Radiology as a field has been out there for more than 100 years and is a vibrant field in most countries including countries without the so called "defensive medicine". There should be a reason for it beyond the legal system, regulations or laws.
A while ago, we had an IT issue that clinicians could see the images in PACS but could not read our report only for a short time. There was a real chaos all over the hospital and non-stop phone calls. There should be a good reason for it.
If the clinicians read their own imaging studies in a large scale, what is the need for night coverage or telerad? Why hospitals even bother thinking about telerad? What is the turn around time? Why failure to communicate the results is the most common reason that radiologists get sued?
The impact that I have on people's lives in a 10 or 12 hour shift is definitely more than any other physician in the hospital. I am not naive and don't claim that every Xray or CT or MRI that I read has impact on patient's management or I don't claim that some group of clinicians are not very good at reading their own small organ system or finding certain pathologies.
Some clinicians esp surgeons are very good at interpreting some parts of imaging studies. Also Some of them already know about the results of a CT or MRI based on their clinical judgment and in fact don't really need to look at the imaging study in detail. However, most clinicians esp in private practice heavily rely on radiology reports. There is a bias among medical students because usually in academic places due to sub-specialized nature of work, some clinicians are good at very limited pathology that they look for (for example, neuro-ophthalmologist who looks at stenosis of transverse sinus).
But even in cases that clinicians are good at interpreting their limited pathology (vascular surgery and AA dissection), due to lots of other differentials, they system heavily relies on radiology interpretation for deciding on the next step. In other words people don't go to a vascular surgeon and say they have aortic dissection. They for example go to a GI doctor f or a family doctor or ED doctor and they say they have abdominal pain. The GI doctor may order a CT and while a GI doctor may be good at looking at the biliary system, he has zero knowledge about aortic dissection. Once the radiologist makes the diagnosis of aortic dissection the patient is referred to the vascular surgeon. Though the vascular surgeon may CLAIM that he doesn't need radiology report to look at the dissection, the patient's live is saved here because of the radiologist. If the radiologist misses the dissection, the GI doctor may send the patient home with some anti-acids. Once I saved a patient when the urologist looked at a CT himself and was about to admit the patient in hospitalist service with the diagnosis of renal stone while the patient had acute aortic dissection.
