Masters of radiology panel discussion--is imaging in decline?

127 What people really want is health and not health care. We, as radiologists, must prepare ourselves to integrate not only current modalities but also molecular imaging and therapy into better utilization, diagnosis, and outcomes. Even if we succeed in these goals, we still must use the data to inform clinicians and improve their use of imaging. Even as radiology becomes less of an income center and tries to become more clinically productive, we must simultaneously master information and increasingly provide leadership to the entire health care enterprise. Kazerooni: It’s a new reality for radiologists, one that does not seem to have a rapid climb back to the past, and it’s something practices have to adapt to. Our value has been measured and judged for the past one to two decades on examination volume, relative value units, and turnaround times. As a specialty, we’ve become addicted to double-digit growth year over year, turning to “nighthawk” providers to read studies at night because business was so good during the day, abrogating our professional physician relationships. What we have not had to pay attention to—and is perhaps our greatest value—is in consultation, such as discussions about appropriateness of testing for the individual patient. There is often no positive feedback mechanism when a radiologist tells a provider a test is not needed. In fact, the feedback can be seen as negative, obstructionist, laziness, or the commentary of someone who is not a “real” physician. Working toward a reimbursement model that incorporates all we do, not a radiology report alone, would be a fundamental change and aligned with the accountable care organization model of care we are rapidly moving toward. Locally, we’re seeing continued reduction in the growth of radiology in our environment in southeastern Michigan and in the state of Michigan in general. It varies among Masters of Radiology Panel Discussion— Is Imaging in Decline?