Radiology

[Zumba]

Hi rads forum, I'm a med student trying to figure out what to go into. I'm torn between anesthesia and radiology. I've asked about anesthesia in the anesthesia forum but would like to get your perspective about radiology. I do like radiology but I have heard numerous people discuss the poor job market and declining reimbursement rates.

For those of you who are more informed, can you tell me what your opinion regarding the future jobs market/reimbursement is? How stable does the future look? Any input would be appreciated!

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[duckie99]

while these are good things to think about with any specialty, the job market is not something that can really be predicted 6-7 years before you finish training. There will always be jobs the more rural you go with higher reimbursements. Jobs in a more competitive market may mean you are doing work you don't necessarily want to do (e.g. you do a neurorads fellowship but still have to read a lot of cxrs) or getting paid less than you want but that is generally true of most fields as well.

However you gotta realize that anesthesia has it's jobs problems to and in my opinion larger issue of midlevel encroachment (crnas). Radiologists really only have to worry about overzealous physicians not sending scans to them and "reading" the scan themselves. The field of radiology is very complex and for every 100 cxrs that are normal and a competent physician would know so there are 5 which have a finding that requires some follow-up that require the eye of a radiologist. And this is just cxrs. No one can read MRIs except rads. It is the standard of care for a radiologist to give a read on a diagnostic study and if this is bypassed resulting in a mistake that physician is screwed.

I think radiology is much more stable in the long run as most every patient will likely get some sort of picture taken as it is essentially standard of care now. Will the radiologist be required to give a read on every daily cxr from the icu? probably if only for legal reasons. Also new technology only means more ways to take pictures of people and more need for a radiologist to learn about the tech, research the tech, etc.

The general rule of thumb is that reimbursements are going to go down pretty much across the board.

Anesthesia and radiology are widely different fields and you should decide on the one you like learning about and enjoy the work flow the best. There are various fellowship opportunities in each. I would not pick one based on reimbursements and lifestyle alone (which it seems you are doing). Good luck.

 

[Rad2013]

Anesthesiology is heavy in pharmacology and physiology. Radiology is heavy in anatomy and pathology. I personally prefer anatomy/pathology to pharm/physio. Some people like the pharm and physio better. Some people like it all.

Where do your interests lie? Just something to consider.

 

[shark2000]

Nothing is similar between these two fields. You can not be interested in both.

If you are seeking JUST money and perceived life-style, you will be miserable sooner or later.

 

[cowme]

I'm not one to prescribe to doomsday scenarios, but if this is your main concern, I'd say that anesthesiology's is significantly worse.


In radiology, our main competition is our american-trained peers who are working for nighthawk companies.

In anesthesia, the main competition is nurses who are willing to accept 1/3 the pay, and peer reviewed studies have thus far shown no difference in outcomes between them and doctors.

 

[choweee]

http://www.medscape.com/features/slideshow/lifestyle/2012/public

See slide 6.

 

[shark2000]

Weeks of vacation or working hours per week should not be a factor in choosing a specialty other than some extremes.
Let's say you hate radiology. Even if you have 8 weeks of vacation which is rare these days and even if you work only 50 hours per week which is again rare these days, you are still F... up.
Irrelevant of what specialty you do, you will spend most of your time at work.

What is the point of hating your life 5 times a day, for having a 2 week vacation in Hawaii per year or driving a BMW while you do not have even time to take kids out with your fancy car? \

Choose wisely. Don't turn yourself in a creature that is looking forward to Saturday on Monday because you hate what you do. I am not idealistic and do not expect you to love what you do. But it should be at lease OK, with some parts that you like. And there are aspects of each job that you hate always. But you have to leave your home relatively happy every morning. This is something that can not be compensated for by a good pay check or a nice vacation.

 

[Zumba]

Nothing is similar between these two fields. You can not be interested in both.

If you are seeking JUST money and perceived life-style, you will be miserable sooner or later.

That is simply ridiculous. I like both for different reasons. I would go into mammography in rads not just because I find the field interesting, get to do procedures, get to deal with something that is essential for the health of women, and for anesthesia i would go into pain, given that I myself got introduced to the field as a result of poor surgical care and ended up with a bad outcome and had to be referred to a pain doc, who worked wonders. So please don't make blanket statements before knowing others.

 

[Zumba]

http://www.medscape.com/features/slideshow/lifestyle/2012/public

See slide 6.

