David Pryluck, MD, senior associate dean, American University of the Caribbean School of Medicine

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Imaging Policy & Legislation

Salary Data Reveal Medicine’s Golden Cage

Are you a glass-half-full or a glass-half-empty kind of person? Either way, there’s lots to unpack in the latest data on physician salaries, this time from Medscape. 

Medscape’s survey of over 10k US physicians across over 29 medical specialties found that overall physician salaries have grown 18% over the last five years, to $352k, while specialists made an average of $382k. 

As with last year, radiologists landed in the top 10 of highest-compensated specialists, a finding that’s in line with previous salary surveys, such as from Doximity. Medscape found that radiologists had an average annual salary of $483k in 2023, compared to $437k in 2022. Radiologists had an average annual salary of $504k in the Doximity data. 

Other nuggets from the Medscape survey:

• “Stagnant” reimbursement relative to rising practice costs has cut into physician income. 
• The gender gap is narrowing. Male primary care doctors in 2023 earn 19% more than females, compared to about 25% previously.
• Male specialist physicians earn 27% more than females, down from 31% last year and 33% the year before that.
• Only 19% of radiologists are women – one of the lowest rates of female participation among medical specialties. 
• 58% of radiologists feel they are fairly paid.
• Radiologists report working an average of 49.6 hours a week.
• 90% of radiologists say they would choose their specialty again, ranking #10.

The Takeaway

On the positive side, physician salaries continue to rise, and medicine is making encouraging progress in narrowing the gender gap. Radiologists seem to be well-compensated and relatively happy, but the specialty has more to do to attract women.

Underlying the raw data is a disturbing undercurrent of physician dissatisfaction, with many feeling as though medicine is a golden cage. In the free-response portion of the survey, doctors described themselves as caught between falling reimbursement and rising costs, with overwork also leading to burnout. 

The Medscape survey shows that addressing physician burnout must become a priority for the US healthcare system, and it can’t be solved merely by boosting salaries. Increasing the number of residency slots is a good first step (see below).

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The Wire

• Boards Go Back to the Future: The certifying exam for diagnostic radiology will be transitioning back to an oral exam in 2028, says the ABR. Residents had to travel to Louisville to take the oral exam until 2013, when the ABR ditched oral testing for a written exam taken at test centers, and all ABR exams have been remote since 2021. DR candidates will soon be able to test online at a location of their choosing. RadTwitter is abuzz, with some criticizing the move while others say the oral format results in better radiologists. 

• Help for the Physician Shortage? The number of residency slots for training new physicians would be expanded under federal legislation that’s been introduced in the U.S. House of Representatives. The Resident Physician Shortage Reduction Act of 2023 would expand the number of residency positions by 14,000 over seven years (the 2023 Main Residency Match had just over 40,000 open positions). The question is, would a 5% annual expansion really solve the doctor shortage, which has been linked to burnout?

• MRI Scans Predict Frail Elders: In a study in Lancet Digital Health of over 40k elderly people in the UK, researchers used 3-tesla MRI to predict physical frailty based on brain structure. Researchers used Siemens Healthineers’ 3-tesla Magnetom Skyra scanner to correlate brain structure with physical measures like grip strength, walking speed, and physical inactivity. Elderly people with higher frailty scores had more white matter hyperintensities and lower gray matter volume on MRI. The findings could help guide prevention strategies in the elderly.

• Bracco Eyes Ultrasound Therapy: Contrast developer Bracco Imaging is eying the potential of ultrasound-guided gene therapy, signing a deal to supply its microbubble ultrasound contrast agents to SonoThera. SonoThera will use Bracco’s contrast agents to research the use of ultrasound to help deliver therapeutic nucleic acid payloads through vessel walls and cell membranes. This would enable the delivery of genetic materials to target cells and organs, while avoiding surrounding tissue. The deal illustrates the growing integration of imaging and therapy.

• One-Stop Lung Evaluation: A radiomics tool that could enable one-stop evaluation of patients for both lung cancer and COPD could make CT lung cancer screening more efficient, say Chinese researchers in Academic Radiology. The model combines both radiographic, clinical, and radiomics features to predict COPD; in validation tests on 443 patients it had accuracy of 0.89 on internal data and 0.84 on external data. The tool could require tweaking to improve its performance on external data, they said.

• Insurers Deny Breast MRI: Insurers are denying reimbursement for breast MRI scans of high-risk women, despite the fact that clinical guidelines support the studies. Insurers denied reimbursement for 11% of breast MRI scans in a study of 682 women with BRCA 1 and BRCA 2 gene mutations, according to a Medscape article on a talk at the Society of Gynecologic Oncology’s Annual Meeting on Women’s Cancer. The denial rate went up from 2020 to 2021.

• Dosimeter Down the Hatch: Researchers from China and Singapore have developed a radiation dosimeter that’s small enough to be built into an ingestible capsule. The capsule has a 5mm diameter and can precisely measure radiation dose to organs like the gastrointestinal tract during radiation therapy. In Nature Biomedical Engineering, they found the swallowable dosimeter was five times more accurate than conventional methods. In the future, the capsule could also be used in the rectum or nasal cavity. 

• Blind Women Trained for Breast Screening: Blind women in India are being trained to perform clinical breast exams using physical palpation, says an article in Future. The women – called medical tactile examiners – typically spend 30-40 minutes per exam, and can detect lumps as small as 6-8mm. While screening mammography is favored over clinical breast exams in Western countries, India has less access to medical technology, and use of MTEs could help catch cancer earlier, improving survival rates.

