Increasing % of studies read by midlevels... what does this mean for the future?

[Shunsui]

Trends in Diagnostic Imaging by Nonphysician Practitioners and Associations With Urbanicity and Scope-of-Practice Authority

We aimed to assess the changing share of diagnostic imaging billed by NPPs and how such changes differ by urbanicity within the context of scope-of-pr…

www.sciencedirect.com

"Studying 110 million imaging claims from commercially insured and Medicare Advantage patients, we found significant increases in imaging claims billed by NPPs (PAs + NPs) between 2016 and 2020. Our findings confirm trends recently reported in Medicare fee-for-service beneficiaries, wherein NPPs interpreted 1.27% of diagnostic imaging studies performed in 2015, up from 0.01% in 1994. Specifically, we found that NPPs interpreted 2.6% and 3.3% of imaging studies in 2016 and 2020, respectively,..."

also saw higher % of NPPs billing for reads in metro compared to rural. Wonder what this means for patient safety...

I understand there's an overwhelming demand for reading more but is this something current med students should consider seriously? Not only the potential threat of AI decreasing demand for rads in the far future but now increasing encroachment from midlevels?

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[Anakinmemer]

At the end of the day you're going to find negative outlooks for literally any specialty in medicine. Some might actually go to **** someday and most won't. No one can accurately predict the future so just do rads if you like rads and do something else if you don't.

 

[guytakingboards]

Mid-levels are definitely taking over simple rads procedures and fluoro. It's the only way to get through the worklist some days.

One hospital I covered a few weeks ago my mid-level did 8 LP's on top of his scheduled fluoro, thora's and para's. That would have sank me. There's just not enough available rad coverage.

I have yet to see midlevels encroach into non-fluoro diagnostics.

 

[Anakinmemer]

And to clarify I am not a radiologist just a fourth year student applying. I assume you are a medical student considering specialties and just want to say I went through the exact same phase of being scared about the future for whatever I chose and always reading up about peoples predictions for each specialty. I can say without a doubt that EVERY specialty will have doom and gloom. Derm is being taken over by PE. Cataracts reimburse pennies compared to what they used to because it's the most targeted procedure by CMS. Anesthesia is losing their jobs to CRNAs. EM is oversaturated and unable to find work. Rads will be replaced by AI. Just ignore it all and pick what you enjoy. Every one of those specialties is still a great choice and the concerns have not come to fruition. EM is on the hot seat right now and yet a family member was just able to sign a job for 310k for 30 hours a week. WIth the option to pick up 24's whenever they want for 8k a piece. That's far from oversaturated and dead if you ask me. Jobs may change in the future but that doesn't mean they won't be good. Stock brokers are extinct and yet were able to transition into roles where they can make MORE money

 

[Shunsui]

And to clarify I am not a radiologist just a fourth year student applying. I assume you are a medical student considering specialties and just want to say I went through the exact same phase of being scared about the future for whatever I chose and always reading up about peoples predictions for each specialty. I can say without a doubt that EVERY specialty will have doom and gloom. Derm is being taken over by PE. Cataracts reimburse pennies compared to what they used to because it's the most targeted procedure by CMS. Anesthesia is losing their jobs to CRNAs. EM is oversaturated and unable to find work. Rads will be replaced by AI. Just ignore it all and pick what you enjoy. Every one of those specialties is still a great choice and the concerns have not come to fruition. EM is on the hot seat right now and yet a family member was just able to sign a job for 310k for 30 hours a week. WIth the option to pick up 24's whenever they want for 8k a piece. That's far from oversaturated and dead if you ask me. Jobs may change in the future but that doesn't mean they won't be good. Stock brokers are extinct and yet were able to transition into roles where they can make MORE money

Yep, M2 here. Thanks for your insight. This is a great perspective and one I will hold as I progress through school.

side note: how do you feel about this upcoming rads match considering the last couple of years were rough by the looks of it?

 

[Cognovi]

EM is on the hot seat right now and yet a family member was just able to sign a job for 310k for 30 hours a week. WIth the option to pick up 24's whenever they want for 8k a piece. That's far from oversaturated and dead if you ask me. Jobs may change in the future but that doesn't mean they won't be good. Stock brokers are extinct and yet were able to transition into roles where they can make MORE money

A 24hour EM shift is insane.

 

[Neopolymath]

A 24hour EM shift is insane.

Anywhere that offers 24s is a sleepy place mostly shipping people out by whining about/using EMTALA as a weapon.

 

[Mh0311]

It means more opportunities for us to be involved as expert witnesses

 

[vm26]

It means more opportunities for us to be involved as expert witnesses

My understanding (possibly misunderstanding) is that physicians cannot testify against a mid-level. Would have to be another mid-level.

 

[Ho0v-man]

A midlevel called the other day asking if vascular should be consulted for the phleboliths in the pelvis. It’s gonna be okay guys.

 

[colbgw02]

A midlevel called the other day asking if vascular should be consulted for the phleboliths in the pelvis. It’s gonna be okay guys.

I hope you said 'yes'. I'd like to hear how the conversation with the vascular surgeon went.

 

[Cognovi]

Just confidently say they should try consulting phlebology, and hang up.

 

[qwerty89]

Trends in Diagnostic Imaging by Nonphysician Practitioners and Associations With Urbanicity and Scope-of-Practice Authority

We aimed to assess the changing share of diagnostic imaging billed by NPPs and how such changes differ by urbanicity within the context of scope-of-pr…

www.sciencedirect.com

"Studying 110 million imaging claims from commercially insured and Medicare Advantage patients, we found significant increases in imaging claims billed by NPPs (PAs + NPs) between 2016 and 2020. Our findings confirm trends recently reported in Medicare fee-for-service beneficiaries, wherein NPPs interpreted 1.27% of diagnostic imaging studies performed in 2015, up from 0.01% in 1994. Specifically, we found that NPPs interpreted 2.6% and 3.3% of imaging studies in 2016 and 2020, respectively,..."

also saw higher % of NPPs billing for reads in metro compared to rural. Wonder what this means for patient safety...

I understand there's an overwhelming demand for reading more but is this something current med students should consider seriously? Not only the potential threat of AI decreasing demand for rads in the far future but now increasing encroachment from midlevels?

I suspect this includes midlevels not employed by radiology groups. I.E. ortho PAs/NPs billing for in office xrays.

That being said our group uses RAs for fluoro. Rads still supervise on site. RA explains everything to the patient. Has patient ready to go. I walk in and give a thumbs up. Watch the fluoro from the control room. If its a shoulder or knee arthrogram its done in a minute or less. I say "thanks" or give another thumbs up and leave. Like another poster said. Its the only way to get through the day. Fluoro is a money loser.