The Radiologist of the Future

March 20, 2019

What will radiology look like in 2029? We asked the experts about the future skills and technologies you will need to succeed.

When you discussed radiology’s future 10 years ago, the conversation covered a wide gamut, ranging from teleradiology to reimbursement changes to avoiding commoditization. The industry faced these challenges head-on and has largely determined how to handle them.

Today, questions about radiology’s future and how you’ll practice center on different issues. Data. Decision-making. A more personalized touch to care. In the coming years, knowing how it all will impact your practice-and understanding how to adjust-will be paramount to staying competitive within the market, industry leaders say.

“I do think there is a great amount of change coming down the pipeline,” says Arun Krishnaraj, MD, a radiologist with the University of Virginia Health System. “Some of the changes are fundamentally different. They deal with emerging technologies and how patients view radiology care and access to radiologists.”

What will change?

While radiology will fundamentally remain the same, the tools and strategies you employ to provide the highest level of patient care will change.

“In the coming decade, it’s going to be the soft skills of radiologists that will make us valued individuals in healthcare,” Krishnaraj says. “It will be our ability to integrate and navigate the vast troves of data in a variety of silos to be at the nexus of healthcare that will make us the drivers of healthcare decision-making.”

Population health

Although it hasn’t historically been your role or focus, implementing more screening programs and clinical decision support (CDS) will put you in the position to positively impact population health, he says.

Instead of only generating more images, you’ll have more opportunities, through CDS, to influence and control what tests patients receive. By doing so, you’ll expand your role in fulfilling the tenet of ensuring the right patient receives the right test at the right time.

Radiology report

The next decade will see a sustained push toward more structured reporting, says Mark Mamlouk, MD, adjunct assistant clinical professor of neuroradiology at the University of California, San Francisco.

“In the coming years, we’ll see more radiologists working to embrace structured reporting over traditional prose reporting,” he says. “We’ll specifically see structured reporting in the context of disease diagnosis, and standardizing the lexicon radiologists use will become more mainstream.”

Related article: For Radiology’s Future, Look to its Past

For instance, right now, he says, reporting a image as “consistent with tumor” or “suggestive of tumor” can mean different things. Standardizing language will increase confidence across-the-board in what radiology reports actually say.

Additionally, he says, existing efforts to make reports more multimedia-rich will expand. If you don’t already, within the coming years, you’ll be able to embed links in your reports that will take referring physicians directly to images that highlights your findings.

Patient-centered care

The industry will make greater strides over the next decade to play a more integrated patient-care role, says Jonathan Flug, MD, a musculoskeletal radiologist at the Mayo Clinic in Phoenix.  

“Radiology has really embraced patient-centered care and has been moving the needle in that direction,” he says. “A couple of years ago, everybody thought they didn’t have time to talk to every patient. But, I think people have found ways to really start thinking more about patients and their whole disease process rather than just image interpretation.”

For example, greater implementation of PI-RADS and LI-RADS-categorization systems for prostate and liver findings-will enhance the information you communicate to referring physicians and patients about your findings. Using these types of systems will augment the accuracy and level of detail in your reports.

Radiogenomics

One of the biggest advancements over the next decade, Mamlouk says, will be in radiogenomics: systems that allow you to analyze the correlation between cancer imaging features and gene expression.

“This will be another way for radiologists to discern if a tumor is this gene expression or that gene expression,” he says. “This will become more advanced over the next 10 years, giving radiologists more metrics for making diagnoses.”

Using radiogenomics could also help your practice or department identify recurrence rates for different types of cancer, contributing to how patients compare one hospital to another when deciding where to pursue treatment.

How can you prepare?

Succeeding in the future will require some investment on your part into understanding new technologies, as well as developing new skills.

Artificial intelligence

The advent of these computer-driven analytic tools is already proving to be valuable to providing faster, more accurate patient care. But, to use them best, you’ll need detailed training, Mamlouk says. And, it’s imperative to build instruction into radiology education.

“We need to start from the basics on different forms of artificial intelligence and the different forms of machine learning,” he says. “We all need to be educated on this, including our radiology trainees.”

Related article: How AI is Evolving in Diagnostic Imaging

Proper use of AI tools has already shown it can help you read through and triage the majority of images you collect, Krishnaraj adds. Various algorithms, such as ones that identify intracranial bleeds, already exist. And, as you gain more AI proficiency - and as the technology advances - you’ll gain more confidence in concentrating more of your efforts on the most complicated and rare findings.

Self-examination

With more patient interaction in radiology’s future, Flug says, you must step back and objectively examine your strengths and weaknesses as a provider and open yourself up to colleague feedback.

“To stay competitive, the first thing we must do is acknowledge what we know and what we don’t know,” he says. “We need better feedback from our co-workers in training and in practice to really examine our diagnostic skills, leadership style, and communication abilities.”

Discuss with each other where and how you can improve to bolster your team, he says, and pave the way for a successful future.

Adaptability

Yesterday’s job isn’t today’s job, and today’s job won’t be tomorrow’s, Krishnaraj says.

“I can’t stress enough that the biggest skill you can have moving forward in radiology is adaptability,” he says. “Our jobs of the future are not yet defined, and if you are an individual who doesn’t like change or doesn’t adapt easily, you are going to suffer and possibly lose your biggest potential to add value.”

Instead of being the radiologist who reads the most images and has the shortest turnaround time, he says, work on your direct communication with patients, hone your consulting skills with your referring physicians, and forge collaborations with pathologists, geneticists, and other specialties. And, at any turn, he says, be willing to embrace any new skills as they appear.

Ultimately, he says, radiology’s future depends less on the tangible tools that will change how you collect and analyze images or strategies that will streamline your daily activities. Instead, it will rely on how you grow and position yourself to interact more closely with other physicians and your patients.

“Radiology’s future starts with ensuring the next generation of our residents and fellows are being trained with these soft skills and a broader outlook on how radiology can impact care,” he says. “Being a more valuable member of a healthcare team goes beyond being able to look things up on the internet or master an algorithm. Our future is in defining ourselves as physicians who understand that we’re here to care for patients directly.”