AuntMinnie.com is the key web site for current news and information about radiology. In a recent article containing various lists pertaining to the specialty (see: Minnies 2015 semifinal candidates), one was captioned as the Biggest Threat[s] to Radiology. Below is the list:
- Code bundling of radiology procedures
- Commoditization of radiology services
- Competition to local practices from teleradiology and national radiology groups
- Concerns about CT radiation dose
- Consolidation of healthcare systems
- Decline in Medicare and third-party reimbursement rates
- Declining job market for radiology professionals
- Declining number of medical students picking radiology in Match
- Increased use of medical imaging by physicians in other specialties (turf battles)
- Shift of radiology reimbursement away from fee-for-service mode
- Use of artificial intelligence to interpret medical images
- Utilization controls that could lead to lower procedure volume
This is a fascinating list and worth pondering. I think that it would be worthwhile if some influential publication in pathology were to publish a similar list for that speciality. Some of the points would probably be similar. Many of the threats in radiology are financial (e.g., Code bundling of radiology procedures; Decline in Medicare and third-party reimbursement rates; Shift of radiology reimbursement away from fee-for-service mode), some relate to the market and status for radiologists (e.g., Declining job market for radiology professionals; Declining number of medical students picking radiology in Match), some refer to professional competitive pressures (see: Competition to local practices from teleradiology and national radiology groups; Increased use of medical imaging by physicians in other specialties (turf battles), and some relate to scientific & safety issues (e.g., Concerns about CT radiation dose).
The item that I found the most interesting was the following: Use of artificial intelligence to interpret medical images. I referred to image analysis software in radiology in a recent note (see: IBM Buys Merge Healthcare; Integrates Watson into CAD Services). This makes sense as a threat because, at some distant time, the interpretation of images could be performed totally by software. However, the likely consequence of the adoption of image analysis software, at least in the short-term, is higher quality reports and greater work efficiency for radiologists. Image analysis software will be used to highlight for the radiologist the abnormal features of an image that are worthy of special attention. In short, the deployment of artificial intelligence, a term that seems to be no longer in broad use, is a mixed bag for radiologists and not exclusively a threat.