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  • #31
    Different perspective.
    I have been at it for a long time and I am constantly learning new things.

    We update our scanning protocols at least every 3 years but most change faster with hardware and software upgrades.

    I study something every day. There are always new papers coming out, expanding what we know or telling us that something we used to believe was never true. Every time I give a lecture I have given before I have to revise it because the field has moved on.

    I am not worried about physician extenders taking over parts of the practice. If there is something that does not require medical training to do, then a doctor should not be doing it. If we can have NPs or PAs do some low level stuff, great. Same for simple procedures. You don't need a doc taking blood pressures or starting IVs. People with less education and training can do those things just fine. Same for any other simple tasks in medicine. Save the docs for practicing medicine.

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    • #32
      MS4 here (I find out if I match into rads in 10 days!). The most recent ACR Bulliten had an article which cited some statistics that 80% of the rad workforce is 45 and older and 50% is 55 and older. Presumably, many more retirees by the time we are practicing.

      Using Econ 101, less supply (I.e. retiring radiologist workforce) + increased demand (imaging demand is largely expected to increase) = increased price (I.e. compensation) for radiologists. This is probably and oversimplification of a complex issue, but you get the point.

      Anecdotally, I had many rads on the interview trail boasting about how great the job market is right now. Could change in 6 years (7 for you as MS3). Who knows.

      Regardless, if you like the speciality, go for it.

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      • #33
        Originally posted by FI-RADS View Post
        MS4 here (I find out if I match into rads in 10 days!). The most recent ACR Bulliten had an article which cited some statistics that 80% of the rad workforce is 45 and older and 50% is 55 and older. Presumably, many more retirees by the time we are practicing..
        Seems about average. Psych and Pathology, lots of old fogies. (and apparently thoracic surgery??)

        https://www.aamc.org/data-reports/wo...specialty-2019

        More interesting would be numbers over 65 or 75

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        • #34
          Originally posted by bosoxs505 View Post
          I am a third year medical student pretty interested in pursuing a radiology residency. I have been following this forum for quite some time and know there are some radiologists on here. I was wondering what the future of the field looks on with the utilization of AI and how that will affect compensation and job prospects going forward.
          It's a fair question, but the answer is that a good human radiologist is worth their weight in gold. Thoughtful clinicians know this, and it is usually reflected in medical school. But, many physicians really have a limited idea of what we do and the general basic knowledge we all learn in residency.

          Zeke Emanuel, the architect of the ACA under Obama, gave the Keynote speech at the ACR meeting in 2016. He essentially told a few thousand radiologists that AI was going to replace them, saying, "we have self driving cars, clearly similar technology can interpret radiology images". If you don't understand what radiologists do, and hate them for some reason, this is a tempting extrapolation. The truth is, machine learning is good at detecting variations in anatomy - picking out lung nodules, calcifications on mammograms, possible areas of ischemia that are undetectable otherwise, etc. Doing work that is hard for humans. What they do not have is the ability to process the information in the clinical context: give recommendations for follow up, talk to clinicians on the phone, do a biopsy, or interpret things that are not pathognomonic (which is most things).

          You don't see NP/PAs interpreting radiology images (yet!?!?), while they work in almost every other context in clinical medicine. That says a lot. Good radiologists are hard enough to find, - nobody is going to be trusting an AI algorithm any time soon. Not before you see a robot for routine clinical concerns, in my opinion.

          Plus, the ACR is an incredibly influential organization in Washington, and any changes that influence rich radiologists, there is going to be a knock-down drag-out fight about it!



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          • #35
            AI will replace Radiologists when AI will fly airplanes with no pilots. I'll pick the plane with the pilot. Every. Single. Day.

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            • #36
              Originally posted by Adam Pontipee View Post
              Plus, the ACR is an incredibly influential organization in Washington, and any changes that influence rich radiologists, there is going to be a knock-down drag-out fight about it!
              As influential as us physicians like to think we are, individual physician groups are mere grains of sound on the lobbying beach.

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              • #37
                Originally posted by Adam Pontipee View Post

                It's a fair question, but the answer is that a good human radiologist is worth their weight in gold. Thoughtful clinicians know this, and it is usually reflected in medical school. But, many physicians really have a limited idea of what we do and the general basic knowledge we all learn in residency.

                Zeke Emanuel, the architect of the ACA under Obama, gave the Keynote speech at the ACR meeting in 2016. He essentially told a few thousand radiologists that AI was going to replace them, saying, "we have self driving cars, clearly similar technology can interpret radiology images". If you don't understand what radiologists do, and hate them for some reason, this is a tempting extrapolation. The truth is, machine learning is good at detecting variations in anatomy - picking out lung nodules, calcifications on mammograms, possible areas of ischemia that are undetectable otherwise, etc. Doing work that is hard for humans. What they do not have is the ability to process the information in the clinical context: give recommendations for follow up, talk to clinicians on the phone, do a biopsy, or interpret things that are not pathognomonic (which is most things).

