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Canadian Association of Radiologists (CAR)

A Wake-Up Call for Canadian Radiology

A Message from the President of the CAR

Dr. E. A. (Ted) Lyons O.C.
June 2010

Is the best part of your working day when you get a call from a clinical colleague asking for help with a problem patient? If not then ask yourself, are you "an integral member of the health care team?" If you are then you likely enjoy your job and are valued by the clinicians. If you are not, then think about where you will find your next job.

It is critical for the Radiologist to be and to be seen to be, AN INTEGRAL MEMBER OF THE HEALTH CARE TEAM.

If your day consists solely of reading cases, remember, that can be done by anyone, anywhere! If you bring no added value, if you are not a member of a clinical team, then you can and likely will be replaced. Scary thought but think about it carefully. Maybe not tomorrow but as hospitals and governments are faced with mounting costs and decreasing revenues, costs will be cut. Physician fee for service income makes up a significant portion of the health care budget. Radiologists are high earners. At the last meeting of the American College of Radiology (ACR), the message was loud and clear. Well-established and respected groups of Radiologists had their contracts and hospitals jobs terminated with little or no notice. They were left with no job. Dr. Paul Chang of the University of Chicago School of Medicine in his keynote lecture at the recent Canadian Association of Radiologists (CAR) Annual Scientific Meeting said that we are in a new era. There will be Radiologists and groups who will be winners and for the first time, there will be losers. Jobs will be lost. This is happening in the United States and could happen in Canada. The Ontario government faced with mounting health care costs is talking seriously about putting physicians on salary. Salary arrangements are always good initially but it does not take long to fall dangerously behind and become non-competitive. Will our clinical colleagues support us or offer us up as sacrificial lambs? Are we a member of their team or someone they never see because we are sitting in a room all day staring at a monitor reporting cases? Film reading is an important role but not your only or even most important role. If you never see patients, never talk to, conference with and act as the problem solver for your clinical colleagues, then they won’t need you. Never think that you are indispensible. You are not, unless you are AN INTEGRAL MEMBER OF THE HEALTH CARE TEAM.

Your radiological "colleagues" across the city, province, country and world are ready to take your job. Predatory radiologists in the United States and likely also in Canada are talking to hospitals about doing your job, better, and/or for less. Think of it. If you were a hospital administrator faced with mounting cost overruns, what would you do? How valuable are you or your group to your clinician colleagues? Can you be replaced? If you can be replaced, then you will be replaced. Count on it.

Maybe some of our senior radiologists are thinking to themselves, "I don’t really care because I will be retiring in the near future." Is this fair or responsible to our residents, medical students, our clinicians, patients or even yourself? Have you worked tirelessly all of your adult life to just let your profession disappear? Is this the legacy you want to leave? It’s not the one that I want to leave. Many of us have spent our careers trying hard to be an integral member of the health care team but we can always do better. It’s time for us ALL to wake up and to be or become "AN INTEGRAL MEMBER OF THE HEALTH CARE TEAM." Make sure that our clinical colleagues and the patients really do need us, the radiologist!

Let me know how you are an integral member of a health care team and in the next President's message I will share your successes anonymously with others.

Are you and is the CAR at the table helping administrators and government health people solve their mounting health care problems? Are we just part of the problem or should we and can we be a party to the solution. Remember that if you are not at the table then you are likely on the menu waiting to be carved up.

Our profession of Radiology is at a crossroads and only you can make a difference. Make sure that you and your colleagues are AN INTEGRAL MEMBER OF THE HEALTH CARE TEAM. How will you do that at a local and provincial level and how should we do that nationally? Your comments would be much appreciated at


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