Tag: career advice

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Is Radiology Falling Apart Or Will It Continue To Thrive? I Need To Know!

radiology falling apart

Question Theme: Is Radiology Falling Apart?

Hi, thanks for doing this blog, it’s been an excellent resource for me as a medical student interested in radiology.

As a medical student, there is a lot about radiology as a field that appeals to me; the short “patients”, the diagnostic nature (you give your interpretation, and you finish w/ the patient), the fact that work doesn’t come home, the essence of medicine being radiology, the flexibility of the field in having non-medical interests, etc. However, as someone who wouldn’t be practicing for the next 7-8 years at least, and as someone who wants ideally to have a substantial long career, there are a couple of things that give me pause that I hope you can clear up.

1) I’ve heard a lot of conflicting thoughts about the radiology job market and the increasing “race to the bottom” for salaries along with w/ increases on workload. Can you comment at all on this and how you see the trends for several years out?

2) I have always leaned toward being a private practice physician. And, I know the direction across all specialties is increased consolidation (practices being bought out by hospitals, venture capitalists, etc.), but it seems like radiology is more prone to this than other fields. Do you see this trend holding for the near future?

3) Re: increasing workload; how flexible are practice options still? Is going to Hawaii or New Zealand for weeks at a time to do remote reads even feasible? What are the main practice options viable for a starting radiologist outside of being an academic/private radiologist?

4) In a similar vein, do you see radiology going down a comparable path to EM, where you have many shifts at odd times and holidays? With the push towards 24/7 coverage, I’ve heard rumors this could be the future of the field, and I do not like the schedules EM physicians have at all.

5) Finally, as more of a fun question, what are some of the most exciting things on the horizon for radiology as a field? I know we hear a lot about AI, but I’m assuming there’s more in the pipeline besides that. Perhaps any new modalities altogether? Or whatever else is exciting to you personally.

Thank you so much for helping out a “jaded” and burnt out M3! Continue being great!

 

Answers:

Great question(s). Each of these queries can be an entire blog! But, I will try to answer each of these in short order.

Will radiology be involved in the “race to the bottom” for income? Well, I do agree that over time, the workload has been ramping up due to increasing efficiencies created by technology. And, I see that trend continuing. However, the pattern will take a slightly different path. But, let me start with a little radiology history.

Initially, the first expansion of work for radiologists was multiple new modalities  (ultrasound, CT, and MRI.) Then, the next revolution was the PACs system and the digitization of images.  Now, we are about to experience a new generation of efficiency, that would be the software and AI revolution to assist you with your work. So, yes, you will be continuing to read more studies quicker. And, the government will not be adding new money into the system. Therefore, we will be much busier over time, and the money reimbursed per procedure will decline. However, with AI, it may not be “harder” to read these studies because AI will help you with things like triage, dictation, and detection. So, if you like technology and anatomy, radiology will still be the best field in medicine!

What about consolidation? Unfortunately, I believe that this trend will continue for a while. Economies of scale will continue to make larger better. What does that mean for you? You will more likely need to work for either a large private practice group, a corporate entity (i.e., large teleradiology company), or a large academic center. The days of 2-10 person private practices are slowly drifting away! (I was thinking about writing on this topic in an up and coming blog as well!)

How flexible are the options to practice? Well, here is where radiology takes the cake. Again, it depends on your debt load and your desire to work. But, all the options that you mentioned are still available. Hawaii and New Zealand are more than possible. And, you can work any number of days per week. Just like any other field, however, the less you work, the less you will make. So, you need a financial backstop if you want these options! If you desire a more atypical area to practice in radiology, that is available too. Try informatics if that suits you! Or, consultation work is possible. The sky is the limit in terms of flexibility!

Will radiology work turn into ER shift work? I believe you will have several choices and that it depends on how you choose to practice radiology. As I mentioned in the last paragraph, I think we will continue to see lots of options to decide how to practice. But, for many young graduates, you are right, some may be forced to do shift work depending on their debt level and where they want to live. But, by no means, will you have to do shift work. Clinicians wish for the presence of a physical radiologist in their hospitals. And, day time work will still be available.