I guess both are pretty happy.

 

[Zumba]

I'm not one to prescribe to doomsday scenarios, but if this is your main concern, I'd say that anesthesiology's is significantly worse.


In radiology, our main competition is our american-trained peers who are working for nighthawk companies.

In anesthesia, the main competition is nurses who are willing to accept 1/3 the pay, and peer reviewed studies have thus far shown no difference in outcomes between them and doctors.

It is a main concern yes. I would like stability career wise. But can nurses realistically replaces anesthesiologists? That I doubt. But i certainly don't want to be competing with nurses of all people for jobs. Do you think there is any possibility that Medicare would lift the ban on reads being done by a US doc?

 

[deleted103644]

It is a main concern yes. I would like stability career wise. But can nurses realistically replaces anesthesiologists? That I doubt. But i certainly don't want to be competing with nurses of all people for jobs. Do you think there is any possibility that Medicare would lift the ban on reads being done by a US doc?

No, the threat to radiology is intense competition between large national teleradiology groups (think Walmart) and (more distantly) automation. The former will get worse as hospitals get better EMR, PACS, video conferencing and general networking and Internet connectivity. The latter I'm betting is at least two decades away from being a serious threat, more likely three or four, but technology is unpredictable.

We'll never outsource final reads, and procedural subspecialties will be safe at least until the singularity.

 

[ar2388]

i also dont think outsourcing is a huge problem because radiology studies tkae a lot of memory and sending that to India or someplace and then waiting to get it back takes time too. especially if oyu need a stat read for an ER call or something.

 

[deleted103644]

i also dont think outsourcing is a huge problem because radiology studies tkae a lot of memory and sending that to India or someplace and then waiting to get it back takes time too. especially if oyu need a stat read for an ER call or something.

This is not a good rationale.

Memory prices are dropping much faster than scan resolutions are increasing, so although I agree outsourcing is not an issue, this is not the reason.

Internet speeds are also increasing rapidly. I could send several gigabytes to India on my home Internet connection in just a few minutes (and if compressed intelligently, a remote radiologist could start reading before the transfer was complete).

 

[ar2388]

This is not a good rationale.

Memory prices are dropping much faster than scan resolutions are increasing, so although I agree outsourcing is not an issue, this is not the reason.

Internet speeds are also increasing rapidly. I could send several gigabytes to India on my home Internet connection in just a few minutes (and if compressed intelligently, a remote radiologist could start reading before the transfer was complete).

hmm i do no know enough about memory and stuff then.

 

[cowme]

It is a main concern yes. I would like stability career wise. But can nurses realistically replaces anesthesiologists? That I doubt. But i certainly don't want to be competing with nurses of all people for jobs. Do you think there is any possibility that Medicare would lift the ban on reads being done by a US doc?

I find it odd that you brush aside the concern of mid levels in anesthesia (something that has a precedent in other specialties--see primary care and NPs, and what that's done for salaries), but worry about outsourcing to foreigners (something that has never happened and has never even been discussed outside of Internet forums.)

 

[Zumba]

I find it odd that you brush aside the concern of mid levels in anesthesia (something that has a precedent in other specialties--see primary care and NPs, and what that's done for salaries), but worry about outsourcing to foreigners (something that has never happened and has never even been discussed outside of Internet forums.)

Sorry maybe my post was not clear. the whole thing about "it's a main concern" was referring to stability of the profession. I am concerned about the threat of CRNAs as midlevels in anesthesia, reason why I was asking. You mention that it's done something to salaries-has it dropped anesthesia salaries? I was not aware of this. Anesthesiologists seem to do well financially. Am I wrong about this?

The whole outsourcing yes you are correct I have read discussions on internet forums about this that's why I was asking. I guess I am trying to become more informed about this.

 

[deleted103644]

Sorry maybe my post was not clear. the whole thing about "it's a main concern" was referring to stability of the profession. I am concerned about the threat of CRNAs as midlevels in anesthesia, reason why I was asking. You mention that it's done something to salaries-has it dropped anesthesia salaries? I was not aware of this. Anesthesiologists seem to do well financially. Am I wrong about this?

The whole outsourcing yes you are correct I have read discussions on internet forums about this that's why I was asking. I guess I am trying to become more informed about this.

