Does hospital-physician alignment jeopardize the future for radiologists?

The future of radiology is up in the air thanks in large part to hospital-physician alignment, New York-based radiologist Dr. Helene Pavlov writes in a recent commentary for While such arrangements can prove beneficial for radiologists in the face of mandatory IT upgrades and changes to reimbursement models, they also tend to lead to reductions in salary and overall use.

IT costs and the ability to negotiate higher fees for service "make a hospital salary appear more secure and desirable than private practice," Pavlov writes. However, she adds, hospital administrators "often believe that radiologists are replaceable; there are 'cheaper virtual teleradiology options' for image interpretation, given that the geographic location for interpreting images is no longer an issue."

Pavlov says that in order to maintain relevance and viability, radiologists today need to be seen as indispensable experts who can provide exceptional service that can't be automated. "They must be able to answer clinical questions accurately for subspecialized clinicians and participate in, if not initiate, clinically relevant research," Pavlov writes. "Justification for employment ... is linked to these value-added services, in addition to critical value reporting, capital resource management, and contributing to a decrease of inappropriate utilization."

Radiologists also must be more willing parts of hospital leadership, helping to ensure cost control clinical effectiveness, Pavlov writes.

"Hospital administrators need to have feedback from their referring physicians and the patients about the direct value imaging and radiologists have in patient treatment decisions," she says. "The challenging part is that these and other quality metrics are essentially intangible and hard to define."

For more on Pavlov's take on hospital-physician alignment in radiology:
- read her full commentary at (reg. required)

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