, you should visit the anesthesia forum sometimes. And no, I'm not talking about theads about the CRNA debacle. Some of those guys know their finance and economics (not sure if it's an anesthesia thing or just a handful of people who just happen to be anesthesia), and they realize that there's no other endgame in sight.

So here is your shot....
What fields would be better to go into? Use your oracle ball. I have plenty more money to blow on eras.

 

[bronx43]

So here is your shot....
What fields would be better to go into? Use your oracle ball. I have plenty more money to blow on eras.

As I've said numerous times, in contractionary markets and economies, everything trends downmarket in favor of reducing costs while preserving as much function and efficiency as possible. What this means for the medical industry is that that those offering expensive care with relatively low cost-effectiveness will get hit first and hardest. Therefore, I think certain super-specialized fields will feel the most pain, especially those fields offering this kind of care to Medicare beneficiaries. Elective surgeries will be reduced in favor of cheaper non-surgical alternatives, regardless of the efficacy of said alternatives.
Another point to keep in mind is that being a patient facing specialty inherently offers more security than those that don't. Here is where radiology comes into play. As I've said before, nothing is going to happen to the field itself. It's just that the market for imaging will be reduced in an effort to cut costs. And in the trend of the expansion of corporate medicine, decreased revenue will be directly displaced to the radiologist, given the glut of practitioners created by the previously larger market. When that happens, expect few jobs, and those that have jobs will have much less pay. Anesthesia faces a similar problem (on top of their self-created CRNA disaster) with the increasingly corporate structure of the health care system, as they overproduced as well, and aren't a patient-facing specialty.

So, bottom line is that patient-facing specialties providing the most care (and more acute care) for the least amount of money will be the sturdiest in the coming decades. Within the medicine realm, I'm going with general internal medicine, who are the essential workhorses of the hospital. Medical subspecialties will likely get see their market share decrease a little bit, with certain subspecialties faring a bit better than others. Within the surgical fields, I see more security for general/trauma/vascular surgeons than orthopedic surgeons or plastic surgeons, due to the issue of acuity.

But, if you LOVE radiology, then I would probably advise that you try to get into interventional radiology, which can be seen as a downmarket alternative to pricey surgery. Or, if I was a radiologist, I would go back and get my MBA and try to get into administration. This is obviously not a plan of scale, as these positions are heavily limited, but as of now, there still seems to be a need for physician administrators. (who knows how hot that job will be in 5-10 years) And if you have any monetary assets, I would invest it well. Screw the big house or the BMW - I would put it in precious metals, farmland, or stocks with good fundamentals (mining stocks or foreign manufacturing companies). I personally don't like the equities market in the long term, but there is still money to be made in the interim, which can be siphoned into safer investments.

 

[cowme]

Nothing relevant? Jesus christ, man. Are you frickin' serious? I can't think of anything MORE relevant than the future of your career. If you wanna just sit there with your eyes closed and ears plugged, then be my guest. If I were a radiology resident, I would be researching everything I can about how healthcare and radiology is going to fit into a debt-laden nation with sluggish manufacturing and a debased currency. Then, I would do everything I can to protect my assets and expand my skillset to hedge against these risks.
Just sitting there and hoping for the best doesn't do jack sh**, dude.

I matched in radiology already, despite your altruistic warnings. I don't care about a decrease in reimbursements. Hopefully, there will be a job waiting for me in 6 years, we will see. But I'm not gonna switch fields or go get an MBA because some chicken little who has a couple years of business experience thinks it's in my best interests. Like I said before, everything in your lengthy post isn't evidence of where the future is headed; it's just pure speculation (other than salary, I agree with you there). But I don't think you are any expert in predicting the future considering you wasted 4 years in med school only to end up doing something other than medicine altogether.

 

[bronx43]

I matched in radiology already, despite your altruistic warnings. I don't care about a decrease in reimbursements. Hopefully, there will be a job waiting for me in 6 years, we will see. But I'm not gonna switch fields or go get an MBA because some chicken little who has a couple years of business experience thinks it's in my best interests. Like I said before, everything in your lengthy post isn't evidence of where the future is headed; it's just pure speculation (other than salary, I agree with you there). But I don't think you are any expert in predicting the future considering you wasted 4 years in med school only to end up doing something other than medicine altogether.

That's fair, but I don't understand what "evidence" you need for the future. That phrase "evidence of where the future is headed" is intrinsically oxymoronic, as evidence is the data of past occurrences. Any statement regarding the future is speculative by nature, despite how robust the logical inferences are. But, I have yet to see a single rebuttal from you or anyone else here that isn't entirely irrelevant.

 

[Radonkulous]

Here is something to think about: http://www.acr.org/HomePageCategori...ndations-on-the-Sustainable-Growth-Rate-.aspx

 

[PokerDoc]

I have yet to see a single rebuttal from you or anyone else here that isn't entirely irrelevant.