Mid level providers don't drop salaries - they drop jobs. You have a few anesthesiologists lucky to ride the wave of increased revenue from physician extenders, while younger generations suffer from a decreased demand for anesthesiologists.

Salaries may eventually fall as the younger anesthesiologists get desperate, but it will make the job market bad before that starts to happen. Think the anesthesia market is already tightening, but not following closely.

 

[Zumba]

Mid level providers don't drop salaries - they drop jobs. You have a few anesthesiologists lucky to ride the wave of increased revenue from physician extenders, while younger generations suffer from a decreased demand for anesthesiologists.

Salaries may eventually fall as the younger anesthesiologists get desperate, but it will make the job market bad before that starts to happen. Think the anesthesia market is already tightening, but not following closely.

I have heard what you mention, but is the radiology market not currently saturated as well from my understanding? I guess I am trying to get as complete a picture before I decide. Is the current radiology market likely to improve or get worse with the new obamacare law?

 

[deleted103644]

I have heard what you mention, but is the radiology market not currently saturated as well from my understanding? I guess I am trying to get as complete a picture before I decide. Is the current radiology market likely to improve or get worse with the new obamacare law?

Yes, likely due to people not retiring and decreasing reimbursements (so private practice guys work harder to maintain salary instead of hiring).

Medicare reimbursement is the main issue, and that's actually mainly separate from "Obamacare". The debt ceiling deal is more likely to hurt in the short run since it directly cuts reimbursements.

You should not decide based on this stuff. Assume all specialties will get equal (much lower) pay in the future and choose the one you would still like.

 

[shark2000]

That is simply ridiculous. I like both for different reasons. I would go into mammography in rads not just because I find the field interesting, get to do procedures, get to deal with something that is essential for the health of women, and for anesthesia i would go into pain, given that I myself got introduced to the field as a result of poor surgical care and ended up with a bad outcome and had to be referred to a pain doc, who worked wonders. So please don't make blanket statements before knowing others.

Your statements are getting more and more crazy. You can put 60% of medical fields instead of radiology or anesthesiology up there and still it works.
Pain medicine and dealing with chronic pain patients round the clock is totally opposite to radiology. Even the clinicians who love patient contact, hate pain patients. How come you like both? Oh, I forgot you looked at physician's income and found these two fields are well paid.

 

[badasshairday]

everyone is going to be paid 150K 10 years from now. So pick what you like.

 

[Zumba]

everyone is going to be paid 150K 10 years from now. So pick what you like.

I somehow doubt that.

 

[EeePC1005PR]

Hi rads forum, I'm a med student trying to figure out what to go into. I'm torn between anesthesia and radiology. I've asked about anesthesia in the anesthesia forum but would like to get your perspective about radiology. I do like radiology but I have heard numerous people discuss the poor job market and declining reimbursement rates.

For those of you who are more informed, can you tell me what your opinion regarding the future jobs market/reimbursement is? How stable does the future look? Any input would be appreciated!

Just my personal opinion: I think as long as you a doctor in a developed country, you are paid enough to lead above average standard of living. The training for both of them are quite long and challenging. So do what you like more, not for the pay. That way you will have happier.

Anesthiology is more to do with physiology and pharmacology. Radiology is anatomy and physics. It shouldn't be that hard to know which field floats your boat, science-wise.

 

[deleted103644]

I somehow doubt that.

It's unlikely, but you should choose your specialty as if it were true.

That way, you'll choose something you actually like and will probably be pleasantly surprised by your salary.

 

[Zumba]

It's unlikely, but you should choose your specialty as if it were true.

That way, you'll choose something you actually like and will probably be pleasantly surprised by your salary.

Sure, that I agree with. However the idea that grads should not be concerned with salary, lifestyle, etc. seems a bit misguided. Both are important. No matter how much you love a specialty/field, if it takes decades to get there to get paid nothing and work like a dog, then it's not worth it. Satisfaction is important.

 

[deleted103644]

Sure, that I agree with. However the idea that grads should not be concerned with salary, lifestyle, etc. seems a bit misguided. Both are important. No matter how much you love a specialty/field, if it takes decades to get there to get paid nothing and work like a dog, then it's not worth it. Satisfaction is important.

The mistake you're making is the assumption that the difference between $100k and $500k makes a bigger impact on your level of satisfaction with your job than your work environment and whether you like what you do.

