Editorial: Will the internet put too many radiologists out of work?

August 23, 2000

Will the Internet put too many radiologists out of work?By Kathy Kincade, EditorIn real estate, the motto is “location, location, location.” These days, in medicine, it’s “productivity,

Will the Internet put too many radiologists out of work?By Kathy Kincade, Editor

In real estate, the motto is “location, location, location.” These days, in medicine, it’s “productivity, productivity, productivity.” This has proven to be good news for the slew of hardware and software developers that recognize an opportunity when they see it. The increasing use of the Internet and Web-based image management tools is enabling ever-broader and faster enterprise-wide distribution of images and associated reports. These moves have in turn helped vendors increase revenues, healthcare delivery systems reduce costs, and patients receive better care.

But what about the radiologists—you know, the folks all this technology is supposed to benefit? According to one radiology management firm, Internet technology and resources already available in the U.S. could considerably decrease inappropriate use of imaging and x-ray exams, resulting in a 30% reduction in radiology costs. With U.S. radiology expenditures estimated at over $65 billion annually and currently growing at a rate of 15% per year, such savings would indeed be significant.

A growing number of hospitals and imaging centers appear to be taking such sentiments to heart. A recent study by Technology Marketing Group (TMG) found that while only 7% of 1800 hospitals and imaging centers surveyed currently use the Internet to distribute images, 24% plan to do so in the next three years. Motivating factors include the ability to provide round-the-clock coverage and to better utilize subspecialists on a regional basis.

But despite their acceptance of the Internet for home-based interpretations, many radiologists see it as a double-edged sword that may well improve productivity but also take money out of their pockets. In addition to competition from centralized reading centers offering 24/7 coverage and prompt, subspecialist interpretation via the Internet, some radiologists worry that nonradiologists will be able to do more of their own interpretrations. An article in the July issue of Diagnostic Imaging calculates that the Internet could, in fact, cost the 25,000 U.S. radiologists more than $7 billion annually in professional fees.

But some radiologists argue that the Internet actually has the potential to maintain and even increase their revenues, primarily through increasing volumes and decreasing film and processing costs. In fact, they see the Internet as an imaging entrepreneur’s dream, especially for newcomers who can now consider building a practice without investing millions of dollars in capital equipment. In addition, the Internet is enabling greater numbers of nonradiologists to integrate imaging into their practices, which only furthers the filmless cause. All of this bodes well for the PACS industry, which is already seeing improved year-over-year sales and anticipating annual market growth rates of 7% to 10% for the next five years.

“As procedure volume grows, services become dispersed across sites, and referral basins become more tightly linked to facilities, the need to efficiently exploit the capabilities of PACS appears to be irresistible,” writes Mitch Goldburgh in an upcoming PACS supplement in Diagnostic Imaging.

Some radiologists may not like it, but those who hesitate will be lost.

Comments/questions: kkincade@mfi.com