up and coming specialty?

[mountaindew2006]

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out of curiosity what's the newest or old up and coming medical specialty???? any thoughts.

I ask this because I recently spoke with a friend that landed a residency in Interventional Radiology and supposedly she was telling me (and I heard from others) that they will be impinging on surgeons' jobs. Which obviously pi$$es surgeons off.

Just wondering, what are other 'up and coming' professions like this? I'm not asking for someone to look through a crystal ball here (for all you wise ones 😛 ) but just wondering.

later

 

[theduke]

Radiology and pathology will definetly be outsourced once the model is perfected though I suppose interventional radiology will remain profitable and hot as ever

 

[Mike59]

I may sound like a nut- but I honestly feel Family Medicine will be the field of the 21st century (especially in the latter half) 🙂

 

[Whisker Barrel Cortex]

Originally posted by mountaindew2006
out of curiosity what's the newest or old up and coming medical specialty???? any thoughts.

I ask this because I recently spoke with a friend that landed a residency in Interventional Radiology and supposedly she was telling me (and I heard from others) that they will be impinging on surgeons' jobs. Which obviously pi$$es surgeons off.

Just wondering, what are other 'up and coming' professions like this? I'm not asking for someone to look through a crystal ball here (for all you wise ones 😛 ) but just wondering.

later

The way it has worked is that interventional radiology has come up with better and innovative ways to do things (cardiac angiography, peripheral angio with stenting, TIPS, many others) and the clinicians learn how to do them and steal them from radiology. So much of vascular radiology is going to vascular surgery now (and much of the diagnostic stuff has been supplanted by non invasive MR angiography and CT angiography).

As for outsourcing of radiology, if you are talking about consolidation of radiologic services in the US into major centers, I believe it will happen to a certain extent. If you are talking about having radiologists in other countries such as India, very little chance this will be significant due to regulatory and legal implications of having a PHYSICIAN in another country doing the evaluations.

 

[LTbulldogs]

neurology....good money (200k+), hours, lifestyle.....subspecialist in high demand also.....

 

[droliver]

Originally posted by mountaindew2006
I ask this because I recently spoke with a friend that landed a residency in Interventional Radiology and supposedly she was telling me (and I heard from others) that they will be impinging on surgeons' jobs. Which obviously pi$$es surgeons off.

Not exactly. Surgeons are pretty pragmatic about advances in image-directed tx. Percutaneous drainage of intra-abdominal collections & abscesses is one of the most valuable and frequent services IR's provide for general surgeons. It often saves the patient (and surgeon) a pretty morbid operative procedure.

IR is really going to have trouble holding onto therapeutic vascular work though as you get more and more of the vascular surgeons trained in catheter-based treatments. It all has to do 1) with access to the patient, which for the most part will always place IR second to the surgeons or cardiologists & 2) surgeons willing to be backup for complications (for which you might have trouble finding when they themselves do endovascular work & feel no obligation to assist you. Cardiologists kind of have CTVS by the balls & can leverage their influence for coverage like they do already with the cardiac cath lab). I've seen this scenario go down @ 2 hospitals since I started training in 1998 & for the most part the IR's there are now mostly excluded from therapeutic vascular cases & any of the diagnostic angiograms on patients being seen by the large vascular surgery group there.

 

[SoulRFlare]

I think the new up and coming specialties will be new to medicine. possibilities include "genetic surgery/therapy", "nano surgery." also, expect treatment of infectious diseases and inflammation to be prominent. my dad was telling me that in the next 20 years, we will be seeing that most ills of the body are caused by these two interrelated factors...(obviously this doesn't include trauma or genetic disorders, though it could be argued that some genetic defects are induced by viral infection...)

 

[pikachu]

Emergency medicine is growing pretty quickly in popularity. However, for my money, the fields of the future are going to be specialists who treat aging baby boomers/victims of the metabolic syndrome: interventional cards, nephrology, GI. For all the talk about the shortage of primary care doctors, the real shortage is in (sub)specialists and there will be lots of heart disease, kidney failure (hypertension/diabetes), and colon cancer screening in the not so distant future.

 

[USFOptho]

Allergy and Immunology, GI, Interventional Rads;

As for the poster saying Fam practice..

I think this may not be too far off.

I mean, the current medicare/socialist system is going to go bankrupt by 2019 (http://www.local6.com/health/2943071/detail.html), and as such, have to change the system, and FAST.

The people that take the biggest hits in a socialized medicine model are the patients, but the fam practice doctors really get reamed too. As the system changes, I think that family practice will go back to what it used to be: higher quality of care, higher salaries for the doctor, lower costs for the patients.

 

[ZephyrX]

Up and coming in terms of popularity? Money? Or just plain new medical subspecialties?

I think that rheumatology is going to become more famous over the next 10 years and rheumatologists will see a salary increase (they have started to see an increase already). Considering that right now it is not in high demand, i guess it qualifies as up and coming.

