What are your thoughts on radiologists having a private practice?
It's the traditional practice model, although becoming less common.
Do msk radiology fellows get experience in nonoperative sports medicine (i.e. physical exam and injections), or it's all about imaging?
Injections? Yes. Ortho physical exam? No. Some fellowships are more procedural than others, so it's conceivable you could have a "clinic" filled with biopsies (uncommon), pain procedures, etc.
How about a general radiologist having an internet-based practice where he would give 2nd opinion to people based purely on their images? Is that sustainable or they wouldn't pay enough to justify time spent interpreting and explaining those images?
No one would pay a general radiologist for a second opinion. They might pay a subspecialist. Such groups exist, but they're often thinly veiled efforts at drumming up business for plaintiff attorneys. Some of these companies are even co-located with lawyer offices. Regardless, it's an odious way to make a living, in my opinion.
Could a radiologist also bill insurance for a regular patient visit if he talks to a patient/examines him just like a Primary care or PMR doctor? I ask this because I know that many doctors have "patient visits" where they basically read the radiology reports and "explain" it to the patient pretending like they are the ones making those imaging diagnoses.
Yeah. Don't hold your breath. You won't get paid for speaking with patients. Even it were formalized, insurance companies won't reimburse a radiologist for that activity. Some radiologists would like to be able to bill for "non-RVU-producing" tasks, like speaking with providers, tumor board, etc. It's a fine idea, but in the setting declining reimbursements, it's unlikely to happen.
Yet the patient also gets a bill from an imaging center/radiologist who probably spent little time to arrive at his diagnosis.
Oh really?
But if I were a patient myself I probably wouldn't pay for a 2nd radiology opinion, because I doubt it would make any clinical difference.
If you were just a patient, then you probably wouldn't even know what a radiologist is, much less who read your study or be able to understand the report sufficiently to judge its accuracy or relevance.
I don't see how a radiologist can distinguish himself from other radiologists the way a surgeon can distinguish, get a reputation..
That's because you don't really know much about radiology. Radiologists have reputations just like everyone else, but it's not a public one, in keeping with the idea of the radiologist as a "doctor's doctor".