This comes a lot sooner than I thought...

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Splenda88

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Go figure. The PA works at Penn…
 
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I believe this is a PA at an Ortho office. There are no PAs reading imaging in the department of radiology at Penn.
 
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wholeheartedly said:
Wow. The entire field of medicine just can’t wait to throw it’s young off a cliff can it.
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Medicine abuses their young like the Catholic Church. The only difference is I can’t get on a class action suit for the former.
 
Suppose this stops at outpatient plain films. (I know, creep is constant, and it probably won't). But does that sound so bad? Unloading the mountains of low-RVU outpatient plain films for things like fracture follow up, joints clinics, scoliosis, etc sounds like a god send. Considering how much midlevels are utilized in surgical fields and even primary hospitalist teams, it doesn't seem unreasonable to let the Ortho NP say that the knee joint spaces are well preserved...
 
efle said:
Suppose this stops at outpatient plain films. (I know, creep is constant, and it probably won't).
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Correct: in the UK, radiographers are reading plain films, mammograms, head CT, thoracolumbar spine MRI, knee MR.
 
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Fpg1245 said:
Medicine abuses their young like the Catholic Church. The only difference is I can’t get on a class action suit for the former.
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Catholic Church is disgusting. They sell their soul to the devil and do anything for a buck.
 
Cognovi said:
Correct: in the UK, radiographers are reading plain films, mammograms, head CT, thoracolumbar spine MRI, knee MR.
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They read spine and knee MRI??
 
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Steve_Zissou said:
Yeah, I wouldn’t hang my hat on “midlevels will hopefully not try and take more turf.”
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Look at the silver lining! Surely there will be catastrophic outcomes left and right from letting non-MDs interpret all this....right? Right??

Just found a paper comparing ~200 radiologists vs ~200 radiographers on 1.4 million screening mammos. Non inferior. Yikes. And I mean that yikes as in, oh no maybe an MD really isn't essential value added.
 
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efle said:
Look at the silver lining! Surely there will be catastrophic outcomes left and right from letting non-MDs interpret all this....right? Right??

Just found a paper comparing ~200 radiologists vs ~200 radiographers on 1.4 million screening mammos. Non inferior. Yikes. And I mean that yikes as in, oh no maybe an MD really isn't essential value added.
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Can you post a link for us? I’d be interested to read that.
 
Fpg1245 said:
So the second reads the majority are radiologist/radiographer? Not one or the other?
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I think the UK requires every mammo get read 2x, and this study just compared the initial reads, finding that it doesn't matter whether it's a radiologist or radiographer

"When performing the double reading of screening digital mammograms as the first reader, radiologists and trained radiographers (ie, technologists) demonstrated no difference as readers in cancer detection rates (7.84 and 7.53 per 1000 examinations, respectively; P = .08)"
 
I'm a PA and agree that PA's should not be interpreting imaging. But PA's bring a lot of value to radiology departments as an FYI to those who like to bag on us on this forum.
 
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efle said:
Look at the silver lining! Surely there will be catastrophic outcomes left and right from letting non-MDs interpret all this....right? Right??

Just found a paper comparing ~200 radiologists vs ~200 radiographers on 1.4 million screening mammos. Non inferior. Yikes. And I mean that yikes as in, oh no maybe an MD really isn't essential value added.
Click to expand...
It's neat to think about how radiology is practiced in other settings.
Note that screening mammography is the area of radiology that requires the least knowledge of general medicine/pathophysiology/anatomy; is highly repetitive and tedious (visually and attentionally challenging - finding needles in a haystack - 7-8 cancers per 1000 studies in the UK, 4-5 in the US because we screen more frequently); is highly structured in its reporting and auditable in terms of followup/outcomes (cancer or no cancer dx); and is highly regulated in terms of training and case volume (in the US it's 960 every two years; in the UK it's 5000 mammograms in 1 year regardless of whether you are a radiologist, radiographer, or breast surgeon by background -- all possible paths to becoming a mammographer).

A while ago a paper from Google was talking about replacing the second reader in the UK with AI that made a lot of buzz.

Meanwhile in the US we have for decades used a crappy version of computer intelligence (CAD) to be the second reader.

All this to say that changes are afoot but it's not broadly generalizable across countries and across the whole field of radiology what those changes are.
 
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Some ortho clinics read and bill for their own plain films, this could be one of those. Inb4 "stepping stone" but with the ever growing radiologist shortage, who cares if some plain films get taken (and then inevitably given back to us once someone gets sued for millions after missing a lis franc injury).
 
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