Radiologists writing on KevinMD about imaging: the radiologist shortage behind delayed reads, radiation dose, mammography and the screening argument, whole-body MRI sold as prevention, point-of-care ultrasound, and whether AI replaces the radiologist, argued by radiologists on both sides. Two maintained records draw on this archive: Cancer: what physicians say, in their own words, and Artificial intelligence: what physicians say, in their own words.
Waiting seven days or more to get a report of your recent CT scan? Welcome to today's new normal. Until a couple of years ago, the digital transformation of radiology dramatically shortened turnaround times of report delivery. The last-century process…
Waiting seven days or more to get a report of your recent CT scan? Welcome to today’s new normal. Until a couple of years ago, the digital transformation of radiology dramatically shortened turnaround times of report delivery. The last-century process of audio dictation, manual transcription, editing, and signing final reports was replaced by direct voice recognition software. Radiologists became the transcribers and editors. Turnaround of reports from study time shortened …
Every day, thousands of health care workers put on lead aprons before stepping into imaging suites, fluoroscopy rooms, and interventional radiology labs. These garments, unglamorous, heavy, and easy to overlook, are the last line of defense between clinical staff and…
Every day, thousands of health care workers put on lead aprons before stepping into imaging suites, fluoroscopy rooms, and interventional radiology labs. These garments, unglamorous, heavy, and easy to overlook, are the last line of defense between clinical staff and the cumulative effects of ionizing radiation. According to the World Health Organization, repeated exposure to radiation can lead to skin and blood damage, cataracts, infertility, congenital disabilities, and …
A third-year medical student told me last month she was not going to apply to radiology. She had been interested all through second year, had done a sub-internship she liked, and had the grades to match anywhere. Then she changed…
A third-year medical student told me last month she was not going to apply to radiology. She had been interested all through second year, had done a sub-internship she liked, and had the grades to match anywhere. Then she changed her mind. The reason, almost verbatim: “My advisor said I should not go into a field that AI is going to replace.”
For decades, an Alzheimer's disease diagnosis has been viewed as simply a confirmation of a disease, not an opportunity for treatment. Typically, patients or family members would notice subtle changes in memory. Once these symptoms reached the point where concern…
For decades, an Alzheimer’s disease diagnosis has been viewed as simply a confirmation of a disease, not an opportunity for treatment. Typically, patients or family members would notice subtle changes in memory. Once these symptoms reached the point where concern was raised to a physician, and referrals were made, often leading to months of waiting to see a neurologist, opportunities for even symptomatic treatment were significantly smaller. This diagnosis-to-treatment gap …
Emergency medicine is exciting, at least, that is the story we tell. It is so exciting that there are entire television (TV) shows built around it. Resuscitations, critical illness. And medical mysteries we get the first crack at solving. That…
Emergency medicine is exciting, at least, that is the story we tell. It is so exciting that there are entire television (TV) shows built around it. Resuscitations, critical illness. And medical mysteries we get the first crack at solving. That is what draws people in. It is what drew me in. But the truth is, real emergency medicine does not look like television. After medical school and residency, after the …
In global conversations about the future of radiology, artificial intelligence (AI) is often positioned as the solution to the field's most pressing challenges. From improving diagnostic accuracy to reducing physician workload, the possibilities seem extensive. Yet, as a medical student…
In global conversations about the future of radiology, artificial intelligence (AI) is often positioned as the solution to the field’s most pressing challenges. From improving diagnostic accuracy to reducing physician workload, the possibilities seem extensive. Yet, as a medical student training in Nigeria, I have come to realize that the conversation around sustainability in radiology must begin much earlier, specifically at the point of access. In my training, I have …
The saying, "treat the patient, not the X-ray," captures a core challenge we face in spine practice: Clinical symptoms and imaging findings often do not align, making it crucial to approach imaging with a structured framework. This lesson was evident…
The saying, “treat the patient, not the X-ray,” captures a core challenge we face in spine practice: Clinical symptoms and imaging findings often do not align, making it crucial to approach imaging with a structured framework. This lesson was evident when we treated two patients with strikingly different presentations. The first was a 35-year-old woman whose MRI report identified severe scoliosis and spinal stenosis. Yet, she was totally asymptomatic, with …
Last year, a 45-year-old woman walked into my screening center in Laurel, MD. She was fit, healthy, and had no symptoms whatsoever. She just wanted peace of mind, the kind of baseline health data that her annual physical could not…
Last year, a 45-year-old woman walked into my screening center in Laurel, MD. She was fit, healthy, and had no symptoms whatsoever. She just wanted peace of mind, the kind of baseline health data that her annual physical could not provide. Ninety minutes later, her whole-body MRI revealed a kidney tumor she did not know existed. No pain. No blood in her urine. Nothing to suggest she was harboring …
In medical school, we only learn a fraction of what we need to know to succeed as doctors. The rest, we learn serendipitously through role modeling, trial and error, and other venues. Without luck, however, we may not learn these…
In medical school, we only learn a fraction of what we need to know to succeed as doctors. The rest, we learn serendipitously through role modeling, trial and error, and other venues. Without luck, however, we may not learn these factors at all. It turns out that unspoken forces, the so-called “hidden curriculum,” may have a greater impact on our personal and professional outcomes than most people realize. As educators …
I hold medical licenses in multiple states. As a teleradiologist, I have to; it is the nature of the work. What I did not fully anticipate was how much time I would spend navigating the patchwork of continuing medical education…
I hold medical licenses in multiple states. As a teleradiologist, I have to; it is the nature of the work. What I did not fully anticipate was how much time I would spend navigating the patchwork of continuing medical education (CME) requirements that vary significantly from state to state.
