Thursday, October 20, 2005

Very interesting article from The Internet Journal of Radiology

Unfortunately, well over 10 years of a “just say yes” philosophy applied, not just in a clinical realm, but in academic realms, is now paying off with grave and dire consequences. While “just say yes” is an effective means of expediting and efficiently obtaining imaging studies for patients, this works when the referring physician is an adequately and competently trained clinician, referring cases for which they have already performed some pre-screening evaluation. In particular, these patients have already undergone a physical exam and historical evaluation by their referring physician that allows them to have a reasonable differential diagnosis of limited scope constructed and then referred for appropriate tailored imaging studies. By removing the radiologist in a primary non-teaching academic center, this allows efficient imaging studies that have been reasonably and appropriately ordered to be performed and to be readily and rapidly interpreted. Though this may allow some unnecessary imaging, particularly as technology evolves, and the referring clinical services are not adequately educated, generally the indication for studies is valid and the efficacy and consequent predictive value positive is high.
In addition, “just say yes” has, in the academic center, trained a generation of clinical physicians to view radiology as strictly a diagnostic tool without need for any expert intervention and as such the radiologist is viewed, in more and more academic centers, as a superfluous intermediary. Many clinical physicians have since expressed that interpretation is viewed as a technical skill rather than as a consultation. If we wish to see a new generation of imaging where radiologists are not viewed in a consultation fashion, but merely as technicians, and their income, livelihood and resources are regulated by actuaries in an insurance system then we should continue “just say yes” for another 10 years. We can hope that the current generation of retiring radiologists can be benevolent enough to understand when they cannot access the imaging that they or their family needs in the next decade.
Full Article at-
Also Read another revealing article by me-

2 comments:

Anonymous said...

what is actually inferred by this article? i'm not clear. does it mean that radiologists should not be consultants but mere technicians?

Sumer's Radiology Site said...

no it means that if we radiologists continue to leave clinicians in control of investigations instead of making them realise that there shud be a consultation with radiologists time will come when they ll regard us as technicians.. im in for a concept of imaging referral where radioloists decide what imaging is to be done!!

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