You will be earning six figures in pretty much any specialty. If you can't be happy with that, you can't be happy.

Salaries are also uncertain enough in the future that choosing a specialty based on this is stupid. Compensation can change any time, and it doesn't play as big a role in job satisfaction as you'd think.

 

[duckie99]

Sure, that I agree with. However the idea that grads should not be concerned with salary, lifestyle, etc. seems a bit misguided. Both are important. No matter how much you love a specialty/field, if it takes decades to get there to get paid nothing and work like a dog, then it's not worth it. Satisfaction is important.

hours wise I'd say anesthesia is much shorter though this comes at the expense of having to pull more night shifts and very early morning shifts. It's typical for anesthesia to get to the hospital by 6:30 am or so to work-up their first cases. Depending on the day you may be out by 4. That's during residency. Attendings run between rooms and work-up patients during the day while they manage the residents and staff in their ORs but I think hours are similar. It's also all shift work.

Radiologists where I am get in around 7:30-8 am and leave around 5:30 with a 1 hour lunch break. During this time they are otherwise working constantly reading out a never-ending list of cases. Hours are far worse in IR (7 am - 7 pm daily).

I think pay is pretty similar between the two fields (though I'm fairly certain rads makes more) you are looking into. So if lifestyle is something you are worried about I think anesthesia is one of the best lifestyle fields out there with decent pay. But as johnny said you weight a field so heavily on pay because that could change by the time you finish training or even 10 years into your full practice.

 

[Dr. USMLE]

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[drizzt3117]

How is 8-530 with an hour lunch break "much longer" than 630-4?

I would say most anesthesiologists get to the hospital by 6. They might leave at 4 if they don't have too much documentation to do. The hours are decent but there's more night coverage/call than radiologists, as well. Both specialties in practice probably work 50-60 hours a week, but I think rads is closer to 50 while anesthesia is closer to 60. Pay is similar but rads is about 10% higher per mgma.

hours wise I'd say anesthesia is much shorter though this comes at the expense of having to pull more night shifts and very early morning shifts. It's typical for anesthesia to get to the hospital by 6:30 am or so to work-up their first cases. Depending on the day you may be out by 4. That's during residency. Attendings run between rooms and work-up patients during the day while they manage the residents and staff in their ORs but I think hours are similar. It's also all shift work.

Radiologists where I am get in around 7:30-8 am and leave around 5:30 with a 1 hour lunch break. During this time they are otherwise working constantly reading out a never-ending list of cases. Hours are far worse in IR (7 am - 7 pm daily).

I think pay is pretty similar between the two fields (though I'm fairly certain rads makes more) you are looking into. So if lifestyle is something you are worried about I think anesthesia is one of the best lifestyle fields out there with decent pay. But as johnny said you weight a field so heavily on pay because that could change by the time you finish training or even 10 years into your full practice.

 

[gasblaster]

How is 8-530 with an hour lunch break "much longer" than 630-4?

I would say most anesthesiologists get to the hospital by 6. They might leave at 4 if they don't have too much documentation to do. The hours are decent but there's more night coverage/call than radiologists, as well. Both specialties in practice probably work 50-60 hours a week, but I think rads is closer to 50 while anesthesia is closer to 60. Pay is similar but rads is about 10% higher per mgma.

I'd agree with this general assessment. Only thing I would add is that in private practice anesthesia there's more flexibility/options in terms of scheduling and hours given the different settings to practice in. Although, I'm not 100% familiar with how rads works outside of the hospital (e.g in free standing facilities).

 

[deleted103644]

I'd agree with this general assessment. Only thing I would add is that in private practice anesthesia there's more flexibility/options in terms of scheduling and hours given the different settings to practice in. Although, I'm not 100% familiar with how rads works outside of the hospital (e.g in free standing facilities).

Hours and pay in PP rads used to be ridiculous. Can't imagine anesthesia came close unless you were supervising a bunch of CRNAs.

Think that pretty much everything except primary care will end up in the hospital though in the not too distant future (unless things seriously change).

 

[duckie99]

How is 8-530 with an hour lunch break "much longer" than 630-4?