• Radiologist’s License Revoked: An Ohio radiologist who had been performing cosmetic surgeries at a laser center he owned had his license revoked by the state medical board. Dr. Wade Banker operates Luxe Laser Center and allegedly “inadequately treated” at least 15 patients from 2014 to 2018 for services like liposuction and tummy tuck, even though his 1998 board certification in diagnostic radiology and vascular and interventional radiology is “not typically associated with cosmetic surgeries,” said a story on WTOL.com. The center plans to appeal.

• ViewRay Exploring Alternatives: Radiation therapy vendor ViewRay said it is exploring “strategic alternatives” after posting a $29M net loss for Q1 2023. The company said that demand for its MRI-guided MRIdian system was strong, with 13 new orders in the quarter versus seven in Q1 2022. But “global macroeconomic headwinds” have created the need to cut costs and conserve cash. The company has retained Goldman Sachs, a move that could result in more consolidation in the radiation oncology segment.

• AI IDs Suboptimal Chest X-Rays: An AI algorithm was able to identify suboptimal chest X-rays on its own, giving radiologic technologists the opportunity to repeat the scans before they reach the radiologist. The AI model had sensitivity of 78% in classifying over 3,200 X-rays as suboptimal, said researchers in Academic Radiology; its performance was even higher for specificity (95%), accuracy (91%), and AUC (0.87). The findings show the growing utility of AI tools for addressing workflow challenges in radiology.

Arterys’ Cloud Breast AI Cuts Turnaround Times

Ready to improve your mammography workflows? Arterys is the first and only cloud-native breast AI provider, and its solution dramatically reduces 3D mammography reading times, while supporting breast cancer detection, density measurements, and personalized risk assessments.  

See the Art of the Possible at HIMSS 2023

See the art of the possible for healthcare at HIMSS 2023 and learn how Microsoft and Nuance are making it real with generative and conversational AI, ambient intelligence, revenue integrity, radiology, and patient engagement solutions. Learn more or schedule a meeting at booth #912.

A Perfect Balance of Utility and Nirvana

The One Viewer philosophy from Visage offers end users from across the enterprise the chance to get access to Visage 7’s powerful tools based on their clinical need, with the same #1 rated viewer for multiple workflows. Book a demo at booth #4308 at HIMSS 2023 to see for yourself.

The Resource Wire

• This Riverain Technologies case study details how the University of Colorado Hospital enhanced its chest X-ray workflow with ClearRead Xray Bone Suppress, which can improve the visibility and detection of focal lung densities, including nodules.

• Intelerad will showcase its enhanced Enterprise Imaging and Informatics Suite at booth #3601 during HIMSS 2023. Book your visit today to see how the suite features the largest medical image exchange network in the world, following Intelerad’s recent acquisition of Life Image.

• Enlitic is not a point-solution AI company. They are delivering unique workflow solutions that enable physicians to focus on patients and tasks that matter. You can learn more at booth #7316 at HIMSS 2023 – schedule your appointment today. 

• When Middlesex Health set out to adopt imaging AI, the Connecticut-based community hospital made the unique decision to start with non-interpretive AI solutions. See how that decision led them to Subtle Medical, and the impact it had with all of the hospital’s imaging stakeholders.

• Bayer’s cloud-based Calantic Digital Solutions AI platform features a suite of disease-specific AI apps that integrate into radiologist workflows, helping radiology teams scale AI deployment and improve efficiency and quality of care.

• We may be entering a third wave of imaging AI’s rapid evolution, that brings a shift from narrow point solutions to comprehensive multi-finding AI systems. Hear this discussion with Annalise.ai Chief Medical Officer Rick Abramson, MD, exploring how this transition could take place, how radiologist and VC perspectives on AI are changing, and how AI might continue to evolve in the future.

• With rising patient acuity rates creating “unsustainable financial challenges,” health systems are looking for innovative ways to increase critical care throughput. A growing number of health systems are achieving this goal with the Hyperfine Swoop point-of-care MRI, which can eliminate risks associated with intrahospital transport and keeps more critical care team members in the ICU.

• See how cloud-native imaging avoids traditional software’s resource utilization constraints and eliminates unexpected disruptions in this Change Healthcare animation.

• United Imaging’s service organization is called Customer Success for a reason. Their mission is to think ahead, understand their customers’ goals and proactively help customers achieve them. They also store critical service parts in the U.S. and back up their promises with the United Performance Guarantee.

• After setting ambitious regulatory and commercialization goals, Lunit leveraged CARPL.ai’s platform and operational guidance to complete the clinical trials needed for its INSIGHT CXR and MMG AI tools’ FDA clearances.

• Meet Merge at HIMSS 2023. Visit booth #3831 for a firsthand look at how Merge solutions from Merative can help you address your enterprise imaging and interoperability needs, and face your future with confidence. Schedule a meeting today.

• Siemens Healthineers’ AI-Rad Companion family of AI-powered workflows has been expanding across modalities and anatomies, automating repetitive tasks and helping improve diagnostic precision. See how AI-Rad Companion can fully integrate into your workflows and support your clinical outcomes here.

• Working on your organization’s AI strategy? This Blackford Analysis post outlines the key considerations for creating your AI goals and strategy, including some you might not have considered.

• Discover how GE HealthCare’s digital solutions enhance collaboration, optimize workflows, and offer real-time insights for improved care. Schedule a meeting at HIMSS 2023 in booth #1712 to explore how these solutions can solve your biggest health IT challenges. Learn more about GEHC @ HIMSS.