The history of New Orleans radiology helps us understand how innovative medical ideas are transmitted and adopted and how the specialty evolved to incorporate these new ideas. As radiology became a ...required component of medical practice, additional expertise was needed. This resulted in the need for standardized specialized training and the necessity for some form of certification. New Orleans radiologists have always been involved in these American Board of Radiology efforts and also have held leadership positions in other national radiology organizations. The practice of radiology evolved from photographers being employees to physicians becoming members of a unique specialty with practice ownership interests. Radiologists united to form large practice groups and joined professional associations to share technological innovations as well as ensure a culture of professional collegiality. In New Orleans, organizations and events such as the New Orleans Radiology Society, the Spring Roentgen Conference, and the New Orleans Ultrasound Association were organized. Local radiologists who directed these efforts also participated on boards of many national radiologic organizations and helped advance the science of radiology. As the financial complexity and political stresses of radiology practice increased, groups merged, with a resultant decrease in individual autonomy and an increase in radiologist burnout. This has directly and indirectly resulted in many radiologists becoming employees as they were in the early days of New Orleans radiology.
Wilhelm Roentgen's discovery of the x-ray in late 1895 was relatively quickly shared with the New Orleans community through reports published in 1896 in local newspapers and medical journals. ...Radiology became popularized through public demonstrations organized by local proponents and was open to both the lay and medical communities. The first clinical x-ray equipment in New Orleans was installed at Charity Hospital in 1896 within the Department of Surgery, and the first examination was performed on December 23, 1896. Initially, those particularly interested in the x-ray phenomenon were photographers and physicists interested in electricity. X-rays were a curiosity, and entrepreneurs set up studios for x-ray photographs and advertised in local newspapers. Early clinical uses were the localization of foreign bodies, particularly bullets, and the evaluation of bones for fractures and other abnormalities. The fluoroscope was quickly adopted by roentgenologists as a faster and easier method for obtaining medical diagnosis but with the disadvantage of the absence of a permanent record. By the early 1910s, the use of x-rays in clinical medicine had been firmly adopted.
Abstract Burnout is a concern for radiologists. The burnout rate is greater among diagnostic radiologists than the mean for all physicians, while radiation oncologists have a slightly lower burnout ...rate. Burnout can result in unprofessional behavior, thoughts of suicide, premature retirement, and errors in patient care. Strategies to reduce burnout include addressing the sources of job dissatisfaction, instilling lifestyle balance, finding reasons to work other than money, improving money management, developing a support group, and seeking help when needed.
The ACR Commission on Human Resources conducts an annual workforce survey to determine the makeup of the radiology workforce and to identify potential plans for hiring new staff in an attempt to ...understand our profession better.
The Practice of Radiology Environment Database group leaders were asked to complete an electronic survey regarding the makeup of their present workforce by subspecialty, as well as the numbers and types of subspecialists hired in 2016 and the numbers and types of subspecialists expected to be hired in 2017 and 2020. They were also asked about midlevel practitioners.
Twenty-six percent of practice leaders (477) representing 11,056 radiologists, 33% of all practicing radiologists in the United States, responded to the survey. The workforce distribution by practice type and radiologists' ages has been relatively stable since 2012. Six percent of the practicing workforce is over the age of 65 years. Sixteen percent of radiologists work part-time, and 21.5% of radiologists are female. The survey results indicate that 1,569 to 2,037 radiologists were hired in 2016. In 2017, 1,826 to 2,370 new job opportunities are anticipated, a 14.1% increase compared with 2016. For 2017, the subspecialists most recruited will be neuroradiologists, general interventionalists, after-hours radiologists, and body imagers. Approximately 2,156 midlevel practitioners are presently working and supervised by radiologists.
The 2017 ACR workforce study shows an optimistic picture and outlook for those seeking jobs as practicing radiologists in 2017. For practice leaders, the market will be much more competitive than it has been in past years.
The hepatorenal index has been reported to be a sensitive and noninvasive test to quantify steatosis, but it is cumbersome and time-consuming and requires specialized software. The aim of this study ...was to improve and simplify the hepatorenal index calculation and determine whether it is an effective tool for differentiating patients with steatosis from those without steatosis, thereby eliminating the need for biopsy in a large number of patients.