What do I find exciting about radiology? That can also be an expansive answer. However, I am a nuclear radiologist, and I am fascinated by the new varieties of diagnostic radiopharmaceuticals coming down the pike for all sorts of diseases. Additionally, I see loads of new cancer treatments with new radiopharmaceuticals as well. Moreover, PET-CT and SPECT-CT  technologies are markedly improving, making visualization, and diagnosis more straightforward and quicker. In terms of other areas, MRI is a continually developing field with new sequences and contrast agents in numerous different fields (MSK, Breast, etc.) And, these technologies are expanding on top of an AI platform. So, is the future of radiologist exciting and bright? Certainly, yes!!! And, once again I can’t emphasize enough the answer to the theme of this letter, “Is Radiology Falling Apart?”, a firm no!

I hope this (briefly) answers and alleviates some of your questions and concerns,

Barry Julius, MD

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Brains Versus Breast: Which One To Choose?

brains versus breast

 

Question About Brains Versus Breast:

Dear Barry,

I hope you are doing well. I am PGY4/R3 radiology resident, hesitant between breast imaging and Neuroimaging. And, I have a concern about lifestyle and job market in the next couple of years. Which one do you think, will have a better job opportunity?

Answer To The Brains Versus Breast Question:

Both areas can make for an excellent career, but it all depends on what kind of environment, pressures, and lifestyle you want. To help you out I can give you a little summary of the critical factors about I would be thinking.
First of all, let’s start with the general pressure of work. In Neuroradiology, if you miss something in a film, it can be the difference between immediate life and death. On the other hand, if you miss cancer, the results are not as immediately devastating. However, the patient is more likely to sue you for your mistakes. So, I think that your choice in this department depends on what you feel you can handle. Moreover, you will be more procedure and patient-oriented if you pursue the mammography angle since you will be performing biopsies and seeing patients. As a non-interventional neuroradiologist, most see very few live patients and do fewer procedures.
Next, the lifestyles for both specialties can overlap. However, the mammographer can find more jobs that tend to be five days a week or part-time gigs without call. For the neuroradiologist, most do some inpatient hospital work, so it leads you to find a career with more weekends and nights. Indeed, this lifestyle does not apply to all neuroradiologists, however.
And finally, the job market for both specialties is relatively hot. Both neuroradiology and breast are the most needed radiologists out there. There is no lack of jobs at present. And, if I use my crystal ball, I don’t see any significant change coming through the market shortly. Of course, radiology job markets do change with the economy and macro-factors that I can’t predict. However, as long as the economy remains vigorous and radiologists continue to retire, you can expect a continued hot job market. If we look out to the more distant future, when that changes, so does radiologist job availability.
That’s my little summary for you!
Barry Julius, MD

 

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What Radiology And IR/DR Programs Don’t Tell Applicants About Interventional Radiology!

IR/DR Programs

After all of the hype about the new IR/DR programs, I am not surprised that it has become so attractive for medical students. However, most applicants don’t realize what happens to the typical resident’s desire for interventional radiology after they begin their residency. Of course, these programs don’t tell them that! It’s bad for business. So, I will give you the lowdown.

On the interview trail, at least since when I became a program director, and before the new IR/DR programs existed, a large percentage of medical students have always claimed interventional radiology was their top choice for fellowship. But, as soon as they would arrive at the program, some of these former desires became a wist of memory. And, the other rarified few would make it to their first, second, or third year and then suddenly drop off of the IR bandwagon. Very few who initially wanted interventional would make it to the end of the residency. Why did that happen? Well, I have some theories.

Constant Consents/Too Much Patient Contact

One thing most residents like to complain about (myself included back in the day): scut. And, in the world of interventional radiology, you can find no lack of scut in any corner. Patients need consents. They complain about their symptoms.

Moreover, as a “real” IR doctor, you need to listen. That can become real old quickly if you cannot stand performing these critical patient duties. It’s not why most residents signed up for radiology.

