Future Of Radiology

[hypersomniac]

Hey, 

Can you guys please elaborate a bit on the future of radiology? 

how is it going to be in terms of tele-radiology? how would it impact the lifestyle and the pay? 

 

I have also been hearing about the fact that Rads salary has been decreasing over the past while and its going to continue decrease. 

Most of the threads regarding this subject are a couple years old. Can anyone elaborate further on this please? how are radiologists currently paid? is it an hourly salary or are they paid per scan? 

 

cheers guys! 

[schmitty]

Vast majority of rads are still fee for service and are paid very well for their work - even with the fee cuts. Fact is, radiologist pay has been so good over the past decade or so relative to other specialties because of increasing efficiency due to technology. Though it always hurts to have pay cuts, it makes some sense that fees should be adjusted periodically if the effort to do certain work decreases over time due to whatever factors. An extreme example of this is cataract surgeries that used to take several hours now take around 15 minutes. This is why ophthalmologists who do these surgeries fill most of the highest paid doctor spots, but recently they have seen some cuts that reflect this change in practice. 

 

As for teleradiology, i don't see it happening anytime soon in Canada. It gets very complex with licencing and liability (how to go after a doc abroad for malpractice?). Also, radiologists are pretty essential components of most hospitals, which frequent direct consultation with other physicians and allied health within these centres, and this is happening more and more. Not to mention the procedures and tests that often need a radiologist to have direct patient contact (e.g. biopsies, U/S, fluoro, LPs, etc, etc). 

 

Lifestyle is not as good as it used to be simply because of increased demand and increased expectations of coverage. E.G. It is no longer acceptable at most places to not have overnight and weekend rads coverage, so call is a reality, the frequency of which depends onthe size of your call group and also your specialty. It's still a lot better than surgical specialties but probably not as good as other so called lifestyle specialties like derm, path, even fam med depending. 

[Lactic Folly]

increasing efficiency due to technology.

if the effort to do certain work decreases over time due to whatever factors. 

 

Hi - not disagreeing with most of what you have said - however, I wonder if you have any particular examples of where technology has reduced the effort of a radiologist's work (although it may have improved efficiency of patient care overall).

 

(You may have read a widely-disseminated article which espouses this view; however, it is unfortunately not based in an understanding of what the work actually entails, and I would like to avoid propagating its thesis unless there are specific examples to support it.)

 

Two examples to the contrary, compared to what I saw over a decade ago:

 

1) Then: Routine MRI brain - all the images for the study were printed out on two films. Just two films, hung on the viewbox for reporting. 

Now: MRI brain consists of hundreds, even over a thousand images to scroll through on PACS.

 

Definitely better detail and characterization, but how much longer will it take to scour all of the 1000+ images for abnormalities and interpret them? 

 

2) Then: Dictations were all typed by human transcriptionists.

Now: Most hospitals have switched to speech recognition software. This is definitely better for turnaround times (and is why I support it), since the report is available immediately after signoff.

 

However, who now spends time correcting all the inevitable mistyped numbers, dropped "no's", and other errors? One could think that macros help, but they can be used with human transcriptionists too, so in the end radiologists are still spending more time editing their dictations to facilitate promptly signed reports. 

[schmitty]

Hi - not disagreeing with most of what you have said - however, I wonder if you have any particular examples of where technology has reduced the effort of a radiologist's work (although it may have improved efficiency of patient care overall).

 

(You may have read a widely-disseminated article which espouses this view; however, it is unfortunately not based in an understanding of what the work actually entails, and I would like to avoid propagating its thesis unless there are specific examples to support it.)

 

Two examples to the contrary, compared to what I saw over a decade ago:

 

1) Then: Routine MRI brain - all the images for the study were printed out on two films. Just two films, hung on the viewbox for reporting. 

Now: MRI brain consists of hundreds, even over a thousand images to scroll through on PACS.

 

Definitely better detail and characterization, but how much longer will it take to scour all of the 1000+ images for abnormalities and interpret them? 

 

2) Then: Dictations were all typed by human transcriptionists.

Now: Most hospitals have switched to speech recognition software. This is definitely better for turnaround times (and is why I support it), since the report is available immediately after signoff.

 

However, who now spends time correcting all the inevitable mistyped numbers, dropped "no's", and other errors? One could think that macros help, but they can be used with human transcriptionists too, so in the end radiologists are still spending more time editing their dictations to facilitate promptly signed reports. 

 

YOu're right, I should not have said "less effort." I meant more efficient. Meaning that radiologists now complete far more studies in a given time than they used to, likely due to technological improvements. This is mostly to thank for the increased pay of radiologists in the past 10-20 years (far outweighing most other physicians in Canada). 

 

As for transcriptionists...many facilities still use transcriptionist services to correct reports. The large institution I am at now uses such a service, for example. Even still, correcting the odd error on reports is far outweighed by the other technological improvements. 

[schmitty]

ANd that is a good point about the MRIs - they are getting more and more complex without a commensurate increase in remuneration, but so far this has not outweighed the increased efficiency, as evidenced by the huge increase in radiologist pay over the past decade or two due to increased efficiency and thus increased productivity. 

 

Edit: http://pubs.rsna.org/doi/full/10.1148/radiol.2522081895 <--a (somewhat old) study measuring productivity of radiologists which, not surprisingly, increased greatly as technology advanced, even as MRI load tripled and CT load doubled as a share of the total studies. There is no doubt technology has increased the complexity of the studies radiologists must read, but pay rates have matched and exceeded this increased complexity due to greater productivity. 

[Lactic Folly]

Appreciate the response. Still unclear how technological improvements have increased reporting efficiency in the last decade. A human being still has to look, think, and produce coherent prose, which takes up most of the time during the reporting process (note I did not say when working, because there are also all the consultations and procedures as you said).

 

Alternate explanation where "technological improvements" lead to increased productivity - if this refers to the advent of better imaging technologies that impact patient care, with a sharp increase in demand, availability, and usage over the past decades.

The productivity of radiologists is driven by demand from referring physicians and patients. The volume of requests for imaging studies keeps scanners operating around the clock. The increased number of studies still needs to be reported in a timely fashion by the available workforce.

This leads to working longer hours, and concentrating more to work at a faster pace (as fast as can be safely managed). So from this standpoint, yes, in a fee-for-service environment, working more hours and reading more studies per week will increase remuneration. 

[hypersomniac]

Thanks for the replies guys! 

I have been hearing very contradictory info about the average income of a full time radiologist who is primarily working at the hospital. Some claim that the average is 600K with no overhead which sounds so out of range to me. On the other hand, CMA profile claims to be somewhere around 300K. Can you guys elaborate what the average income is please?  

tnx

[#YOLO]

Thanks for the replies guys! 

I have been hearing very contradictory info about the average income of a full time radiologist who is primarily working at the hospital. Some claim that the average is 600K with no overhead which sounds so out of range to me. On the other hand, CMA profile claims to be somewhere around 300K. Can you guys elaborate what the average income is please?  

tnx

400s range...not a buyers market atm. 

[schmitty]

400s range...not a buyers market atm. 

 

Really? Gonna complain about grossing in the 400s? Have a little perspective. 

[#YOLO]

Really? Gonna complain about grossing in the 400s? Have a little perspective. 

not complaining bud...its just not what it used to be in terms of salaries. also jobs are hard to come by in rads now. 1-2 fellowships for community jobs...again not a buyers market. take what u can get. 

[medicallyinclined]

400s range...not a buyers market atm. 

 

Where are you getting this figure from?