The variation in numbers
In Montana, the state requires exactly zero hours of CME for license renewal. Drive across the border to Washington, …
The use of MRI body scanning as a preventative tool was highlighted by the president's recent rope-a-dope with the media. Community practice whole-body MRI businesses now exist, local entrepreneurs directly marketing these services to the public. These scans are not…
The use of MRI body scanning as a preventative tool was highlighted by the president’s recent rope-a-dope with the media. Community practice whole-body MRI businesses now exist, local entrepreneurs directly marketing these services to the public. These scans are not reimbursable by traditional health payers.
The attraction of MRI is its lack of ionizing radiation, as well as its proven sensitivity to a variety of pathologies. Example: Detection of breast …
He spent his youth memorizing lungs. That was how he learned chest X-rays, not by chasing abnormalities, but by studying thousands of perfectly normal films until his eyes could sense when something was ever so slightly wrong. "If you don't…
He spent his youth memorizing lungs. That was how he learned chest X-rays, not by chasing abnormalities, but by studying thousands of perfectly normal films until his eyes could sense when something was ever so slightly wrong. “If you don’t know normal,” he would tell residents, “you’ll never understand abnormal.”
He was a chest physician, not a radiologist, yet his skill with chest imaging became legendary. At Taipei Veterans General Hospital, …
In December 2017, a fellowship-trained neuroradiologist in good standing was pulled off his teleradiology shift mid-interpretation by the police, put in handcuffs, and taken to jail. He was accused of reading ultrasound studies too quickly, approximately three to five minutes…
In December 2017, a fellowship-trained neuroradiologist in good standing was pulled off his teleradiology shift mid-interpretation by the police, put in handcuffs, and taken to jail. He was accused of reading ultrasound studies too quickly, approximately three to five minutes per interpretation, inconceivable to the district attorney and their hired plaintiff radiologist expert. Because there were Medicaid patients involved, he was said to be defrauding the government. The allegation was …
The patient was in her forties. She experienced chest pain, but it did not appear to be "classic." Her ECG was normal. Her labs did not raise alarms. The team leaned toward anxiety. Hours later, she went into cardiac arrest…
The patient was in her forties. She experienced chest pain, but it did not appear to be “classic.” Her ECG was normal. Her labs did not raise alarms. The team leaned toward anxiety. Hours later, she went into cardiac arrest from a heart attack. That silence after the code still stays with me. We anchored on the first test. We closed the case too early. We stopped listening to her …
As physicians, we are highly motivated, educated, hardworking and compassionate individuals. We deserve the best that life can offer. I do not mean the nicest houses or fanciest cars (although there is nothing wrong with luxuries). What I am referring…
As physicians, we are highly motivated, educated, hardworking and compassionate individuals. We deserve the best that life can offer. I do not mean the nicest houses or fanciest cars (although there is nothing wrong with luxuries). What I am referring to is having the type of career that brings out the best in us. A work environment that allows us to share our gifts easily and effortlessly ultimately contributing to …
Emergency physicians Resa E. Lewiss and Courtney M. Smalley discuss their article, "Why point-of-care ultrasound belongs in emergency department triage." Amid the crisis of overcrowded waiting rooms and long wait times, they argue for the immediate integration of a powerful,…
Emergency physicians Resa E. Lewiss and Courtney M. Smalley discuss their article, “Why point-of-care ultrasound belongs in emergency department triage.” Amid the crisis of overcrowded waiting rooms and long wait times, they argue for the immediate integration of a powerful, underutilized tool: point-of-care ultrasound (POCUS). Resa and Courtney use compelling …
That was one of my uneventful night duties—until early morning. As usual, I had a hectic on-call day, where I barely got half an hour for dinner—which we consider routine. Around 3 a.m., I received a request for an abdominal…
That was one of my uneventful night duties—until early morning. As usual, I had a hectic on-call day, where I barely got half an hour for dinner—which we consider routine. Around 3 a.m., I received a request for an abdominal CT scan for a middle-aged male patient with abdominal pain. The surgeons were suspecting mesenteric ischemia—blockage in abdominal vessels, which can be life-threatening.
As a radiologist, I've heard the same question too many times, usually from anxious medical students struggling to decide if they should pursue radiology: "Is AI going to replace radiologists?" I understand the concern. I had similar fears during training.…
As a radiologist, I’ve heard the same question too many times, usually from anxious medical students struggling to decide if they should pursue radiology:
“Is AI going to replace radiologists?”
I understand the concern. I had similar fears during training. But after years of practicing medicine and watching AI promises play out in the real world, I can confidently say this: AI is not replacing radiologists. It’s not even close. And those …
Dreaming of medicine Everyone has an origin story. Mine doesn't include any radioactive spiders or vats of glowing fluid, but I did get a few extra volts of electricity being defibrillated back to life at seventeen, and that's close enough…
Dreaming of medicine
Everyone has an origin story. Mine doesn’t include any radioactive spiders or vats of glowing fluid, but I did get a few extra volts of electricity being defibrillated back to life at seventeen, and that’s close enough to a tragic backstory for me. It was a short-lived event, but long enough to change everything. I remember the blur of motion as a team of doctors worked around me. …
Nationwide, radiology groups are approaching hospitals and asking for massive subsidies to maintain their radiology coverage. Much of the time, hospital administrators and CEOs balk and would prefer to drag their feet or try to replace the group rather than…
Nationwide, radiology groups are approaching hospitals and asking for massive subsidies to maintain their radiology coverage. Much of the time, hospital administrators and CEOs balk and would prefer to drag their feet or try to replace the group rather than pay market rates for radiological services. These hospitals end up paying double or even triple for worse coverage with some of the same radiologists—while those radiologists end up making much …
