A Faster Radiologist

One of Henry Ford’s most famous quotes is,

“If I would have asked people what they wanted, they would have said a faster horse.” -Henry Ford

As the story goes, he went on to create the Ford Motor company with the vision of having an automobile owned by every family in America.

He leveraged technology, people, and process to perfect the assembly line. He then was able to mass produce automobiles at an affordable price while simultaneously being able to pay workers more money and creating disposable income for a new class of people.

Diagnostic medicine is at the same turning point.

Radiologists (as all physicians) are measured on production metrics called an RVU or a relative value unit. Based on the amount of time, complexity, and other factors the higher the RVU the higher the professional payment.

Over the years we have seen a rise of technology such as CT, MRI, and hybrid imaging in nuclear medicine and with PET-CT.

The advancement in medical technology has continued to increase and provide more images, with more information, the radiologist’s ability to gather and collect the additional patient information they need to make a definitive diagnosis has also become harder to access. (think EMR and EHR)

In parallel, there has also been tremendous pressure applied to reduce the value of RVU’s in imaging thus forcing physicians to produce more images, with more information, on more people in order to remain “break even.”

Think about walking into work one day and your manager or boss telling you that you need to do 2X the work in the same amount of time or find your salary cut by 50%.

Most of us would say no thank you and walk out the door.

Healthcare does not need faster radiologists.

We need radiologists to educate, listen, and ensure that the right questions are being asked based on a patient’s presentation.

We need radiologists to interpret the “why do I feel this way” and turn it into the “how do I generate the best answer” and lead to the “what do we do to make me feel better.”

We need radiologists to be able to focus on the connections inside of healthcare. Connecting diagnostic questions and answers to other physicians leading to the appropriate treatment(s). Educating other physicians on the right questions to ask, the difference between various imaging technologies, and the importance of having complete information on patients.

Connecting and communicating the information directly to patients while helping them to prepare for their follow-up appointments.

Much like Ford, we need the role of the radiologist to be that…

“Quality Is Job 1.”

We do not need a faster radiologist.

We need a more qualitative radiologist.

Radiology occurs at the N of 1.

As always you can feel free to email me at cancergeek@gmail.com or follow me on Twitter @cancergeek



2 responses to “A Faster Radiologist

  1. I agree that speed of the tools used to diagnose and treat patients is simply not of great value. What patients and their doctors want is guidance in choosing the appropriate test and subsequent treatment. Too many kidney cancer patients at risk for metastases in their lungs are given chest x rays, which will generally not find the small, more treatable mets.

    Others are sent by a less-informed doctor to get a particular treatment which is NOT appropriate for one kind of cancer, yet effective for another.

    Patients want to access their reports as soon as they are created, so as to be prepared to discuss those findings with the doctor. There are too many instances of the problem–the broken rib or gall stone–are not being confirmed, but with the ‘incidental finding” on a growth on a kidney or such. It is not uncommon for that finding NOT to be reported to the patient–or did the doctor simply ignore it?

    Patients come to recognize that it is often the radiologist who is the diagnostician, and that those reports belong to us.

  2. Nice said Andy. Technology can be used to help get answers accurately and efficiently, but someone needs to ensure that we are asking the right questions.

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