March 3, 2009

Commoditization of Radiology

In the latest issue of the Journal of the American College of Radiology (JACR), Giles Boland MD took on a hot topic of 'commoditization' of radiology specialty.

What is Commoditization?
  • The word 'commoditization' is actually derived from a noun 'commodity'. Commodity means "a raw material or primary argricultural product that can be bought and sold, such as copper or coffee" , according to an Apple's Dictionary.
  • According to Wikipedia: Commodity is "anything for which there is demand but that is supplied without qualitative differentiation across a market".
  • "A product that is the same no matter who produces it."
  • Examples: oil, rice, sugar, salt, ethanol, gold, silver
What If Radiology Is a Commodity...
  • No referring physicians care whether who interprets the examination.
  • There is no differentiation among different providers.
  • Price of radiology services are determined as a function of the market: fluctuating and universal, changing based on supply and demand.
  • Etc.
What Leads Radiology To Become a Commodity?
  • Electronic imaging network, PACS
  • Teleradiology
  • Individual radiologist
What Radiologists Can Do To Prevent It?
Well, you can't stop the pace of technology (electronic networking, PACS), and business (teleradiology), but you can do more as an individual radiologist:
  1. Be a part of clinical care team: active participation in an interdepartmental conference, active engagement in patient care (phone call or personal discussion)
  2. Build an effective relationship with referring physicians
  3. Guide technologists to obtain appropriate images of high quality
  4. Devise disease-specific imaging protocols
  5. Participate in an effort to reduce radiation dose
  6. Actively involve in reduction of unnecessary imaging and update imaging appropriateness criteria
  7. Educate younger, newcomer radiology residents, fellows, medical students on best imaging practice
  8. Be subspecialized, or at least having an area of expertise in one or two specific modalities or clinical specialties, to keep up with referring physicians.

Boland GWL. Teleradiology for auction: the radiologist commoditized and how to prevent it. JACR 2009 (DOI 10.1016/j.jacr.2008.10.006).

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