Is it time to remove the "R" from ROAD to success?

[Bertelman]

Agreed. The first computers were multi-million dollar monstrosities -- who could have imagined that someday everyone would have one at home at a cost of about a grand. Or DVD players that debuted at about a grand and now you can get one for $60. In ten years we will all be doing our dishes with DaVinci's.

I'm sure that's what they were saying when it came out ten years ago. Not denying the cool factor, but they haven't exactly caught like wildfire. Still seems to be a hospital marketing ploy with few uses.

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[cfdavid]

Agreed. The first computers were multi-million dollar monstrosities -- who could have imagined that someday everyone would have one at home at a cost of about a grand. Or DVD players that debuted at about a grand and now you can get one for $60. In ten years we will all be doing our dishes with DaVinci's.

As soon as they come up with a robot that can effectively clean a home, I'm IN!

 

[cfdavid]

I'm sure that's what they were saying when it came out ten years ago. Not denying the cool factor, but they haven't exactly caught like wildfire. Still seems to be a hospital marketing ploy with few uses.

Perhaps. I guess it'll really come down to what, proven, advantages these machines can truly offer the patient.

 

[RokChalkJayhawk]

Can you say Davinci by remote control? Halfway across the state, or country, or planet. It is within the realm of concievability.

Well, that's a possibility, but:

A) It's too expensive and isn't very adaptable to a broad variety of situations.

B) If it breaks down, someone's ass is stuck to a table somewhere and in big trouble. Not so much of a problem of that with x-rays.

Is it possible? Yes. Likely? Much less than it is possible that a majority of diagnostic radiology will be done from a distance.

 

[Law2Doc]

Well, that's a possibility, but:

A) It's too expensive and isn't very adaptable to a broad variety of situations.

B) If it breaks down, someone's ass is stuck to a table somewhere and in big trouble. Not so much of a problem of that with x-rays.

Is it possible? Yes. Likely? Much less than it is possible that a majority of diagnostic radiology will be done from a distance.

Neither specialty is going to be eliminated. But your first two points will be remedied with technological improvements and time. And FWIW, with most of the newer rads toys these days, there is a patient stuck in a big noisy machine much less comfortable than an operating table if something breaks down.

 

[RxnMan]

I'm sure that's what they were saying when it came out ten years ago. Not denying the cool factor, but they haven't exactly caught like wildfire. Still seems to be a hospital marketing ploy with few uses.

This is my experience as well. As long as the different specialities keep up with tech and techniques, they won't go extinct any time soon.

Law2Doc's mention of dish-washing Da Vinci's got me thinking...could you have one guy commanding 10 Da Vinci's in parallel washing ten dishes...at once? Or maybe you could hook them in series, one controlling the next? If you could do that, could you have a ring of Da Vinci's controlling themselves? M. C. Escher would be proud.

 

[RokChalkJayhawk]

Neither specialty is going to be eliminated. But your first two points will be remedied with technological improvements and time. And FWIW, with most of the newer rads toys these days, there is a patient stuck in a big noisy machine much less comfortable than an operating table if something breaks down.

Hah... well if the Davinci breaks down then the person can die... That tends to be uncomfortable.

 

[Law2Doc]

Hah... well if the Davinci breaks down then the person can die... That tends to be uncomfortable.

Moreso for the doctor, manufacturer and their insurance carriers than the patient, who is likely well anesthetized.

 

[adismo]

my heart goes out to all those radiologists out there. great effort you guys, keep striving, never give up, haha

 

[da8s0859q]

Gosh, I'd hate to have to change my "(E-)ROAD to happiness" bit.

I suppose I don't have too terribly much of value to add to the discussion since I'm fairly inexperienced as far as all of that is concerned, but I will say that I tend to not give much weight to anything that sounds a little too much like a doomsday theory ("They're gonna outsource all our work!", etc.).

The last physician I shadowed laughed at the question when I brought up how radiology seems to be changing a lot from an outside perspective. He didn't seem terribly convinced that they'll be hurting too much.

 

[megadon]

Still have to an American MD license to read stuff. Doesn't sound like it is getting shipped overseas anytime soon. Plus guess what, radiologists make bank, they will fight their turf tooth and nail.

 

[Tired]

Still have to an American MD license to read stuff. Doesn't sound like it is getting shipped overseas anytime soon. Plus guess what, radiologists make bank, they will fight their turf tooth and nail.

