Radiology Question:

"Turf wars." As radiology explodes into a massive field with many new types of imaging studies and applications, specialists from other fields seek to read and interpret the studies that pertain to their field. This is already happening in interventional radiology, where specialists from other fields seek to do minimally invasive procedures, for instance vascular surgery. Other examples include cardiology and their interest to do cardiac CT and MRI. It will be a challenge to prevent the fragmentation of radiology and the assimilation of its parts into other specialties; however, the sheer volume of imaging studies in radiology has increased drastically in recent years and it is doubtful that other specialists will be able to take on a CT work list while also meeting their clinical demands. As a specialty, we need to provide excellent service and interpretation - that's our challenge.
"Outsourcing." Given the portable nature of radiology and high bandwidth network connections, it is possible to have a radiologist on the other side of the world report the same studies we are doing here. There is concern that work for radiologists here will be exported to markets where labour is cheaper. This is happening in the US far more than in Canada. Also, one must consider that radiology training worldwide is not necessarily equivalent. A radiologist in another country may not necessarily be able to provide the same quality of interpretation/consultation that radiologists here may be able to. Secondly, liability becomes an issue. If a radiologist in another country is consistently making misses, who takes responsibility? How is litigation pursued? These are some reasons why outsourcing outside of Canada has not been a major factor here so far. It is more likely that teleradiology partnerships will develop where one group may cover on-call overnight or in smaller groups or practice settings covering vacation or conference leaves. This can also assist with remote centres having difficulty recruiting radiologists or delivering some specialty expertise.
Radiology Training: With the expansion of the specialty comes a massive expansion in the knowledge requirements for graduates from radiology residency. As the specialty continues to grow, the training will evolve to help residents cope with the large amount of knowledge and training required. Future options may be to subdivide radiology residency early on into subspecialties as they do in internal medicine. In Canada, this isn't happening yet, but could evolve to this in the future.