Radiology: getting ready for tomorrow

[Taurus]

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A lot of the fellowship programs of the other superspecialities like cardiolog, even neurology now have started offering fellowships in Imaging.

Cards can't read rest of chest besides heart. In private practice, there's typically not enough neuro for a person to be dedicated to it 100% of the time.

Rads will be just fine. I'm glad that at least the profession sees the challenges ahead and is having discussion about it vs. sticking our heads in the sand and pretending everything is hunky dory.

 

[Taurus]

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[Taurus]

Both the American College of Gastroenterology and the American Society of Gastrointestinal Endoscopy has expressed strong disinterest in the virtual colonoscopies and Medicare and so far sided with them.

CT colonography could detect 78% of polyps as small as 6 millimeters in diameter. Yet the scans caught only 65% of polyps 5 millimeters or smaller....Virtual colonoscopy has a 14% false-positive rate....it requires the same bowel prep (cleansing of the bowels) as a real colonoscopy.

Fairly strong arguments against the procedure, with little benefit.

And 90% sensitivity if the polyp is 10 mm or greater (Johnson CD et al, 2008). In the previous study, there were 7 perfs in 3163 optical colonoscopy cases (Kim DH et al, 2007). Put it another way, you have a 2.2 in 1000 chances of walking around with a bag at your side. There were 0 perfs in the virtual colonoscopy cases. There is around ~10% chance of needing a follow-up colonoscopy after virtual colonoscopy. Virtual colonoscopy is still new and the technology will only get better. Once the technology matures and if you consider the less invasiveness of the procedure and the cost benefit, virtual colonoscopy will become the screening standard in the future.

Are you really surprised that GI docs don't like virtual colonoscopy? It eats into their profit center. GI docs can also read virtual colonoscopies, but they can't read the rest of the GI. Therefore, they have been trying to argue, like the cards, that there should be separate billing codes for the virtual colonoscopy and the rest of the GI. Rads aren't having any of that ridiculousness.

 

[drjaymehta]

Taurus, I agree with the point, cards can read the heart and not the rest of the chest, similar is with the GIs..point very well taken...I suppose only if a person is a total anti radiologist, then he will go ahead and tell against that...

As I have mentioned, there is a thread started which expresses that IR will be a branch out from DR..Well, I think that is great news..I believe, just like many other DOCTORS and MEDICAL STUDENTS..that its one field which will constantly keep on inventing new modalities of treatment, especially for the TUMORS, MOLECULAR ABNORMALITIES, OBSTRUCTIONS, VASCULAR DISEASES...

the only concern as a student interested in Radiology is...

With the advent of this as a new speciality ( Is it Official that its going to be a new speciality...I sincerely respect the person who has started the thread but then too does any one else also have any confirmed evidence, then please post it on this thread too)....Will vascular stenting and imaging, be back to the IRs..

Though at a lot of places, the IRs do vascular stenting currently, but I have heard that there are some greedy cardiologists who are also offering renal stenting etc etc... Will this see a better change with the advent of IR

Also, If IR becomes an independant speciality, then how would it be functioning?? anyone has any idea..any news on that...By which year is it going to be an Independant speciality...will someone matching for 2011, be able to apply for it directly..

Just as Taurus pointed out, this is the awareness which we as students are taking..Is there any similar awareness by the ACR or the SIR...
I have heard that they have been lobbying to put an end to the self-referring and have been successful in the same..any other such similar discussions then please do post so that all others know...

Thank you everybody for replying so well...I am so sure that a lot of people will benefit from the discussion on this thread...Please keep on posting..Kudos..

 

[drjaymehta]

hey guys do keep on posting...my above post is a collection of some unanswered questions in the whole of the topic...

Expecting replies..

 

[radslooking]

Virtual colonoscopy will take off. Who wants a tube stuck up their ass? If you see something on virtual colonoscopy, then stick up a tube. Otherwise, no thanks. Oh yeah, stories like these make people want to get virtual colonoscopies too.

Colonoscopies have been suspended at the Miami Veterans Affairs hospital where thousands of veterans may have been exposed to hepatitis or HIV because equipment used in the procedures was not properly sanitized.
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Yeah, the same tube that got stuck up your ass is the same one that got stuck up thousands of people's asses.

well, they still need to prep them and insufflate with air don't they? I'm not so sure it's that much more comfortable. i'd be interested to see data on it though. The spectre of a tube up your ass is enough to scare most people.

I continue to think rads biggest future problem is declining reimbursement, and cost pressure from sending images overseas. I don't see specialists killing them as much, because somebody has to read the entire film.

 

[drjaymehta]

doesnt the rule of not doing self referral apply to the GI physicians as well.......

By the rule, none other than the rads are allowed to comment on images...

Thats why the cardio guys are not liking radio guys i suppose...

 

[HESC]

just thought I'd share this with the rads forum.
I found it while perusing the pathology news blogs.
A report about Dayhawk type rads getting auctioned off to the lowest bidder. sounds bad for rads...

just FYI, the pathology POD labs he refers to have been pretty much shut down by legislation that passed last year.

 

[drjaymehta]

yeah but if you go through that article you will also see that more and more number of sub specialists radiologists and Interventional Radiologists are going to be in demand even in the smaller centers..

the opinion about the general radiologist does seem to be true..
but the only thing supporting their position is the anti self referral laws at this time...so it should not be that much of a problem to them as well..

 

[drjaymehta]

Is CLINICAL teaching incorporated in Diagnostic Radiology...

if Interventional Radiology becomes a new speciality...what will be their curriculum like..

Please post if anyone has any idea...