Academic Radiology and the Future of the Specialty

Abstract

All for one.One for all.Every man for himself.—The Three Stooges This issue of JACR contains an important article by Drs Dodd, Fletcher, and Thorwarth on the plight of academic radiology and why this problem is perhaps the most important facing our specialty. As noted by the authors, a large number of the departments responsible for training future radiologists and conducting the research that nourishes the technological advancement that fuels radiology have been limping along under a burden of insufficient funding to address those goals. The reasons for this state of affairs are manifold and to some extent determined by any given institution’s specific circumstances. However, for most, declining per case reimbursement, adverse payer mixes, institutional restrictions on radiologists’ entrepreneurship, and taxes on income that must be paid to institutions play at least some role. Most significant, however, has been the run on recent graduates of residency and fellowship programs, as well as on academic department faculty members, by community practices. Impelled by the ad hoc hiring freeze devolving from declining per examination reimbursement of the 1990s, and the dramatic avidity for radiologists accompanying today’s increased work volumes, most academic institutions increasingly are having difficulty financially competing for radiologists to address the academic missions. Although the degree of resultant suffering varies widely, the authors are correct to my mind in pointing out that it is the mid-level academic departments that are faring the worst.