This Week In Radiology: Tackling The Global Radiology Gap & The Over-Diagnosis Controversy

It’s been a crazy week in radiology! The Minnie’s are gearing up, ASTRO finished up this week, and we’re getting inundated with article after article from every possible direction. As usual, there were a ton of interesting articles that came out this week related to our industry, and if you’re as busy as we are then there’s a pretty big chance you missed out on seeing—much less actually reading—most of them. Some were research related, some were fun, and some were inspiring, but there were a few articles that really stood out to us, and that we feel like are important for people to read. Not only are they incredibly interesting, they also cover two pretty controversial issues concerning the radiology industry right now. Here’s a quick breakdown for you!

“When A Medical Test Leads To Another, And Another…”: Challenging Over-Diagnosis

We appreciated this article for a number of reasons, but most importantly because it’s a very interesting perspective on a topic that’s hugely controversial in our industry right now: should incidental findings discovered during imaging scans be reported to patients (even when they’re irrelevant to the current issue), or is it our responsibility as radiologists to only report pertinent findings? It’s a huge debate in radiology, and we’ve heard arguments from both sides.

On one hand, many feel that we as radiologists are obligated to share all findings with patients, even if they’re incidental and seemingly unrelated to the original injury. Proponents for this approach argue that it’s not our job to determine what’s relevant or irrelevant to a patient, it’s our job to simply provide them with all the information we discover while reading the report and then whatever happens afterward isn’t our concern.

Lobbyers on the other side of the argument disagree. Their issue with the “all-inclusive diagnosis” approach is that in many cases, healthcare providers flag minor abnormalities that aren’t actually dangerous but lead to more diagnostic testing and, in several cases, invasive treatments. Researchers argue that guidelines should be put in place to help physicians determine when an incidental finding presents a true risk to the patient or when the risk is low enough that it doesn’t actually need to be pursued. Whether you agree or disagree, it’s certainly an interesting concept.

“Most Of The World Doesn’t Have Access To X-Rays”: The Reality Of The Global Radiology Gap

The global radiology gap is something we don’t hear about a ton, but it’s something that needs to be discussed. This article from The Atlantic shared some pretty shocking statistics about the global radiology gap, including the fact that…

• 2/3 of the planet doesn’t have access to basic radiology services (we’re talking things like simple x-rays and ultrasounds).
• The country of Kenya (which has a population of 43 million people) only has 200 radiologists. Massachusetts General Hospital has 126.
• There are more radiologists working in the four teaching hospitals on Longwood Avenue in Boston than there are in the entirety of West Africa.

Basic technology like CT scanners are easily accessible in more than 96% of US emergency departments, but in places like Nepal patients often spend over a month’s income and travel multiple days to find a facility with an x-ray or ultrasound. Even more shocking than that is the fact that nearly 50% of the x-rays and 40% of ultrasounds in resource-deprived countries aren’t even fully functional.

These statistics shed light upon the sad reality that the access to healthcare we take so much for granted is something much of the global community is suffering without. It’s our duty as an industry to be proactive, to find ways to educate others on the disparity of global radiology access and look for lasting solutions. It’s a pretty daunting task, but it’s one that’s absolutely necessary.

It’s an important time in our industry. There’s a lot of improvements being made, but there are still several issues that need to be addressed. Having an open dialogue about these controversial topics, understanding and expressing arguments from each different perspective and working together to create positive change will go a long way towards bettering our industry as a whole.