Lifestyle Is Not What They Thought It Would Be

Overall, which radiologist subspecialist awakens the earliest in the morning? Well, that’s easy- the interventionalist. And, who often leaves the latest? The same. Also, some interventionalists may get called in for all hours of the night at any time on their lonesome. Now, radiology may not be the lifestyle specialty that it was years ago in any subsegment of radiology, let alone interventional radiology. Regardless, this sort of long day in interventional does not attract many radiology residents to the field. You may be the only one in your residency!

Risk Of Needlesticks

In any medical field, you will encounter physical dangers. But notably, the interventionalists have a higher likelihood of bodily injury. Most critically, these folks use lots of sharp needles. And, guess what? When you utilize lots of needles, you increase your chances of a needle stick and the good stuff that comes with it- Hepatitis, HIV, and more. Many residents think about this only after they start their residency. And, walla, they make their decision not to enter the field!

You Can Perform Procedures As A DR Graduate

No. Interventionalists are not the only ones that can perform procedures. If you decide to take a rural job or practice as a general radiologist, you will likely be responsible for some of these. I know of many “non-interventionalists” that perform all sorts of biopsies, vascular work, and interventional oncology. So, why bother if you don’t need that extra certificate of qualification?

Not As Glamorous As They First Thought (PICCs and Ports)

Nowadays, most interventionalists perform all sorts of procedures. And, most likely, it will not be many of those stent placements in the neck or embolization of the liver. Most techniques are much more mundane. You will probably have done a lot more PICC lines and Portacaths than any high tech complex procedure out there. Yes, you will be a critical member of the team. But no, you will most likely perform more garden variety interventional procedures than complicated ones.

Heavy Lead

In some “fancy” institutions, they have made sure that each interventionalist needs to wear anti-gravity lead before any procedure. But, more likely than not, you will need to wear a regular lead uniform most of the time. And, unless you maintain yourself in excellent shape, many lead garments tend to cause back and muscle pain. In fact, at a certain age, it is not uncommon for many interventionalists to switch to a DR specialty because of the wear and tear on their bodies. Most new radiology residents do not realize the long term consequences of wearing a heavy uniform until they hear the complaints of their mentors.

 

Bottom Line: What Does This Mean For The Future Of The IR/DR Programs?

After all of these issues, and as much as I like the field of interventional radiology as a profession, I find it fascinating that the IR/DR residency has become one of the most popular and competitive specialties out there. I think many residents have not done their research and have fallen for all the hype.

Now, call me crazy, but I believe that one of two things may happen since residents are signing up early before they get to know the specialty. Either, the attrition rate for these IR/DR residencies may become more significant than the founders realized or the programs will have created lots of disenchanted and unhappy IR/DR clinicians. Only time will tell. I hope I am wrong!

 

 

 

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Which Radiology Practices Are Ripe For A Buyout?

buyout

When they start in practice, most new radiologists fear one thing more than most. Will a private equity firm buy out my practice even before I make partner? For one, this lousy timing can lead to the abandonment of the promise of partnership. Or even worse, it can cause the loss of a job. We discussed a bit about private equity buyouts in a previous blog. But, this week, one of my residents asked a great question. Is it possible to tell which practices are headed for a private equity buyout? So, I thought that would be an excellent topic for today. (Residents come up with the best ideas!) More importantly, I think this will be helpful for many of you in deciding on which practice to join.

How Old Are The Partners?

You might think that age has no boundaries. But that aphorism does not strike true in the world of ownership. If you are looking into a practice where most or all partners are over 50, you may want to think twice.

Think of it this way. Why would someone over 50 not want to receive a premium buyout when their work life may only last another 5 to 15 years? If you, as a partner, had the option of taking a payout of a few million dollars, you would undoubtedly want to consider it, especially since you can continue to work in the same practice, perhaps at a slightly lower income level. But that does not matter. You have received a flush payment that you can add to your investments for your retirement. You would probably come out way ahead of the game.

On the other hand, if most of the partners are under 50, a private equity buyout would not benefit them as much. Why? These folks would be losing out on a higher annual income than owning one’s practice brings. And these radiologists have many more years of work ahead of them.

