A panel of nine radiologists discussed this topic and more during a roundtable discussion on the future of the radiology job market. The discussion was hosted by Dr. Howard Forman from Yale University and Dr. Marcia Javitt from the Uniformed Services University of the Health Sciences (AJR, July 2012, Vol. 199:1, pp. 127-132).
The market is currently in a supply-and-demand crunch, caused in part by the economic downturn of 2008, which may have reduced retirement fund value for senior radiologists and caused them to continue working longer, said Dr. Alexander Norbash of Boston University Medical Center. And groups have been faced with the challenge of balancing multiple payment reductions and trying to maintain income while also increasing the work performance of individual radiologists.
But is this trend something that should be extrapolated into the future? Not necessarily, according to Norbash.
"Personally, I am optimistic about radiology," he said. "The challenge we're facing is [not necessarily the amount of jobs available, but] our inability to fundamentally and eloquently verbalize the added value we bring to every single interaction. ... We have to be more specific in terms of demonstrating how beneficial we are to healthcare delivery systems, to referring physicians, and, most importantly, to our society's health."
Radiology is often characterized by wide swings between perceived oversupply and undersupply of radiologists, but the issue of declining reimbursements is real, according to Dr. Norman Beauchamp Jr. of the University of Washington. Yet the future also holds an increasing shift toward preventative care, to which radiologists can make a major contribution.
"If we look at the demographics, by 2030, it's estimated that 40% of the population will have some type of cardiovascular disease, 8 million more people will have coronary heart disease, and 4 million more will have strokes. Radiology will play a big role in the management of those diseases," Beauchamp said. "Reimbursement per study will probably go down, but I think in some ways that's a good thing. Specifically, the value of imaging is clearly there, but we do have to make it more affordable if we are to continue to be asked to contribute to patient care."
Increased efficiency is contributing to the downturn in the radiology job market, but there are also decreased expectations of radiologists and a lack of communication of radiologists' expertise to doctors in training, said Dr. Alan Kaye of Bridgeport Hospital in Westport, CT.
"Far fewer referring physicians come to look at images and review cases with us," he said. "Sometimes I have to threaten the surgical residents or the attendings that I will not render an interpretation of a CT study until we review the patient's clinical information and imaging findings together."
"If we shut the door so we can read a longer work list, we're not teaching our residents well," he continued. "This is becoming the culture of radiology -- to melt the stack and not do the consultations. This takes a lot less time to read the images, but it decreases job satisfaction and demand for new radiologists."
Radiologists also need to consider how other specialties will affect radiology and its future, according to Dr. Ellen Mendelson from Northwestern University.
"I think the answer is in creating a greater public face, both with other physicians and with our patients," Mendelson said. "I do think our future will be based on political activity and a certain amount of education."
Working on imaging safety and radiation dose reduction, having consistent imaging protocols across institutions, and delivering measurably high levels of care are ways for radiologists to demonstrate their worth in the healthcare enterprise, Norbash concluded.
"Evolution occurs when species are challenged," he said. "If we're challenged, this is a chance for us to improve. That's how we have to see the situation. That's how we have to see the circumstances. We have to take full advantage of these opportunities."
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