Because

Any statement regarding the future is speculative by nature.

Don't care to counter your speculation. It's your opinion, and you're entitled to it. That's about it.

 

[Radonkulous]

Interesting study I stumbled across: http://www.ncbi.nlm.nih.gov/pubmed/19703759

"From 1998 to 2005, IR's market share decreased six-fold (1998: 33% to 2005: 5.6%) whereas VS market share increased from 27% to 43% and IC from 10% to 29% (P < .05).:

 

[DrBowtie]

It's no secret IR is getting crushed in PAD.

And you (Bronx) laughed at the sustainability of the rads moonlighting, but working 26 weeks a year as a hospitalist at 250k, I think most would say that's being overpaid.

 

[colbgw02]

As I've said numerous times, in contractionary markets and economies, everything trends downmarket in favor of reducing costs while preserving as much function and efficiency as possible. What this means for the medical industry is that that those offering expensive care with relatively low cost-effectiveness will get hit first and hardest. Therefore, I think certain super-specialized fields will feel the most pain, especially those fields offering this kind of care to Medicare beneficiaries. Elective surgeries will be reduced in favor of cheaper non-surgical alternatives, regardless of the efficacy of said alternatives.
Another point to keep in mind is that being a patient facing specialty inherently offers more security than those that don't. Here is where radiology comes into play. As I've said before, nothing is going to happen to the field itself. It's just that the market for imaging will be reduced in an effort to cut costs. And in the trend of the expansion of corporate medicine, decreased revenue will be directly displaced to the radiologist, given the glut of practitioners created by the previously larger market. When that happens, expect few jobs, and those that have jobs will have much less pay. Anesthesia faces a similar problem (on top of their self-created CRNA disaster) with the increasingly corporate structure of the health care system, as they overproduced as well, and aren't a patient-facing specialty.

I think this analysis makes sense from a business viewpoint, but I'm not sure it holds up from a medical standpoint. Please to explain...

I think you're undervaluing radiology's role in the day-to-day business of modern healthcare delivery in the U.S. It seems like your analysis assumes that the general, patient-facing specialties are capable of providing cheaper, more efficient care if only they wouldn't order so many imaging studies. They won't do that though, because they can't. To oversimplify it - they don't know how. You might as well try to tell a surgeon to start operating without anesthesia. We have entire generations of providers who have been trained to practice based upon the radiologist's input. And, as mid-levels expand the scope of their practice, there will be more and more providers with a greater reliance of imaging.

The second issue, which isn't really that unrelated, is one of standard of care. Let's assume, for a moment, that providers are willing to forego the stat head CT for every presentation of new-onset headache (unlikely, as explained above). What about the patients? The public has become accustomed to a very high standard of care in this country, and - for better or for worse - radiology is a pillar of that care. For one, medical imaging offers a substantial CYA component to providers, and two, pictures offer a psychological reassurance to which the patient can relate. I don't see how an appreciable decrease in imaging utilization can't also be accompanied by a sea change in medical litigation that fundamentally changes our country's concept of standard of care. It's possible, but it's a huge hurdle and a change that I think is unlikely.

Overall, my point is that there are more than just dollars and cents factors that affect radiology's viability.

And in case anyone is thinking, "well, the specialists will just read their own studies", I think that's been covered sufficiently elsewhere in the forum.

I'm not trying to purport that radiology won't undergo changes, I just don't think those changes will fundamentally alter the specialty's place in medicine. Salaries will go down, but not because there will be a huge change in how or with what frequency medical imaging is used. Salaries will go down because costs must come down, and imaging is an obvious place to start because of its scope and scale. But that sort of change has a floor. As opposed to what I think bronx is proposing, which would represent a basal change that would affect the overall utilization of medical imaging.

 

[T99]

Seems like you are not aware of future of radiology, Sir.

I think this analysis makes sense from a business viewpoint, but I'm not sure it holds up from a medical standpoint. Please to explain...

I think you're undervaluing radiology's role in the day-to-day business of modern healthcare delivery in the U.S. It seems like your analysis assumes that the general, patient-facing specialties are capable of providing cheaper, more efficient care if only they wouldn't order so many imaging studies. They won't do that though, because they can't. To oversimplify it - they don't know how. You might as well try to tell a surgeon to start operating without anesthesia. We have entire generations of providers who have been trained to practice based upon the radiologist's input. And, as mid-levels expand the scope of their practice, there will be more and more providers with a greater reliance of imaging.

The second issue, which isn't really that unrelated, is one of standard of care. Let's assume, for a moment, that providers are willing to forego the stat head CT for every presentation of new-onset headache (unlikely, as explained above). What about the patients? The public has become accustomed to a very high standard of care in this country, and - for better or for worse - radiology is a pillar of that care. For one, medical imaging offers a substantial CYA component to providers, and two, pictures offer a psychological reassurance to which the patient can relate. I don't see how an appreciable decrease in imaging utilization can't also be accompanied by a sea change in medical litigation that fundamentally changes our country's concept of standard of care. It's possible, but it's a huge hurdle and a change that I think is unlikely.

