On the flip side, the fun part of doing client visits is meeting our clients! Especially fun for me is my habit of going into emergency rooms of hospitals we cover in the middle of the night (or at least in the late evening) and meeting the ED physicians we actually work with, many of whom I have spoken with hundreds of times over the years but never actually met. On this trip I met with three such, in different ERs across the northeast, and the experience was I am happy to say mutually gratifying. The coolest thing is the look of recognition that dawns on the face of the ED doc when I introduce myself, one that says, “Hey I know that voice…” and the look of wonder that follows – one of the docs followed up the look with the words “well, I’ll be darned!” One technologist said to me “you’re actually real??!!” to which I just had to respond by saying “go ahead and pinch me and find out!”
Another interesting experience I had is when I visited one of our client hospitals during the day. The radiologist who took me around to the ER, introduced me to the ED physician, beginning by first introducing himself to her. I was intrigued when she responded “ Oh hi, we’ve spoken on the phone a bunch of times but never actually met”. I couldn’t help thinking – wait a minute, these are folks who work in the same building!! – so Teleradiology isn’t all that remote after all!!!
Among my favorite ED physician conversations is with a female ED physician who worked nights (and whose husband evidently worked days) who once said to me “hey there’s something wrong here, I’m speaking to you more often than I speak to my husband!”
And that is the fun part of day-night international Teleradiology!
Client Visits
I am currently finishing up a hectic round of client visits in the North Eastern United states and the thing that has struck me on this trip that is unprecedented is the sense of uncertainty and pessimism that seems to permeate the field of clinical radiology in the US. Over and over again I have heard the same reports of declining radiology reimbursements, radiology groups losing their contracts, a hypercompetitive job market etc etc etc. Senior radiologists are holding on to their positions and refusing to retire. And fresh graduates are doing fellowship after fellowship as no job is readily available. The conversations typically end with the expressed hope that as in the past this is just the worst point of a cycle and that things can only improve…
Interestingly for me, I have seen a whole such cycle – when I finished my residency training in 1998 the situation was similarly grim, with few job
opportunities. As a result medical graduates in the US stopped applying for radiology residencies. Consequently a few years later there was again a radiologist shortage and opportunities were once again plentiful.
The pendulum has now come full swing. During downturns, there is always a concern that they will last forever, but the only practical philosophy now for radiology groups is to just focus on doing a good job and let the rest take care of itself, as the forces at play are beyond anyone’s individual capacity to withstand.
One such force, intriguingly is the large University hospital practice which is extending its tentacles statewide. In at least two states in the northeast, I heard of such a situation, wherein a large University hospital had taken over a smaller community hospital in its vicinity. In one case, the radiologist group at the smaller hospital was effectively ousted in the process.
I find this intriguing because for the longest time, the telerads have been the ‘bad guys’ – the commoditizers of radiology practice, and the people who came in and stole radiology practices, and all were tarred with the same brush, regardless of whether or not they ascribed to this ethic.
Now all of a sudden it is the large academic practices that are showing ‘predatory’ tendencies. I am curious to see if this trend will be commented upon, or, whether, like global warming, it will be largely ignored.