Location

Depending on the location, a practice may or may not be enticing to a private equity firm. So, what kind of sites would stimulate these companies’ appetites? If I were a private equity firm, I would want to ensure that the practice has a good payor mix. Therefore, the more affluent the community, the more likely a private equity firm would swoop in and buy an imaging business.

Also, if I were a private equity firm, I would want to ensure that I could rapidly recruit radiologists for my practice if the former employees were to leave. So, I do not wish to choose a very rural location where it may be hard to attract on-site radiologists. Or, I do not want to pick a place that may seem undesirable to radiologists.

Age Of The Practice

This factor is likely one that you probably have not thought much about. However, the age of the practice itself can affect how quickly a private equity firm can buy it out. Suppose a radiology business has had long-standing contracts with a hospital or imaging center. In that case, it is much harder for a private equity firm to swoop in and make a hostile takeover. You may have heard of something called goodwill. If a practice has had a contract for, say, fifty years, the price of that goodwill becomes very high. And guess what? The private equity firm would likely have to pay that price to buy out the practice. Private equity firms don’t like to shell out more money than they need.

What Is The Market For The Other Practices In The Area?

So, if you are looking at a practice and you notice that private equity firms have already bought out most of the other imaging centers in the area, well then, likely, the business you are interviewing at will be next. Generally, it is not a good sign when you are talking to the last independent practice in a neighborhood. Likely, that independence won’t last too long!

Partner Dissatisfaction

Finally, you should get a sense of the “esprit de corps” of the partners in a practice. Who wants to let go of a good thing if everyone is happy? Probably no one. So, if the partners seem satisfied, that goes a long way in preventing the business from getting bought out. So, be careful to interview the partners and talk to colleagues to find out how the partners feel about where they work. Smiles can make all the difference in the world.

What Is The Moral Of All This Talk About A Buyout?

Well, it naturally comes back to due diligence. Joining a practice is a significant decision you should not take, especially when you plan to work there for the next 10, 20, or 30 years. Therefore, the possibility of a private equity buyout should be another factor to consider when you are targeting where to interview. You certainly do not want to be left in the dust as an employee when you find out the partners have taken a deal!

 

 

 

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Work Expectations For New Attendings: How To Know If You Meet Them

work expectations

Every career stage has its difficulties. And you thought figuring out the ropes as a resident was difficult? Working as a new board-certified radiologist in your career of interest is no different. Just like you have in the past, you will worry about both the quality and quantity of your work. So, how do you know what you do is enough to make a good impression on your future partners and colleagues? Some would say that if you have to ask this question, you are probably not reading enough. But I think that answer is way too simplistic. Instead of relying on aphorisms, let’s go through some work expectations for completing enough studies at each early stage during the first few months and years before starting as a partner in a practice.

First Few Months Of Work Expectations

At the beginning of your first employment opportunity, most practices tend to give new employees a bit more leeway (although not all!). Rather than focusing on quantity, most practices would want you to concentrate your efforts on maintaining the quality of your work. That said, if you garner a reputation of working slowly as a slug, that is not likely to do wonders for your likelihood of becoming a partner or a long-term employee within a practice. Most practices have unstated minimum work expectations. And as a new employee, you should expect to try to take as much work as you can reasonably muster so long as you are not overdoing it and you are not sacrificing the quality of your work.

You should always try to help by taking extra cases, performing as many procedures as possible, and becoming the “invaluable go-to guy or gal.” Don’t let yourself get stuck in the mind frame of “that is not my responsibility.” Of course, if the folks that run the practice are assigning you duties that you have not trained for and cannot complete, you need to say something. But for the most part, you should welcome the additional responsibilities and expectations the owners have given you.

So, what are some signs that you are not reading enough to maintain weight and meet practice work expectations? If you notice the partners are frustrated that they have to take over much of your work because you are not working fast enough, then maybe you need to consider taking it up a notch. Fortunately, most practices, however, will give you a little bit of leeway at this point in your career.

