SPECIAL EDITION
X-Ray Vision
Individuals hold key to riding out radiology's challenges
The strength of practices, departments, and specialties depends on how well prepared their members are
By Jane Lowers, Supplements Editor
The phrase "the perfect storm" has appeared in Diagnostic Imaging on several occasions over the past few years as we have tracked the forces that batter radiology as a specialty. The confluence of growing procedure volume, a shortage of radiologists, and shrinking reimbursements has created the specialty's most challenging era. Those conditions have spun off miniature storms of eroding turf, early retirement, and foundering financial support for research.
All these factors make regular appearances in these pages, as we report on the efforts of specialty societies, academic departments, and private practices to counter or minimize their effects. Some interesting solutions have emerged, including informatics technology to increase productivity, partnerships with competing specialties to preserve control of certain procedures, and use of physician extenders to free up radiologists' time for interpretation.
One of the most important solutions, however, is the most fundamental: making sure that individual radiologists, from residents to senior partners, are well prepared to take on the future's challenges. A practice can negotiate better rates and specialty societies can lobby for reimbursement. Individual radiologists may start to look like commodities in the big picture, but each needs to be carefully developed and tended to keep the specialty strong.
Radiologists must also be negotiators and business innovators and champions of customer service. As Dr. Eric Trefelner writes on page 64, too many residents enter private practice unfamiliar with the contracts and legal perils that await them. Likewise, for the sake of the specialty, some young radiologists must also be taught to excel as researchers and as leaders. Slowly, and somewhat haphazardly, residency programs around the country are recognizing these needs and creating training opportunities designed to help residents help their specialty. Dr. James Thrall, on page 8, introduces a number of these programs and underscores their importance.
The idea of building a better radiologist doesn't end with residency, however. Yet another force, the American Board of Medical Specialties, is taking steps to make sure that every physician commits to a lifelong path of self-evaluation and self-improvement. It emphasizes not only clinical expertise but measured quality improvement and effective communication with patients and peers.
This special edition represents a departure from the typical emphasis in Diagnostic Imaging on clinical imaging and leading-edge research. Instead, we look at the most fundamental element of radiology: the radiologist. The forces that are shaping the specialty are also shaping the way new radiologists are educated, not only in clinical skill but also in leadership, research, customer service, and technology. Success at that level may determine how well the specialty weathers the storm.
