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Beam Me Up, Scotty


If this is the new normal, maybe future radiologists won’t feel the stress of declining reimbursement and oppressive liability. They won’t know any different.

Many people thought my dad was a pessimistic worrywart. Apparently, I inherited more than just my father’s initials, as many feel the same about me. The family joke is that the “D. G.” in our initials stands for “doom and gloom.”(I prefer to characterize it as realistic observation and life experience.) I have also been described as a “Cassandra,” a mythological mortal with the curse of seeing the future but never being believed. Only time will tell.

Many of my musings on the current state and future of radiology aren’t particularly rosy although they reflect reality as I see it. I don’t see how anyone could question that we are entering a critical period in medicine in general and radiology in particular. There is no doubt radiologists will continue to play a large role in the practice of medicine but how that role will be valued is unclear.

A few years ago I attended a state American College of Radiology chapter meeting and the majority of speakers painted a bleak picture for the future of radiology, especially in terms of reimbursement and liability. There were a number of residents there and they really got an ear full.

I decided to attend the resident meeting at the end of the business meeting to see the unknown case presentations. The moderating faculty member started the session by acknowledging the pessimistic mood of the meeting and stating that he was concerned for everyone about to embark on a career in our specialty. His concern was that they would all find jobs. He then made the very reasonable observation that since whatever they were going to be paid would be more money than they had ever earned before, the fact that it might be substantially less than the peak earning years of my generation wouldn’t mean anything to them.

Change is the only constant and we always get through it, as unpleasant or uncomfortable as it may be. Nowadays we frequently hear the term “the new normal.” Once we get a few years or generations past the period of upheaval, the new normal becomes the only reality for those living it. So it is highly likely that the stress of declining reimbursement, increasing liability, and oppressive regulation will mostly be felt by people like me who have known a different environment.

Truthfully, I am an optimist, if not about the immediate future of radiology, then the future of our country and humanity. After all, my favorite show is Star Trek. This show is all about continued innovation, progress, and improvement for the whole human race. This is the story of the human race. Yes, there have been some stumbles (the Dark Ages, the Black Death, World Wars I and II, Obamacare) but we have always recovered and gone on to bigger and better things. One of my favorite teachers, Nick Murray, says, “Optimism is the only realism.” I know he is right.

I don’t know the path that gets us there but, in my heart, I know that Dr. Leonard “Bones” McCoy of the starship Enterprise a few hundred years in the future is a fellow radiologist. Live long and prosper!

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