As far as cards and gi. If and when non-invasive diagnostics replace cardiac caths and colonoscopies will the tables turn? It is doubtful, I guess, since procedures to correct the findings of screening exams will still exist. Still, it is uncertain what changes to the income of cards/gi's the future will be bring.

 

[waterbug]

I wouldn't worry about path/radiology being outsourced overseas - that is a huge legal liability for hospitals. With the way malpractice is in this country, hospitals need American board certified doctors on their staff.

 

[Neuronix]

Originally posted by LTbulldogs
neurology....good money (200k+), hours, lifestyle.....subspecialist in high demand also.....

That's not what the neurologists here tell me at all. According to a conversation I had with one the other day, academic neurologists should expect to make well under $100k/year. According to a survey I read recently, they also work a high average of hours per week. The neurologists here are all being pushed to bring in research money, as their department loses too much money on the clinical side.

Will this improve in the future? Beats me. It may be better for private practice, just get used to the idea of alot of call.

 

[Gleevec]

Urology

A lot of members in society are up and coming, especially with the advent of drugs like Cialis and Viagra.

😉

 

[Vincristine]

Originally posted by Whisker Barrel Cortex
If you are talking about having radiologists in other countries such as India, very little chance this will be significant due to regulatory and legal implications of having a PHYSICIAN in another country doing the evaluations.

Hmm, I'm sure you know more about this, but my not-so-large mostly community-based hospital already outsources its afterhours radiology to Austrailia (where it's daytime there). From what I hear, they are quite happy with the service and quality of the reads. They know the studies will be read promptly by one of two radiologists who are also available by phone if needed. If figure if it happens in East-Central Illinois, it'll be bigger than that soon.

 

[goobernaculum]

FP can definitely be argued as an "up and coming specialty", but it's gonna mean that a lot of restructuring of the medical system will have to happen first.

neurology? no way. they were seen as the studs/really smart guys as early as the 70s (maybe 80s even), but since MRI and CT technology has been advancing, neurologists have been less "useful", let's say. Though still necessary, neurology is a field on the decline.

VIR is definitely the hot field these days. however, there's some doubt about it's future. i heard one doctor liken it to the biotech stocks in the 90s. VIRs and interventional cards guys step on each others toes a lot, and the cards guys certainly have their eyes on expanding to vasculature beyond the heart. in fact, people say that cards guys might be better at the vasculature work just due to experience, whereas VIR guys have only one solid year of fellowship to train for this stuff (aside from a couple of months in their 4 year rads residency). VIR will definitely stay hot for the next 5-10 years (perhaps more). But the competition might get a little hairy in the future. VIR has the technology, but that's all that's really separating them from the cards guys and even some neurosurgeons getting experience with vasculature.

 

[Whisker Barrel Cortex]

Originally posted by keraven
Hmm, I'm sure you know more about this, but my not-so-large mostly community-based hospital already outsources its afterhours radiology to Austrailia (where it's daytime there). From what I hear, they are quite happy with the service and quality of the reads. They know the studies will be read promptly by one of two radiologists who are also available by phone if needed. If figure if it happens in East-Central Illinois, it'll be bigger than that soon.

The "nighthawk" services are American trained and board certified radiologists that are recruited to go to Australia. I've already gotten some emails about these positions (and I've got 3 years left to go). They pay just as well as American jobs so the expected money saving aspect is not there. It is more of a convenience for radiologists who hire these services to cover their night call so they don't have to do it. This is very common and does not take away jobs from US radiologists, just makes their lives easier. What does not happen is to have reads done by non-US trained radiologists in other countries. This is full of legal ramifications that will prevent its use in my opinion.

 

[Whisker Barrel Cortex]

Here is a link to one of the Australia job opportunities, which I may consider in the future.

http://www.radworking.com/Physician/Index.cfm?source=viewdetail&JobID=4933

 

[mountaindew2006]

Interesting...FP ??? That's an interesting one. However, I suppose with the way medicine is going, insurance companies would much rather pay an FP to remedy a problem before it needs a 'specialist's' attention. My only reservation with that is how about the "attack" of nurse practioners and PAs and the like? I've heard they're already doing a lot of what FPs used to do, especially in rural areas.

Secondly, to play devil's advocate on the subject of radiology. It seems plausible that given an MD with a business degree (or one w/o that for that matter), he/she would try to increase profits by having imaging done by MDs in other countries (ie India). I noticed how people were making reference to legal issues. However, doesnt it seem plausible in a day and age where much of radiologists' jobs can be done at home via the internet (a friend of mine's mother does something like this---she's emailed or transmitted images to read at home) that things could be sent overseas. Say, if someone opened up an institute of radiologic imaging reading services, where hundreds of radiologists were hired to read images and if done CORRECTLY (obviously requiring a lot of training), I dont see how patients nor CEOs of hospitals would have problems with this? Say, if hundreds of highly trained radiologist in India not just random docs over there were to do this, I dont see how this could be stopped? I understand the issues of lawsuits, but radiologists here arent immune to that either.

