gait for torment

Very little mention here or on many similar videos I've watched recently of the role of the relentless pursuit of "efficiency" in medicine. Hospitals and practices are mostly run by business people now, or MDs who have gotten their MBAs, and the drive for "efficiency" is practically a religion in those quarters. Let's call it by a more honest name: profit maximization. Radiologist and other docs can use all the new software tools they want to read faster and better, but the pressure for profits will not abate. And profits will be measured on a person-by-person basis, currently more or less purely by RVUs generated by that person. Leaders will continue to push their radiologists to the limit. I once asked one of our then vice-chairs (an MD MBA and prominent business professor) how he would know that the department was pushing its radiologist too hard. His answer was that they would quit. So, push people until they start collapsing. If they haven't quit, you can push them harder. There needs to be a counterforce coming from the side of real medicine, i.e. care for patients (and their doctors for that matter) that is rooted in a deep commitment to quality of care, not lip service. Administration's one tool is money: solve every dilemma by offering more in a carefully manipulating way. But the problem is pursuit of money overwhelming the pursuit of meaning and purpose. Radiologists themselves participate in this because of anxiety about money: something is wrong when ~25% of radiologist say one of the reasons for burnout is not enough compensation, when radiology is one of the highest paid jobs in the country. They are buying into the message that money is everything, even a measure of their happiness in their job. It is a pathology, and won't change until the leadership changes, or perhaps doctors unionize or otherwise organize a resistance. But there is an opportunity here for a truly visionary leader. Maybe some prominent academic practice somewhere will lead the way.

When chips are down. What do we cling to?’ Ultimately it’s fulfilment.

Thank you for the video, Dr. Puneet. This video was extremely helpful to me as I'm a recent medical graduate attempting to write my first article.

Hey I’m looking into IR myself! I think it’s one of the coolest things about medicine right now honestly!