It’s a constant drumbeat: healthcare costs too much. There aren’t enough docs to meet demand. Yet, the powers that be want to be able to say that they got low-cost access for everybody. You might have heard of the “Iron Triangle” of healthcare: There can be low cost, widespread (if not universal) access, and/or high quality…pick any two, but the third will suffer in making it happen.
I don’t know how prevalent it yet is for noctors to read imaging studies. I do know that non-radiologist docs have been doing it forever, whether they bill for it. They might be wonderful at interpreting the stuff they know about…but, how about the incidental stuff on the images near their areas of interest? Is the surgeon going to notice and/or properly interpret the small renal-cell carcinoma that their lumbar MR happened to show or the lung lesion at the edge of the field-of-view for their shoulder X-ray?
I’ve also seen more than a few “How could he have missed that?!?!” cases from other radiologists over the years. Of course, nobody’s perfect, myself included. But, before we rads start throwing stones, we should probably remember that our own houses have some decent-sized windows in them.
The matter of supply/demand is a worthwhile consideration, too—just how many rads really want to have exclusive reading rights for X-rays? Unless you’re one of those increasingly rare old school guys who can look at a chest X-ray and predict that the patient has mitral-valve prolapse, you probably regard them as ever-more-voluminous busywork. And, perhaps at earning $5 a pop for them (while retaining your sky’s-the-limit med-mal liability for each one), maybe you’d really rather someone else took care of them while you focused on higher-RVU stuff.
One of my concerns with noctors officially taking over X-ray reads is that, not uncommonly, these imaging studies are being ordered by other noctors. At least, when a radiologist is on the receiving end, there’s a physician in the equation. Otherwise, the risk of “the blind leading the blind” looms larger.
And, since part of how we came to this pass was on the basis of cost and utilization: how many more of those X-rays are going to morph into advanced imaging when a noctor honestly states, “Gosh, I don’t know what that is,” or “I’m not sure I can rule that out?” Whereas, perhaps, a radiologist seeing the same image might have confidently reported a benign lesion needing no further action, or simply “Normal study.”