First Few Years

After the initial probation period, you really have to consider whether you are keeping up with the appropriate amount of RVUs and meeting work expectations. No longer can you rest on your laurels because you are the new gal in town. It’s not just about quality anymore!

At this point, your colleagues expect you to pull your weight by completing your assigned lists, which is why they hired you. In addition, you should be helping out with others; if the day ends at 5 pm and you can help others complete their work after this time, by all means, go ahead. Especially when you have your sights on the partnership, you should put your best efforts forward. At most practices, your performance still counts toward your group’s chances of adding you to their fold.

Which candidates will your practice cut during the first few years? Essentially, any partnership track employees who did not fulfill the expectations of their initial reasons for hiring. If you feel that this includes you in this category, beware!

In addition, those folks on the chopping block include employees that cannot adapt to workload changes and work expectations. Practices are not stagnant. Instead, you can’t expect to read the same amount of studies in any given year. Working conditions can become busier, or your practice may add new modalities and procedures. So, always ask if you are keeping up with their expectations even after your first few months. You are not quite at the end of the tunnel until the group has officially voted you in!

Final Thoughts On Work Expectations

Working at a job where you intend to stay for years is more of a marathon than a sprint. Therefore, your mentality needs to be one of “what can I add to the practice?” rather than “why should I do extra work?” or “it’s not my job!” If you maintain this attitude toward your work, you will not only form good employment habits, but you will also think of your role as part of a team effort, not just pulling for oneself. And in the end, that is what most partnerships expect. So, go forth and put your best foot forward. Then, you, too, will find success!

 

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Private Equity Buyouts Of Radiology Practices – Who Gets Hurt?

privare equity

Why would anyone want to buy out a practice? Well, like all things economic, it’s simple: To make money. And that is what private equity companies do. They take over companies so the owners can collect a share of the profits. And who exactly are the private equity owners? These folks are private groups of investors that pool their money together to purchase companies. But, unlike publicly traded companies, the government does not regulate these companies as strictly.

So, why is this important for the typical radiologist to understand? Within the past few years, consolidation has hit the radiology industry. Some of this consolidation has resulted from private equity companies buying out radiology practices throughout the United States. And, who knows? Private equity companies may buy out your current or future practice. So, here is a summary of what you can expect, who wins, and who loses.

What Happens To The Radiologists After A Buyout?

The radiologist’s destiny is the million-dollar question. (Literally and figuratively!) Soon after a buyout, you may notice that the radiology employees lose some of their ability to advocate for patients (1). The private practice partner radiologists no longer hold the purse strings to enact change. So, all radiology employees of the new private equity entity must follow the rules of the new owner/leader.

Next, contract negotiations ensue. Initially, former partners and employees will tend to get good benefits, similar to the old practice. Over time, however, the stakes can change dramatically. In lean times, salary cuts and layoffs can begin rapidly. Since former partners no longer control the salaries, these folks may have just to take what they get. During more flush times, the former partners no longer reap the potential outsized rewards.

Further, in the future, you may notice that capital expenditures decrease to save profits for the private equity owners. That new CT scanner will be challenging to justify in the budget unless it has the potential to bring in new revenues. Private equity-owned practices can no longer buy equipment with the motivation of improving care alone.

The Winners

The most apparent winners are the older radiologists in the practice who will soon retire anyway. These owners can now collect on a payday that may be as high as 10-12 times their yearly salary. (2) This added benefit, in addition to their savings from years of practice, can allow an early retirement or a more leisurely lifestyle while working fewer days per week.

Depending on the terms of the agreement, the private equity firm can also gain much from buying a practice. The private equity can skim the additional profits previously from its former partners. However, this is all variable and depends on the partnership’s deal.

Occasionally, inefficient practices may also win in these arrangements. For instance, sometimes practices spend too much or cannot take advantage of economies of scale to increase efficiencies. So, it may take an outside entity to improve profitability. Of course, this assumes that the private equity entity knows how to run a practice better than the original employer and delivers some of the added profits to the radiologists. (Many times, that is not true!)