                You don't see NP/PAs interpreting radiology images (yet!?!?), while they work in almost every other context in clinical medicine. That says a lot. Good radiologists are hard enough to find, - nobody is going to be trusting an AI algorithm any time soon. Not before you see a robot for routine clinical concerns, in my opinion.

                Plus, the ACR is an incredibly influential organization in Washington, and any changes that influence rich radiologists, there is going to be a knock-down drag-out fight about it!


                Doesn’t imaging reimbursement get cut like all the time?

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                • #38
                  Originally posted by Turf Doc View Post

                  Doesn’t imaging reimbursement get cut like all the time?
                  Not without a knock-down drag-out fight from rich radiologists.

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                  • #39
                    Originally posted by FI-RADS View Post
                    MS4 here (I find out if I match into rads in 10 days!). The most recent ACR Bulliten had an article which cited some statistics that 80% of the rad workforce is 45 and older and 50% is 55 and older. Presumably, many more retirees by the time we are practicing.

                    Using Econ 101, less supply (I.e. retiring radiologist workforce) + increased demand (imaging demand is largely expected to increase) = increased price (I.e. compensation) for radiologists. This is probably and oversimplification of a complex issue, but you get the point.

                    Anecdotally, I had many rads on the interview trail boasting about how great the job market is right now. Could change in 6 years (7 for you as MS3). Who knows.

                    Regardless, if you like the speciality, go for it.
                    Good luck on the match.

                    In terms of old rads working, I would say radiology caters towards allowing people to work later in life relative to other specialties. There are no physical demands so as long as you have your eyesight and can pick up the dictaphone, you can work as a diagnostic guy/gal.

                    The supply and demand curve for rads is a bit diff than other specialties due to tele and increased associated efficiency. Most non-microscopic size hospitals in rando BFE need a surgeon, a hospitalist and/or some sort of doctor to see patients and consults but the creation of telerads has enabled a degree of efficiency that isn't common in other specialties. Instead now the few studies that random BFE hospital would do can be farmed out to tele without requiring an on-site or in network radiologist. These economies of scale will probably persist and strengthen and we will likely see less and less small town radiologists with everything mainly done by tele or a large medical center with various satellite clinics/campuses. This would likely somewhat reduce demand for rads. To what degree this is offset by the fact that the ED wants to do a head to toe CTA on every patient that walks in the door, is anyone's guess.

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                    • #40
                      Originally posted by Turf Doc View Post

                      Doesn’t imaging reimbursement get cut like all the time?
                      Yes

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                      • #41
                        Reimbursements for all specialists get cut. Some of the cuts for radiology reflect increases in efficiency. Radiologists read a lot more cases now than they used to.

                        I do not see telerad reducing the need for radiologists. The cases still need to be read. They never needed to be read by someone on site. Systems were just set up that way. Telerad has been booming along with the market for radiologists. One can now work in a small town and read cases from anywhere this lets those who want it to do geographic arbitrage- work in a low cost of living area but do the same job as if they were in Manhattan.

                        Right now, some small hospitals are paying premiums to have some radiologist presence on site for the services that require that and farming out the rest.

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                        • #42
                          Originally posted by afan View Post
                          Reimbursements for all specialists get cut. Some of the cuts for radiology reflect increases in efficiency. Radiologists read a lot more cases now than they used to.

                          I do not see telerad reducing the need for radiologists. The cases still need to be read. They never needed to be read by someone on site. Systems were just set up that way. Telerad has been booming along with the market for radiologists. One can now work in a small town and read cases from anywhere this lets those who want it to do geographic arbitrage- work in a low cost of living area but do the same job as if they were in Manhattan.

                          Right now, some small hospitals are paying premiums to have some radiologist presence on site for the services that require that and farming out the rest.
                          tele enables more efficiency in that you only need a IR/mammo for boots on ground. Before I envision lots of rads in BFE(in aggregate) who frankly weren’t busy. There is no need for that in future when you have a bunch of tele guys/gals running really fast on their mouse wheel cranking through tons of studies.

                          the cases still need to be read but that is easily absorbed by large tele networks instead of having a rad sit around in BFE who is frankly doing like 0.5 FTE workload.

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                          • #43
                            Once there is another leap in AI technology and computing power the. all kinds of human jobs will be replaced. We just don't know what it will be yet, but its coming.

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                            • #44
                              Originally posted by resident_1 View Post
                              Once there is another leap in AI technology and computing power the. all kinds of human jobs will be replaced. We just don't know what it will be yet, but its coming.
                              Computer operators and data entry clerks have all been made obsolete by technology.

                              My guess, most migrated to web design or social influencers on YouTube. The point is new opportunities are typically created, typically in the same industry.

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                              • #45
                                Originally posted by resident_1 View Post
                                Once there is another leap in AI technology and computing power the. all kinds of human jobs will be replaced. We just don't know what it will be yet, but its coming.
                                People have been saying this for many decades now. It will surely happen at some point, that's true, but we don't know if in 20, 100, or 200 years from now.

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