Is the radiology industry in trouble? Depends on your perspective

An article published in the New York Times last week lamenting the career prospects for budding radiologists appears to be just one more piece of bad news about the state of the specialty.

According to the article--which focused a lot of attention on the recent controversy over the decision by St. Barnabas Hospital to end its radiology residency program--radiology graduates have huge medical bills to pay, are having trouble finding jobs and are wondering whether it's too late to switch specialties.

Even though St. Barnabas ultimately reversed course on that decision, the article goes on to suggest the troubles facing young radiologists are emblematic of those that have depressed the specialty as a whole: "deep Medicare cuts, cut-rate competition driven by technology, doubts about the health value of many tests and procedures and new measures to tilt public money to primary care."

Depressing stuff, indeed.

But a guest editorial published in this month's issue of the American Journal of Roentgenology by Howard Forman, section editor for healthcare policy and quality at the Yale School of Medicine, looks at things from a different perspective.

In the editorial, Forman writes that while he has been relatively pessimistic about issues relating to radiology--particularly those involving reimbursement--since the Deficit Reduction Act of 2005 was signed into law, most of the cuts imagined or predicted at the time have been implemented.

As a result, he says, it's getting pretty hard to argue, from a public policy perspective, that radiologists are overpaid.

It's also become clear that the specialty is adapting to the demands placed on it by such reimbursement reforms, Forman says. For example, more and more radiology practices are providing 24-hour, seven-day-a-week coverage, making it more unlikely that hospitals are going to be looking at outsourcing radiology services if those services already are available in-house.

Put simply, Forman says, radiology is becoming "more efficient and more adept at managing change."

As an optimist, I'm more inclined to share Forman's opinion. Articles like the former suggest that in looking at the state of radiology, the specialty's glass is, at best, half empty.

But, when one thinks about the indispensable role radiologists play in providing innovative and impactful care for their patients, that glass may be half full--and filling. - Mike  @FierceHealthIT

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