The Losers

Unfortunately, the biggest losers are the former non-partner stakeholders. These include full-time employees and employees on a partnership track. A buyout can derail the best-laid plans for the future. No longer can partnership track radiologists collect upon the sweat equity they have already committed to their years of practice. Likewise, former employees can no longer count on a similar job structure and contract.

The former younger partners may also lose a bit in the deal. No longer can they rely on many years of good salary ahead. The private equity firm will determine its future. On the other hand, at least these former partners will get a portion of a nest egg to add to their future retirement savings in the buyout.

Unlike those practices that stand to gain from a private equity arrangement, other private equity practices may liquidate the assets of an imaging business to the bare bone and improve profitability on paper so that the private equity firm can eventually resell the company to another entity. These sorts of practices can destroy a radiology imaging center. Good employees leave. Morale declines. And ultimately, the radiology practice can cease to exist. It can certainly happen.

How Much Can You Stand To Gain Or Lose?

So, if you are on the winning side of the equation and make 400,000 dollars per year, you may collect over 4-5 million dollars depending on who formerly owned the equipment and resources. That number, combined with continued employment, may satisfy those winners in the deal.

In the losing lane, non-partners no longer have the chance to build equity in practice. If you think about it, you have already committed three years to a partnership track, and the business has not already made you a partner; you have already lost those dollars of sweat equity. So, if your salary was 300,000 and the practice partners made 500,000, you have lost out on the difference of 200,000 dollars per year for three years or 600,000 dollars. You have also missed out on the ability to collect the 500,000 dollars in perpetuity once you have become a partner. Now, you are subject to the whims of the private equity firm.

The Basics Of Private Equity Buyouts

Describing a private equity buyout is relatively simple. It merely follows the laws of economics. You win if you are on the right side of the equation (the senior and private equity partners). On the other hand, if the equation does not favor you (most employees and some junior partners), you lose. So, if you are fortunate enough to choose among multiple deals, ensure you are doing what is best for your practice. A private equity deal can enhance or destroy your radiologists’ livelihoods!

I would love to hear your comments. What do you think about private equity buyouts in the field of radiology? Any experiences with private equity firms?

 

(1) http://www.physicianspractice.com/blog/understanding-hospital-buyouts-physician-practices

(2) https://www.aao.org/senior-ophthalmologists/scope/article/private-equity-buyouts-of-ophthalmology-practices

 

 

 

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Teleradiology, A Risky Business?

It took years and years of hard work and dedication, long hours and sleepless nights, and the time has finally come.  You’ve got your home office set up, a couple of high resolution monitors, a few licenses and insurance in place.  You’re ready to take that leap of faith and get started in the world of teleradiology, right?

After all, entering the world of teleradiology seems like the dream choice for many radiologists.  Whether you’re working in a small practice by day, hospital at night, or trying to balance work and family, teleradiology can be the ideal choice for your primary income or to supplement your income.

Not so fast.  It’s 2017.  Just two decades ago, healthcare providers didn’t face significant penalties for improperly disclosing protected health information (PHI).  Since then, regulations surrounding the privacy and security of PHI have evolved to include strict requirements and corresponding steep financial penalties for non-compliance.

Where does this leave you? Is it far too risky to give it a try?

With security protocols and policies such as Information Security Risk Analysis, Information Security Risk Management Program, Information Security Audit Controls, System Activity Review Policy, Security Incident Response Policy, Data Backup and Storage Policy, Data Disposal Policy, Media Re-Use Policy, Workstation Policy, and Electronic PHI Movement Policy, is it best to stay out of the game?  You will also have to think about privacy policies such as PHI Uses and Disclosures, Patient Access, Accounting of Disclosures, Sanctions Policy, and Breach Policies and Procedures.  Don’t forget about the Regulations imposed by both federal and state authorities – there’s HIPAA, the Privacy Rule, Security Rule, HITRUST, The Omnibus Rule, Unique Identifiers Rule and the Enforcement Rule just to name a few.

Still ready?  Still have that home office, those high resolution monitors, various licenses and insurance in place?  Great!  Let’s do it!

