Point: Generalism vs Subspecialization—The ACR Should Encourage Radiologists to Structure Their Practices Around a Model of Subspecialization

Subspecialization in radiology: effects on the diagnostic spectrum of radiologists and report turnaround time in a Swiss university hospital

“…Greater in-depth skills in a well-defined area of their field allow radiologists to solve more complex problems, which is likely to have a positive mental effect. In addition, the growing complexity of a specialty like radiology makes it more and more difficult for an individual radiologist to master all its many facets with the required depth of expertise [17,18].…”

Managing a Multisite Academic–Private Radiology Practice Reading Environment: Impact of IT Downtimes on Enterprise Efficiency

“…In the current complex and resource-intensive health care environment, medical imaging's central role in patient care has mandated that radiology meet the simultaneous requirements of being high quality and delivered in an efficient and timely manner; interpretation of both simple and complex studies needs to be rendered accurately and quickly [1,2]. To meet the goals of accuracy and efficiency, radiology enterprises often create complex IT informatics infrastructures that aggregate cases from multiple sites and distribute them to geographically separate radiologists.…”

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Purpose: The aim of this study was to assess whether the complex radiology IT infrastructures needed for large, geographically diversified, radiology practices are inherently stable with respect to system downtimes, and to characterize the nature of the downtimes to better understand their impact on radiology department workflow.Methods: All radiology IT unplanned downtimes over a 12-month period in a hybrid academiceprivate practice that performs all interpretations in-house (no commercial "nighthawk" services) for approximately 900,000 studies per year, originating at 6 hospitals, 10 outpatient imaging centers, and multiple low-volume off-hours sites, were logged and characterized using 5 downtime metrics: duration, etiology, failure type, extent, and severity.Results: In 12 consecutive months, 117 unplanned downtimes occurred with the following characteristics: duration: median time ¼ 3.5 hours with 34% <1.5 hours and 30% >12 hours; etiology: 87% were due to software malfunctions, and 13% to hardware malfunctions; failure type: 88% were transient component failures, 12% were complete component failures; extent: all sites experienced downtimes, but downtimes were always localized to a subset of sites, and no system-wide downtimes occurred; severity (impact on radiologist workflow): 47% had minimal impact, 50% moderate impact, and 3% severe impact.

Conclusions:In the complex radiology IT system that was studied, downtimes were common; they were usually a result of transient software malfunctions; the geographic extent was always localized rather than system wide; and most often, the impacts on radiologist workflow were modest.

INTRODUCTIONIn the current complex and resource-intensive health care environment, medical imaging's central role in patient care has mandated that radiology meet the simultaneous requirements of being high quality and delivered in an efficient and timely manner; interpretation of both simple and complex studies needs to be rendered accurately and quickly [1,2]. To meet the goals of accuracy and efficiency, radiology enterprises often create complex IT informatics

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Musculoskeletal Radiology Practice Subspecialization in Canada: A Subject of Substance?

“…They claim that a subspecialized structure enables a practice to complete the work faster and more accurately. 2 Others view it differently, noting that many imaging referrals come from primary care physicians, who are generalists in their own right. 3 They also worry that the profession might be at risk of fragmentation if it consists only of subspecialists because these radiologists may feel a stronger collaboration with their medical and surgical colleagues, eventually migrating to those outside departments.…”