I would say most anesthesiologists get to the hospital by 6. They might leave at 4 if they don't have too much documentation to do. The hours are decent but there's more night coverage/call than radiologists, as well. Both specialties in practice probably work 50-60 hours a week, but I think rads is closer to 50 while anesthesia is closer to 60. Pay is similar but rads is about 10% higher per mgma.

gotta take in to account that most all surgeries are scheduled on weekdays at institutions I've been a part of. So if you are working in a non-OB non-trauma environment those hours are only during 5 days a week with call on weekends/nights from what I know. Hours can be a pain if you do lots of trauma, OB, or transplant. Agree that they probably take more overnights (at least during residency).

The work hours for rads at my institution are theoretically easier on weekends though it can still be a lot of volume because of inpatients and emergency stuff with less readers available. I can't comment on pp.

 

[drizzt3117]

gotta take in to account that most all surgeries are scheduled on weekdays at institutions I've been a part of. So if you are working in a non-OB non-trauma environment those hours are only during 5 days a week with call on weekends/nights from what I know. Hours can be a pain if you do lots of trauma, OB, or transplant. Agree that they probably take more overnights (at least during residency).

The work hours for rads at my institution are theoretically easier on weekends though it can still be a lot of volume because of inpatients and emergency stuff with less readers available. I can't comment on pp.

Any level 2 trauma center has to have anesthesia in house at all times, so unless you're at a tiny hospital (that's probably only run by crnas) you'll have to take nights. obviously if you do critical care, your hours will be terrible. In general I think it's fair to say the hours for anesthesia are no better than those for rads and could be worse.

 

[shark2000]

What are you guys talking about is mostly in academic centers. In pp, the pace is totally different. The life style is completely different in pp.On average, rads work harder in pp than anesthesia. Also currently, there is more flexibility regarding hours and schedule for anesthesia. All of it may change in the future.

 

[drizzt3117]

What are you guys talking about is mostly in academic centers. In pp, the pace is totally different. The life style is completely different in pp.On average, rads work harder in pp than anesthesia. Also currently, there is more flexibility regarding hours and schedule for anesthesia. All of it may change in the future.

I'm at a community hospital and the anesthesia folks certainly work harder than the radiologists. Ratio is similar to what I posted above. Same is true for the large private practice groups in my home town in WI. Radiologists in that group are banking really really hard with barely over 40 hours/wk.

 

[deleted103644]

I'm at a community hospital and the anesthesia folks certainly work harder than the radiologists. Ratio is similar to what I posted above. Same is true for the large private practice groups in my home town in WI. Radiologists in that group are banking really really hard with barely over 40 hours/wk.

Yeah, but groups like that are getting fired and replaced with teleradiology. (And from your description, can't really blame the hospitals for doing it.)

 

[drizzt3117]

Yeah, but groups like that are getting fired and replaced with teleradiology. (And from your description, can't really blame the hospitals for doing it.)

Not here. They have a good relationship with the core hospitals and cover a ton of outlying hospitals in person for procedures daily which would be impossible to replace. My TY uses teleradiology overnight and it's such a f-ing joke that they're getting rid of it soon. All the attendings just ask the in-house radiologists to over-read it in the morning and on medicine, ICU, and surgical services we don't even bother sending out the studies for reads, it's better to just interpret it ourselves or wait for the next day. Teleradiology is so much worse quality; just one moderate lawsuit would eliminate years of profits. This past week a pt had a type A aortic dissection that was read by tele as "no evidence of acute dissection, abnormal contour would appreciate clinical correlation.". The CT surgeons were beyond furious when the overread found the dissection the next AM, luckily the pt is doing ok after surgery.

Actually the trend is toward 24 hour in person attending coverage even at centers with residents, much less the community.

 

[deleted103644]

I'm not saying current teleradiology is any good, but if there is nothing physically tying the radiologist to the hospital (ie no procedures), it's pretty inevitable.

Especially for the cush PP groups that were charging too much and sending their overnight reads to teleradiology anyway.

 

[drizzt3117]

I'm not saying current teleradiology is any good, but if there is nothing physically tying the radiologist to the hospital (ie no procedures), it's pretty inevitable.

Especially for the cush PP groups that were charging too much and sending their overnight reads to teleradiology anyway.

I don't think it is inevitable. You can take call from home and be on call for procedures (IR or otherwise). I'd be fine with this as an attending (nm that I'm doing IR) and so are the people in that group. I believe they do that for outlying hospitals but have one person in house at the big comm hospital overnight. Their group is about 30 ppl so q30 overnight in house call isn't too bad.