But how?

My suggestion is, find a teleradiology company that has built a strong Data Security and Compliance Department.  A teleradiology company that has taken the necessary measures to secure Protected Health Information. One that is sought after by the larger urgent care centers, hospitals, and government entities because they have put these measures in place.  Urgent Care acquisitions are at an all time high.  These larger healthcare organizations are driving the teleradiology industry to be more security conscious.  If you want to be successful in this industry you will choose a teleradiology provider that is able to meet the expectations of these larger healthcare organizations.

This will be the teleradiology company that grows, and that contracts with the largest clients.

This will be the teleradiology company that safely and securely helps you realize the dream of becoming a teleradiologist.

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Has Technology Ruined Your Chance Of Employment In Radiology?

Has Technology Ruined Your Chances of Employment in Radiology?

Among the many benefits of living in the Computer Age are the rapid technological advancements that continue to bring convenience and joy to our daily lives. From handheld devices with 24/7 internet access to cars that drive themselves, the future many hoped for (and dreamed of) is happening right now. But while the positive aspects of new technologies mostly outweigh the negatives, disruptive change naturally creates both winners and losers, particularly on the employment front. The medical field is not immune to this phenomenon.

In the recent past, victims of technological encroachment tended to be lower skilled workers whose roles could be easily automated. Today however, potential job automation targets include professionals in high-skill fields ranging from law to engineering to medicine. In short, automation is now “blind to the color of your collar”, according to Jerry Kaplan, author of “Humans Need Not Apply”, (https://www.amazon.com/Humans-Need-Not-Apply-Intelligence/dp/0300213557) a sobering book that sheds light on the uncertain future facing modern workforces.

All of this is a roundabout way of asking a very uncomfortable question: Are robots coming for your radiology job?

The short answer is no…but don’t let your guard down. Here’s why.

Today the poster child of artificial intelligence (AI), IBM’s “Watson”, can already find clots in pulmonary arteries. And unlike a busy radiologist who might read 20,000 or so studies per year, Watson is on target to review 30 billion medical images (http://www.medscape.com/viewarticle/863127) It goes without saying that Watson’s only going to get better.

What’s more, a number of Silicon Valley startups are currently applying new technologies to automate and improve the delivery of medicine. One firm in particular, Enlitic, is even developing a deep-learning system that uses AI to analyze X-ray and CT scans. According to an article in the Economist, (http://www.economist.com/news/special-report/21700758-will-smarter-machines-cause-mass-unemployment-automation-and-anxiety) Enlitic’s system has performed 50% better in tests than a group of three expert radiologists at classifying malignant tumors. When used to examine X-rays, their deep-learning system also significantly outperformed human experts. Of course, this emerging technology leaves much to be desired in the bedside manner department, but that’s what robot doctors (http://www.techtimes.com/articles/131870/20160209/will-robots-in-healthcare-make-doctors-obsolete.htm) are for.

Now before you go and trade your radiology degree for a barista outfit, consider the fact that according to most experts, including the CEO of Elitic himself (Igor Barani, MD, a radiation oncologist), artificial intelligence and radiologists aren’t diametrically opposed. In fact, they’re largely symbiotic. By design, AI will increasingly free radiologists from mundane tasks that can be automated, like reviewing CT scans for lung nodules. As Barani puts it, “tasks that can be automated should be given to the machine—not as surrender but secession.” This outlook portends a future in which radiologists are increasingly empowered to deliver better patient care, not supplanted by robotic overlords.

Regardless of what technology naysayers say, there will always be radiology careers for talented individuals (http://scpmgphysiciancareers.com/) to pursue. That being said, the role of radiologists will almost certainly narrow in the coming years and decades to one of inference, not detection — and that’s an important takeaway. With little doubt, the medical field will require fewer radiologists per capita because of deep learning technologies that simply do a better job of identifying anomalies. The successful radiologists of tomorrow will be the ones who can reduce AI-generated data into useful information that helps patients get better, faster. That’s not a future to be scared of; it’s one all current and prospective radiologists should eagerly anticipate.