An Uncertain Future for Radiology

With today’s changing health care laws and landscape, the future of how radiology is practiced will surely change. If radiologists are not aware of the changes, they will be left behind wondering how their field has become obsolete. 

The Affordable Care Act (ACA) will undoubtedly increase the number of insured patients, which many radiologists will think will ultimately lead to increases in imaging. However, the ACA will also drive down reimbursements for physician services, including radiology tests, by negotiating lower rates to doctors who join the health exchange plans, as well as giving patients more financial responsibility, which will make patients more price-conscious. 

The new laws are changing the health care landscape. More and more solo practice physicians or small group practices are forming larger groups or joining large hospital systems, most likely due to the perceived changes that will occur, some due to the ACA. The possibility of changing reimbursements from fee-for-service to bundled payment based on patient symptoms and patient outcomes is also fueling the shift from small groups to larger groups. 

Where does the change leave the radiologist? In my opinion, if individual radiologists are not perceived as necessary for a practice or health care system, and the perception is that they are easily replaceable, the differentiating factor between radiologists will just be cost and radiologists will just be a commodity.  With the increased competition among different physician specialists for patients and the turf battles that exist over which physician performs certain services, radiologists will be left out of the loop. 

Interventional radiologists have seen this issue over the last few decades and have slowly transformed their practice to a hybrid radiology practice, where they see patients, read radiology cases, and perform image guided procedures.  The rest of radiology needs to follow this approach in order to survive and keep a place in the ever changing health care landscape.