One hundred one patients who had undergone ultrasound-guided percutaneous liver biopsy at our institution were selected from a patient database. Patients with renal disease, patients with liver masses, and patients whose liver and right kidney were not included on the same image were excluded. Images were acquired with high-resolution ultrasound, and the hepatorenal index was calculated using freeware based on comparison of hepatic and renal brightness.
Of the 101 patients, 63 had 5% or less steatosis and 38 had more than 5% steatosis. Using freeware available online from the National Institutes of Health, we calculated hepatorenal index values for all patients. Our data showed a strong correlation between the hepatorenal index and percentage of fat (r = 0.71, p < 0.0001). A hepatorenal index of 1.28 or greater had a 100% sensitivity for identifying more than 5% fat, 54% specificity, 0.57 positive predictive value, and 1.0 negative predictive value. If this method had been used prospectively to select patients for biopsy in our sample, 34% of biopsies could have been avoided.
The hepatorenal index is a simple, reliable, and cost-effective screening tool for identifying patients who should not undergo liver biopsy for evaluation of steatosis.
The Society of Radiologists in Ultrasound convened a multidisciplinary panel of experts in the field of vascular ultrasonography (US) to come to a consensus regarding Doppler US for assistance in the ...diagnosis of carotid artery stenosis. The panel's consensus statement is believed to represent a reasonable position on the basis of analysis of available literature and panelists' experience. Key elements of the statement include the following: (a) All internal carotid artery (ICA) examinations should be performed with gray-scale, color Doppler, and spectral Doppler US. (b) The degree of stenosis determined at gray-scale and Doppler US should be stratified into the categories of normal (no stenosis), <50% stenosis, 50%-69% stenosis, > or =70% stenosis to near occlusion, near occlusion, and total occlusion. (c) ICA peak systolic velocity (PSV) and presence of plaque on gray-scale and/or color Doppler images are primarily used in diagnosis and grading of ICA stenosis; two additional parameters, ICA-to-common carotid artery PSV ratio and ICA end-diastolic velocity may also be used when clinical or technical factors raise concern that ICA PSV may not be representative of the extent of disease. (d) ICA should be diagnosed as (i) normal when ICA PSV is less than 125 cm/sec and no plaque or intimal thickening is visible; (ii) <50% stenosis when ICA PSV is less than 125 cm/sec and plaque or intimal thickening is visible; (iii) 50%-69% stenosis when ICA PSV is 125-230 cm/sec and plaque is visible; (iv) > or =70% stenosis to near occlusion when ICA PSV is greater than 230 cm/sec and visible plaque and lumen narrowing are seen; (v) near occlusion when there is a markedly narrowed lumen at color Doppler US; and (vi) total occlusion when there is no detectable patent lumen at gray-scale US and no flow at spectral, power, and color Doppler US. (e) The final report should discuss velocity measurements and gray-scale and color Doppler findings. Study limitations should be noted when they exist. The conclusion should state an estimated degree of ICA stenosis as reflected in the above categories. The panel also considered various technical aspects of carotid US and methods for quality assessment and identified several important unanswered questions meriting future research.
Abstract Purpose The ACR Commission on Human Resources conducts an annual electronic survey to better understand the present workforce scenario for radiologists. Methods The Practice of Radiology ...Environment Database was used to identify group leads, who were asked to complete an electronic survey developed by the Commission on Human Resources. The survey asked group leads to report the number of radiologists they currently employ or supervise, the number hired in 2015, and the numbers they plan to hire in 2016 and 2019. Leaders were asked to report the subspecialty area used as the main reason for hiring each physician, as well the ages and genders of their current workforce. Results Thirty-two percent of group leaders, corresponding to 13,074 radiologists or 39% of all practicing radiologists, responded to this survey. The percentage of practicing radiologists who are male is 78.6%, compared with 21.4% who are female. Six percent of radiologists are older than 65 years, and 22% are between the ages of 56 and 65 years. Nineteen percent of radiologists older than 65 years retired in 2015. Fifteen percent of all radiologists work part-time. Among the part-time radiologists, 9% are male and 30% are female. General radiologists now make up only 13.3% of the radiologist workforce. In 2015, 45% of new hires moved from existing jobs; 55% were first-time hires. In 2016, it is projected that between 1,713 and 2,223 new jobs will be available, a 16.2% increase from hiring in 2015. Conclusions Job opportunities for radiologists have continued to increase since 2013.
