Our health is a key factor in our every-day lives, controlling our activities and what we are able to do. Radiologists act as one of the most important doctors in detecting diseases early on. Even though they are such crucial doctors, there is already a worldwide shortage. Not surprisingly, this is coincided with a substantial gap in the number of radiologists in developed and developing countries. As more technology to detect diseases is introduced into the field of medicine, will there even be a need for trained radiologists in the future? Advancements in recent years have created deep learning algorithm machines (known as artificial intelligence) that are able to detect abnormalities in medical images. However, current and future improvements in artificial intelligence and technology are not able to replace the role of radiologists and will only expand the demand for skilled radiologists worldwide.
Radiology is a specialty branch of medicine that focuses on detecting and treating diseases with medical imaging technology.
The American College of Radiology defines radiologists as “medical doctors that specialize in diagnosing and treating injuries and diseases using medical imaging (radiology) procedures” (American College of Radiology). Although radiology is already a specialty in the medical field, it can further be divided into different areas of study. Diagnostic radiology, much like the name indicates, focuses on diagnosing different conditions through the interpretation of medical images. After medical images have been taken, an interventional radiologist uses them as a guide in developing treatment plans and procedures.
In contrast to a physician, radiologists must go through a longer school and training process. After having completed about 13 years of their training, they are able to treat and diagnose injuries. According to the American Medical Association, radiology “is one of the most technologically advanced fields in medicine. Since the discovery of the X-ray in 1895, radiology has been at the forefront of minimally invasive medical imaging” (American Medical Association).
Each medical profession is important in providing for the health of an individual, yet radiologists are especially crucial. “Radiologists save lives. Image interpretation is the most visible contribution of radiologists. The population should be informed about the importance of diagnostic imaging,” says Dr. Tayo Denton (Ontario Association of Radiologists). Equally as important to a radiologist are the medical devices they use. The Department of Radiology & Biomedical Imaging says that a CT scan “ranks as one of the top five medical developments in the last 40 years, according to most medical surveys. It has proven so valuable as a medical diagnostic tool that the 1979 Nobel Prize in Medicine was awarded to the inventors of CT” (Department of Radiology & Biomedical Imaging)
As of today, there is already a shortage of radiologists in the United States as well as in impoverished countries around the world.
A study conducted by Andrew B. Rosenkrantz, Danny R. Hughes and Richard Duszak, Jr focused on analyzing the most recent trends of the United States radiologist workforce. In their research they concluded that although “the number of radiology trainees dramatically increased, radiologists per 100,000 population increased only slightly, and radiologists’ share of the overall physician workforce declined” (Radiological Society of North America). Such an analyzation of radiology trends in the US is alarming, considering the significant role they have in the healthcare system.
The United States is not the only country that has a low number of radiologists. Developing countries are often faced with a greater lack of medical care and struggle to supply the technology that radiologists rely on. According to the World Health Organization (WHO), approximately two-thirds of the global population lacks access to diagnostic imaging services. Pablo Jiménez, the Regional Adviser on Radiology and Radiation Protection at the WHO says that “access to diagnostic imaging services has a great impact on public health and can potentially reduce, for example, infant mortality or increase detection of some types of cancer at an early stage. Unfortunately, current shortages of human resources and obsolete or broken equipment are making it increasingly difficult to provide adequate access and quality in our region” (Pan American Health Organization/WHO). This gap in radiologists can be particularly seen in African countries. The Journal of Global Radiology found that the entire country of Liberia currently has two practicing radiologists, of which only one is a Liberian national. In comparison, the Massachusetts General Hospital in Boston has 134 practicing radiologists.
Part of the struggle that poor countries face is attracting radiologists to work in remote areas. Such jobs are often accompanied with a lower salary, isolation from large cities, and scarce professional opportunities to advance in their field. Recent increases in tele-radiology, the electronic transmission of medical images, have allowed rural areas to rely on experienced radiologists in larger cities as a source of supplementary medical care. Dr. Henrique Carrete Jr, the president of the Colegio Interamericano de Radiology (CIR) in Brazil, has observed the positive effects that tele-radiology is having. According to him, Brazil is “beginning to see specialists trained in large centers returning to their hometowns, sometimes in more distant and smaller cities. Tele-radiology is a way to supplement their salary by reading exams from larger cities where demand is higher” (Radiology Society of North America).
Artificial intelligence (AI) and machine algorithms are a relatively new area of study, making many radiologists question whether their job is bound for extinction in the near future.
With the advancement of technology in the medical field, AI algorithms have emerged in recent years. The computers are programmed to detect any abnormalities on medical images, something a radiologist would normally look for. Dr. Arun Krishnaraj of the University of Virginia says that as AI machines further improve, “no radiologist, no matter how advanced his or her visual acumen, will be able to top the machines.” So why do we still have radiologists? According to Dr. Krishnaraj, “future radiologists will be far better than the radiologists of today because of machines, not in spite of them. (Data Science Institute)
The challenge with artificial intelligence, according to Thomas Davenport of the Harvard Business Review, is the narrow tasks that algorithms have. In order to fully analyze a medical image with AI, thousands of algorithms would be required. The development of such algorithms in that large of a quantity is still far away. According to him, “the job of image interpretation encompasses only one set of tasks that radiologists perform. Even in the unlikely event that AI took over image reading and interpretation, most radiologists could redirect their focus to these other essential activities” (Harvard Business).
In the event that drastic AI advancements are made within the next few years, the question of how to program algorithms is still unanswered. AI is trained to detect abnormalities based on previously taken medical images. For example, an algorithm that diagnoses cancer was trained with medical images that are labeled as having cancer. Yet the vast question of how to obtain these labeled medical images still looms. Davenport says that “there is no aggregated repository of radiology images, labeled or otherwise. They are owned by vendors, hospitals and physicians, imaging facilities, and patients, and collecting and labeling them to accumulate a critical mass for AI training will be challenging and time-consuming” (Harvard Business).
The possibility that machines will completely take a radiologist’s job is very unlikely, as even algorithms have their own flaws. A medical student who is considering a path to radiology should not be deterred. Instead, they should consider artificial intelligence as an aid to their work. With future technological advancements, medical professionals will be able to broaden their area of practice, helping to fight the radiologist shortages in developing countries and rural areas. Such a future would ensure that countries like Liberia are not left with two radiologists, while sole hospitals in the United States have more.
Ali, Farah S, Samantha G. Harrington, Stephen B. Kennedy and Sarwat Hussain. “Diagnostic Radiology in Liberia: A Country Report.” The Journal of Global Radiology.
Allyn, Jennifer. “International Radiology Societies Tackle Radiologist Shortage.” Radiological Society of North America.
“What Is a Radiologist?” American College of Radiology.
“Radiology — Diagnostic.” American Medical Association.
Davenport, Thomas H., and Keith J. Dreyer. “AI Will Change Radiology, but It Won’t Replace Radiologists.” Harvard Business Review.
Denton, Dr. Tayo. “Importance of Radiology.” Ontario Association of Radiologists.
“Benefits of Imaging Using Radiation.” UCSF Radiology.
“Find a Radiologist.” Massachusetts General Hospital.
Krishnaraj, Arun. “The Future Radiologist.” American College of Radiology.
Mitchell, Cristina. “World Radiography Day.” Pan American Health Organization / World Health Organization.
Rosenkrantz, Andrew B, Danny R. Hughes, and Richard Duszak, Jr. “The U.S. Radiologist Workforce: An Analysis of Temporal and Geographic Variation by Using Large National Datasets.” Radiological Society of North America.