Overall, my point is that there are more than just dollars and cents factors that affect radiology's viability.

And in case anyone is thinking, "well, the specialists will just read their own studies", I think that's been covered sufficiently elsewhere in the forum.

I'm not trying to purport that radiology won't undergo changes, I just don't think those changes will fundamentally alter the specialty's place in medicine. Salaries will go down, but not because there will be a huge change in how or with what frequency medical imaging is used. Salaries will go down because costs must come down, and imaging is an obvious place to start because of its scope and scale. But that sort of change has a floor. As opposed to what I think bronx is proposing, which would represent a basal change that would affect the overall utilization of medical imaging.

 

[officedepot]

radiology as a field is expanding because technology is becoming better.

There is debate as to the extent of IR's role in health care and appears to be some variability when reading the forums and discussing with other physicians (some say rads is killing everyone whereas others will say vasc surg, cardiology, GI, etc are taking everything away). Hard to tell really. Probably depends on where you do your fellowship and what you make of it. My personal take is that rads as a whole select themselves out of certain procedures because it is not the kind of lifestyle they had in mind when they initially went into rads (see neuroIR and the increasing number of neurosurgeons going into the field though rads is still a definite route from what I can tell and depending on the fellowship location and what they require - i.e. rads are selecting themselves out of that field I think due to lifestyle whereas neurosurg are used to it). In the end I think IR is what you make of it. If you make yourself available you'll get plenty of procedures. If not you'll do picc lines, drains, vasc access, etc. Whatever floats your boat I guess (personally I didn't go to med school to do what a nurse could do - picc lines that is).

 

[Radonkulous]

radiology as a field is expanding because technology is becoming better.

There is debate as to the extent of IR's role in health care and appears to be some variability when reading the forums and discussing with other physicians (some say rads is killing everyone whereas others will say vasc surg, cardiology, GI, etc are taking everything away). Hard to tell really. Probably depends on where you do your fellowship and what you make of it. My personal take is that rads as a whole select themselves out of certain procedures because it is not the kind of lifestyle they had in mind when they initially went into rads (see neuroIR and the increasing number of neurosurgeons going into the field though rads is still a definite route from what I can tell and depending on the fellowship location and what they require - i.e. rads are selecting themselves out of that field I think due to lifestyle whereas neurosurg are used to it). In the end I think IR is what you make of it. If you make yourself available you'll get plenty of procedures. If not you'll do picc lines, drains, vasc access, etc. Whatever floats your boat I guess (personally I didn't go to med school to do what a nurse could do - picc lines that is).

Are Neurorads being pushed out of INR or do they still dominate? My feeling is there aren't enough neurosurgeons trained each year to push out rads trained INR docs. Maybe neurologists will steal some turf, but I think this is one fields the rads guys need to hold onto.

 

[OHMAN0125]

Are Neurorads being pushed out of INR or do they still dominate? My feeling is there aren't enough neurosurgeons trained each year to push out rads trained INR docs. Maybe neurologists will steal some turf, but I think this is one fields the rads guys need to hold onto.

The problem is there's not enough radiology residents that want to do it. If noone does it then the surgeons and neurologists will. The problem is most residents that want to do procedures will go into IR instead of NIR. This is already a small proportion so you can imagine the numbers that actually do NIR. Funny enough, I think IR (even with the loss of a lot of PAD) has so much diversity (biliary, renal, gastro, onc, etc) and better hours that most residents will always pursue that unless they have a keen interest in NIR.

 

[Radonkulous]

The problem is there's not enough radiology residents that want to do it. If noone does it then the surgeons and neurologists will. The problem is most residents that want to do procedures will go into IR instead of NIR. This is already a small proportion so you can imagine the numbers that actually do NIR. Funny enough, I think IR (even with the loss of a lot of PAD) has so much diversity (biliary, renal, gastro, onc, etc) and better hours that most residents will always pursue that unless they have a keen interest in NIR.

That's crazy given a lot of depts. are rads run or rads co-run. It'd be nice if they could incorporate some NIR into IR training as well. It seems like UCSF is completely rads run. Places like MIR have a several residents going into NIR. I can't imagine neurosurgeons are outpacing rads in fellowship placement given how few of them there are anyway. I can see the push for neurologists though.

 

[badasshairday]

I think the turf issue regarding PAD is overblown. Is it true that Vsurg and Cards have made huge inroads? Yes. But it was basically given away by the old school VIR docs that don't care to have clinic and have any pt care responsibilities. If you want PAD as a VIR, you can get it, as long as you take part in pt care. Obviously it is this would be hard if you aren't trained in PAD interventions, but as long as you know how to do it, the patient's are there.