I'm not saying I'm advocating this, but given the current flow of things it seems this is where things are aheaded--overseas.
In fact, forget about indian. Even places like the caribbean or students from the caribbean, couldnt they just be suffice? Especially those from the caribbean, if they don't pass the boards here, and have MD degrees (valid probably in the caribbean only) couldnt they do this?

Just my thoughts. I dont know if there are restrictions on things like this, but I think there should be given those of us who graduate from US med schools who worked our a$$es of!!

 

[Gleevec]

Originally posted by mountaindew2006
Interesting...FP ??? That's an interesting one. However, I suppose with the way medicine is going, insurance companies would much rather pay an FP to remedy a problem before it needs a 'specialist's' attention. My only reservation with that is how about the "attack" of nurse practioners and PAs and the like? I've heard they're already doing a lot of what FPs used to do, especially in rural areas.

Secondly, to play devil's advocate on the subject of radiology. It seems plausible that given an MD with a business degree (or one w/o that for that matter), he/she would try to increase profits by having imaging done by MDs in other countries (ie India). I noticed how people were making reference to legal issues. However, doesnt it seem plausible in a day and age where much of radiologists' jobs can be done at home via the internet (a friend of mine's mother does something like this---she's emailed or transmitted images to read at home) that things could be sent overseas. Say, if someone opened up an institute of radiologic imaging reading services, where hundreds of radiologists were hired to read images and if done CORRECTLY (obviously requiring a lot of training), I dont see how patients nor CEOs of hospitals would have problems with this? Say, if hundreds of highly trained radiologist in India not just random docs over there were to do this, I dont see how this could be stopped? I understand the issues of lawsuits, but radiologists here arent immune to that either.

I'm not saying I'm advocating this, but given the current flow of things it seems this is where things are aheaded--overseas.
In fact, forget about indian. Even places like the caribbean or students from the caribbean, couldnt they just be suffice? Especially those from the caribbean, if they don't pass the boards here, and have MD degrees (valid probably in the caribbean only) couldnt they do this?

Just my thoughts. I dont know if there are restrictions on things like this, but I think there should be given those of us who graduate from US med schools who worked our a$$es of!!

The thing is not all radiologists will have this problem. Those who work hard in the hospital, help out doctors in person, etc are invaluable and simply cannot be outsourced. The lazy radiologists who want to read films, write up results, and dont really want to interact with anyone else, it would seem those would be the types who would lose their jobs more readily, since they lack the "non-outsourceable" skills that would ensure their job.

 

[pathstudent]

Radiology and pathology will definetly be outsourced once the model is perfected though I suppose interventional radiology will remain profitable and hot as ever

Why do you think that? Hospitals don't hire radiologists or pathologists. They bill patients for their services just like everyone else. Moreover, all a pathologist or radiologist would have to do is to refuse to provide any services to the hospital unless they can provide all their services.

And what about when a serious error is made? The patient won't be able to sue a doctor in another country which would pretty much put a stop to it right there if such a system was in place.

I dont see how patients nor CEOs of hospitals would have problems with this?

CEOs of hospitals don't pay radiologists!

 

[mountaindew2006]

point taken. However, suppose there were radiologists that were willing to work regardless, meaning you did not have a boycott from the radiology department (esp since its very hard to say that EVERYONE would boycott). Moreover, as I stated, I'm sure there are far too many caribbean students who are just looking for the opportunity to jump at a residency spot (and later obv become an attending) that would pretty much work 'as much as possible'.

I guess my real question is this. Are there any laws, etc set up CURRENTLY which would prohibit foreign DOCS from reading/intrepreting imaging? I'm assuming the answer is no since there are docs in australia doing this currently (although someone did state that some were US board certified).

It just bothers me, and is kind of scary that if someone could think of this from a profitable point of view...perhaps a great % of radiologists COULD become jobless ??? I dont know about you but it doesnt sit well.

LOL....and dont worry I'm not planning on going into radiology or anything.
later

 

[El Duderino]

The people that take the biggest hits in a socialized medicine model are the patients

Er... Well, I don't want to get all political and stuff here, but I think the 44 million Americans that don't have any health insurance (and the just as many under-insured) would disagree.

I'm not saying the system stinks, but it definitely has its drawbacks. I would argue that the ones losing out in socialized medicine are the docs. The US is the only country in the western world without universal health coverage, and it is also the country where docs make the most money. Coincidence? Could be, but I don't think so - especially considering the past. In the 70s and 80s, with indemnity plans and fee-for-service being the norm, doctors made a heck of a lot more than they do today. As more and more of the US health care system becomes socialized (by virtue of the ever-growing Medicare and Medicaid) and increasingly funded by the government (45% at the present time), docs probably will see their relative income drop.

JM2C.

 

[mountaindew2006]

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