 

[deleted103644]

I don't think it is inevitable. You can take call from home and be on call for procedures (IR or otherwise). I'd be fine with this as an attending (nm that I'm doing IR) and so are the people in that group. I believe they do that for outlying hospitals but have one person in house at the big comm hospital overnight. Their group is about 30 ppl so q30 overnight in house call isn't too bad.

Yes, but teleradiology can provide overnight subspecialists. No small group can do that.

I really think this is the future of radiology in non-academic settings. It will suck, but I really do think it's inevitable.

I figure as long as I stick to IR or academic neuro with some procedures I'll be fine.

 

[drizzt3117]

Yes, but teleradiology can provide overnight subspecialists. No small group can do that.

I really think this is the future of radiology in non-academic settings. It will suck, but I really do think it's inevitable.

I figure as long as I stick to IR or academic neuro with some procedures I'll be fine.

A 30 person group will have 5-6 ppl in each subspecialty. They'll take turns taking weeks of home call for stat reads. This particular group even has a dedicated neurointerventionalist.

I've talked with the CEO of my hospital about this; they are thinking about transitioning away from tele for the reasons I mentioned above; this particular hospital is one of the most cost efficient in the country, so I imagine they aren't the only ones who feel this way. Partially it's 2/2 the wholesale revolt from their medical staff.

 

[deleted103644]

There's no real reason for the majority of radiologists to be located at the hospital at all. Sure, physicians can come to talk to them, but you can talk to a remote radiologist too.

I wouldn't rely on the loyalty of other medical staff to keep us in house. The current teleradiology groups aren't that great, but I wouldn't bet my career on them (or their successors) not eventually succeeding.

 

[drizzt3117]

There's no real reason for the majority of radiologists to be located at the hospital at all. Sure, physicians can come to talk to them, but you can talk to a remote radiologist too.

I wouldn't rely on the loyalty of other medical staff to keep us in house. The current teleradiology groups aren't that great, but I wouldn't bet my career on them (or their successors) not eventually succeeding.

I do think it's less common for staff to visit the RR in the community; I don't even know where the RR is at my TY's hospital.

 

[deleted103644]

I do think it's less common for staff to visit the RR in the community; I don't even know where the RR is at my TY's hospital.

It's possible that there's enough inertia to keep teleradiology from taking over everything during our careers, but it seems like a pretty logical next step.

 

[drizzt3117]

It's possible that there's enough inertia to keep teleradiology from taking over everything during our careers, but it seems like a pretty logical next step.

It's been a logical next step for 20 years and hasn't even moved the needle.

 

[deleted103644]

It's been a logical next step for 20 years and hasn't even moved the needle.

The level of technological advancement, particularly in networking and storage, over the past 20 years has been huge. The Internet is only ~20 years old.

Many hospitals still don't use EMR (which is insane), that doesn't make it' adoption less inevitable. There is a lot of inertia in medicine, but these things will still happen.

 

[deleted314957]

I somehow doubt that.

don't

 

[drizzt3117]

The level of technological advancement, particularly in networking and storage, over the past 20 years has been huge. The Internet is only ~20 years old.

Many hospitals still don't use EMR (which is insane), that doesn't make it' adoption less inevitable. There is a lot of inertia in medicine, but these things will still happen.

The problem is, you still need ppl in house for procedures. Telerads is being adopted more by the radiology groups than the hospitals, with some exceptions.

 

[deleted103644]

The problem is, you still need ppl in house for procedures. Telerads is being adopted more by the radiology groups than the hospitals, with some exceptions.

Yes, I already made an exception for procedures.

There have been some attempts to keep procedures within predominantly diagnostic subspecialties, but they could easily all fall under IR (which will probably spin off).

Radiology groups that adopt teleradiology are signing their own death warrants.

Groups that will survive will be providing teleradiology to other groups, not using it to make call easier.

 

[drizzt3117]

We're just going to have to see what happens. I know heads of a number of large, successful radiology groups who all say the same thing. Everyone expects reimbursements to fall a bit but that's the extent of it.

Yes, I already made an exception for procedures.

There have been some attempts to keep procedures within predominantly diagnostic subspecialties, but they could easily all fall under IR (which will probably spin off).

Radiology groups that adopt teleradiology are signing their own death warrants.

Groups that will survive will be providing teleradiology to other groups, not using it to make call easier.