Published on the Dec. 6, 2011 DiagnosticImaging.com web site
By Whitney L.J. Howell
Over the past 20 years, not only has clinical instruction during radiology residency changed, but so has the practice life that comes after it. Even as a growing number of medical students select radiology as a specialty, practice-setting preferences have shifted for your younger colleagues. They also have a different set of priorities to consider.
Unlike generations past, most radiology residents don’t transition directly into practice. Almost all continue on to fellowship training, preparing themselves for sub-specialty practice. The extra training prepares young practitioners for clinical care, but it does little to get them ready for the realities and complexities of day-to-day practice.
“As an industry, radiology doesn’t do enough to prepare our residents,” said Keith Smith, MD, former director of the radiology residency program at the University of North Carolina at Chapel Hill School of Medicine. “Largely, residents are very focused on passing their board exams and have very little mental energy left for other things. We do talk about life in private practice and billing and documentation, however.”
And, from those conversations, he said, it’s appears that the majority of radiology residents are forgoing private practice for the security of an employment position with a hospital or larger physician practice.
Be Cordial and Cooperative
After residency, the first priority for new practitioners must be changing how their view relationships with referring physicians, Smith said. Residents often maintain an “us versus them” mentality, fostering contentious interactions.
“Many residents look at requests for service from other departments as additional burdens,” he said. “They react with dread when asked to do things when, once they’re out in practice, they begin to see it as a paycheck. Having a good working relationship with referring physicians and understanding their needs can be very helpful.”
Ben Huang, MD, a UNC radiologist who finished residency in 2005, said he once viewed requests from referring physicians as a waste of his time. As an attending today, however, he appreciates the need for collegiality between radiologists and other specialties.
“When I was a resident, I tended to be more obstructionist,” Huang said. “I let the attendings make the final calls, so it didn’t matter if I were diplomatic with the referring physicians.”
But cultivating relationships with referring physicians has been advantageous for him. Primary care providers and other physicians have gotten a clear sense of who he is as a radiologist over time and are comfortable sending their patients to him for diagnostic imaging services. This is increasingly more important as radiologists are becoming a more involved partner in patient care, advising on image appropriateness, a new role spurred by healthcare reform and patient safety initiatives.
To read the remainder of the article: http://www.diagnosticimaging.com/practice-management/content/article/113619/2001863