How about the more practical concern, of teleradiology cutting out local groups in favor of lower-cost radiologists in cheaper areas of the country? If you're a hospital in Manhattan, why not send all your films to a discounted radiology group in Iowa?

 

[jdh71]

How about the more practical concern, of teleradiology cutting out local groups in favor of lower-cost radiologists in cheaper areas of the country? If you're a hospital in Manhattan, why not send all your films to a discounted radiology group in Iowa?

Why not? Capitalism at it's finest. Lucky for you, tough to do that sort of thing with total-hips

 

[Tired]

Why not? Capitalism at it's finest. Lucky for you, tough to do that sort of thing with total-hips

True enough, unless that mechanical operating thing ends up working out (unlikely, I think, except maybe the minimally-invasive cases).

I just find it amusing that "outsourcing to India" is the big fear on SDN, but it looks a lot more likely that U.S.-trained radiologists will end up cutting each others' throats by exploiting regional overhead differences.

 

[Law2Doc]

How about the more practical concern, of teleradiology cutting out local groups in favor of lower-cost radiologists in cheaper areas of the country? If you're a hospital in Manhattan, why not send all your films to a discounted radiology group in Iowa?

That certainly will happen, although whether a part of the country is "cheaper" depends on the fixed costs, and the fixed costs in rads, I suspect, tend to be driven by the machines (which cost pretty much the same nationally) and things like liability insurance, which varies nationally but not necessarilly tied to the cost of living of a region; many parts of the country have higher fixed costs than Manhattan simply because their juries are historically more generous/runaway. Then again, how many people price shop for this kind of thing -- most people assume their insurance covers whatever films they need and ignore it.

But it will (and does) go both ways -- with the right pull, a wealthy or demanding patient can now have his films read by the big name guys at the top national programs rather than his generalist in the burbs. Why not get your second opinion from the best when it's just one click of the mouse away?

 

[Long Dong]

How about the more practical concern, of teleradiology cutting out local groups in favor of lower-cost radiologists in cheaper areas of the country? If you're a hospital in Manhattan, why not send all your films to a discounted radiology group in Iowa?

I've heard of US docs in australia reading films. Not sure if the cost of living is lower down under or not. And not sure if they need a license from that state as well

 

[deleted77919]

I've heard of US docs in australia reading films. Not sure if the cost of living is lower down under or not. And not sure if they need a license from that state as well

One of the main advantages to this was an issue of time, rather than cost of living. This way the "nighthawk" service is actually reading films in the daytime there, when it is night in the US. Helps a lot of people out with call responsibility and you don't have to pay a premium since you aren't asking them to work overnight shifts when they'd rather be sleeping.

 

[cfdavid]

One of the main advantages to this was an issue of time, rather than cost of living. This way the "nighthawk" service is actually reading films in the daytime there, when it is night in the US. Helps a lot of people out with call responsibility and you don't have to pay a premium since you aren't asking them to work overnight shifts when they'd rather be sleeping.

I heard a residency director at my med school speak of looking for areas in Romania to man with U.S. trained radiologists. He used the same "nighthawk"-type of arguement. But, in reality, I wonder how long it would be until they paid those "US trained" guys much less based on cost of living and other possible incentives such as maid services, housing etc. We'll see how that plays out.

I don't think it'll be a major threat to US docs, and it's always easy to view the sky as falling. But, it rarely ever does. I think many fields will change, but they'll evolve successfuly with those challenges, and US docs should still have it pretty good. I wish I had a crystal ball....

 

[Bubb Rubb]

I heard a residency director at my med school speak of looking for areas in Romania to man with U.S. trained radiologists. He used the same "nighthawk"-type of arguement. But, in reality, I wonder how long it would be until they paid those "US trained" guys much less based on cost of living and other possible incentives such as maid services, housing etc. We'll see how that plays out.

you're still asking board certified radiologists from the US to relocate. even if in an attractive location (zurich, sydney?) such a position will still command a competitive salary.

 

[cfdavid]

you're still asking board certified radiologists from the US to relocate. even if in an attractive location (zurich, sydney?) such a position will still command a competitive salary.

I hope so. Even though I'm not interested in Radiology, I don't want to see depressed wages in any specialty, frankly. It's always easy to speculate, but my experience is that many initiatives that sound great on paper may not pan out when implemented (or attempted to) due to unforeseen circumstances. Sometimes even good ole common sense gets in the way!