Well, for instance, at the institution I'm at, every radiology cross sectional study has to be protocoled by a radiologist. That's thousands of studies a day, each involving figuring which study is appropriate, how it should be performed, sometimes talking to the clinician and tech, and all this has to be documented. It's not a small amount of "paperwork" and sure doesn't seem to be an insignificant part of any radiologist here's day. My experience with IM is they really have nothing like this. And can you seriously say there are eg no battling egos in radiology? I gave examples above of patient noncompliance -- radiology is a procedural field and so folks need to comply with things before and after the procedure, which can certainly cause headaches. And how does radiology not have billing or reimbursement issues? They are the highest paid specialty (per medscape) magically?
Anyway I think the prior poster lost me at the notion of a magic field with no scut or battling egos. this doesn't anywhere exist in medicine. There are simply dogs with different fleas. Thats why I think the prior poster is going to have a very different take in a few years.
I didn't read his comments as speaking in absolutes, nor was I.
Clearly there are ego issues. I think the point remains that it's less of an issue than in many, if not most, other fields. Like several specialties, radiology tends to attract laid-back personalities. I don't think that's particularly earth shattering news.
You're way off on your thoughts on protocoling; it's a small part of a radiologist's day. To give you an idea, I recently protocoled about 250 studies - it took me 10 minutes. Even when confusing or difficult orders show up, that number maybe gets pushed to 30 minutes. Maybe.
Yes, there are non-compliance issues, but again - as compared to other fields - it's an afterthought. The patient ate breakfast before a RUQ? Fine, reschedule it. The patient refuses contrast? Fine, do it without. The patient didn't stop their coumadin before a biopsy? Fine, reschedule it. Most of these problems have solutions that are so simple that I don't even know about it until after. The conversation normally goes like this: "What happened to the nine o'clock UGI?" "The patient ate breakfast, so he's coming back next week." "Oh, okay (heads back to reading room)."
And let's not conflate IR with DR. Depending on your institution's IR practice model, then they will have all of the issues of what is essentially a minimally-invasive surgery clinic. That model isn't, at present, reflective of IR elsewhere, and those issues certainly don't apply to DR.
Regarding reimbursements, I read RadicalRadon's comments differently. I think he was simply pointing out that coding is not a day-to-day issue for radiologists. It's not. Reimbursement is a big issue in radiology nowadays, certainly, but it's not like radiologists spend their days filling out insurance forms or choosing ICD-9 codes.
Everyone can cite specific examples that don't jive with my experiences. Nonetheless, I've been doing this for long enough and in enough different places that I'm confident that the above is generally reflective of the field. And I'm very confident that these issues are less of a concern than in most other fields, to include IM, as you suggested.