Latest / Becker’s Healthcare Podcast / How Radiology Leaders Can Tackle Workforce Pressures and Burnout

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How Radiology Leaders Can Tackle Workforce Pressures and Burnout · Becker’s Healthcare Podcast

• 0:00
  - Hi, everyone. This is Brian Zimmerman with Becker's
• 0:02
  - Healthcare. Thank you so much for tuning into
• 0:04
  - the Becker's Healthcare podcast.
• 0:06
  - Today, we're going to talk about how radiology
• 0:08
  - leaders are navigating today's workforce pressures.
• 0:11
  - Joining me for this discussion is James Lin,
• 0:13
  - vice president of radiology
• 0:15
  - at Vituity. Doctor Lin, thank you so much
• 0:18
  - for being here today. Thanks, Brian, for having
• 0:20
  - me. So so to start here, doctor Lin,
• 0:22
  - can you give our listeners just a quick
• 0:24
  - sense of your background,
• 0:25
  - the practice you built at in Focused Medical
• 0:27
  - Imaging, and what you're now taking on as
• 0:29
  - Vituity's vice president of radiology.
• 0:33
  - Yes. I started my practice radiology in 2005
• 0:37
  - when I graduated from training.
• 0:40
  - And
• 0:41
  - our... My background was I started a radiology
• 0:44
  - group with a co resident of mine, a
• 0:46
  - guy named doctor Aldrich Shim. The two of
• 0:49
  - us started at one practice at one imaging
• 0:51
  - center.
• 0:52
  - And over the last twenty years or so,
• 0:55
  - we've grown that practice of just the two
• 0:57
  - of us to about 40 radiologists
• 1:00
  - across 20 hospitals and about 20 imaging centers.
• 1:03
  - And it was just a slow uphill climb
• 1:07
  - over that last twenty years. So I was
• 1:08
  - the CEO of that company. It was a
• 1:10
  - 100% radiologist owned,
• 1:12
  - and we... You know, I learned everything. I
• 1:15
  - didn't go to business school. I was a
• 1:16
  - doctor,
• 1:17
  - and I learned everything about business through those
• 1:19
  - twenty years.
• 1:20
  - And then now I have...
• 1:22
  - We have merged with Vituity,
• 1:25
  - and I'm serving as their vice president. And
• 1:27
  - it's a similar role in the sense that
• 1:29
  - it
• 1:31
  - is... They're both radiologist
• 1:33
  - physician owned practices,
• 1:35
  - but I have a lot more
• 1:37
  - support, and
• 1:38
  - it's just a larger company which allows me
• 1:40
  - to have a lot more ability to scale
• 1:42
  - the company. So...
• 1:44
  - Well, wonderful to have you and appreciate you
• 1:47
  - you sharing that that background. We'll pour... Pull
• 1:49
  - on that that that your your vast experience
• 1:51
  - in radiology as we move through this this
• 1:54
  - conversation today.
• 1:56
  - Let's get start here to building on the
• 1:58
  - conversation, building on the introduction,
• 2:00
  - just getting a sense of sort of the
• 2:02
  - lay of the land, so to speak, for
• 2:03
  - radiology right now.
• 2:05
  - There's rising volumes,
• 2:08
  - demand is up, tight workforce expectations for faster
• 2:11
  - turnaround.
• 2:12
  - You know, the... If you look at the
• 2:13
  - numbers, radiologists are leaving practice today. I think...
• 2:17
  - Correct me if I'm wrong on this, doctor
• 2:18
  - Lim, but at nearly double the rate they
• 2:20
  - were perhaps a decade ago. When you talk
• 2:22
  - to your colleagues, when you're you're you're doing
• 2:25
  - the work you're doing, what does this pressure
• 2:27
  - actually feel like day to day?
• 2:29
  - Yeah. I I think it's...
• 2:32
  - We are we are... So a lot of
• 2:34
  - times people ask me, you know, what is
• 2:35
  - it like to be a radiologist now? You
• 2:37
  - know, and and even my mom, several years
• 2:40
  - ago, told me you're gonna lose your job
• 2:41
  - because of AI. Right. So it's been just
• 2:44
  - this crazy
• 2:45
  - last... I would say last, like, eight to
• 2:47
  - ten years of just
• 2:49
  - all kinds of pressure. But I think that
• 2:51
  - the term that I hear the most from
• 2:53
  - radiologists,
• 2:54
  - or from even administrators
• 2:56
  - talking about radiology is that it's like drinking
• 2:59
  - from a fire hose. That's the most common
• 3:01
  - term I hear over and over again. And
• 3:02
  - that's truly what it is is the volumes
• 3:05
  - have exploded. And I would say that's probably
• 3:07
  - happened in the last, like, four
• 3:09
  - four ish years
• 3:11
  - after COVID.
• 3:13
  - For whatever reason, after COVID,
• 3:15
  - the the ER volumes are up, the inpatient
• 3:17
  - volumes are up, and perhaps that has to
• 3:20
  - do something with the baby boomer generation
• 3:23
  - hitting kind of that
• 3:25
  - sweet spot of where they're starting to not
• 3:26
  - only retire, but, you know, getting to the
• 3:28
  - later part of their lives. Maybe that population
• 3:31
  - boom has something to do with it. Maybe
• 3:32
  - it has something to do with more,
• 3:34
  - advanced providers providing care, and so there... Maybe
• 3:37
  - perhaps there's overutilization
• 3:39
  - of radiology.
• 3:40
  - You know, that's outside the scope of this
• 3:42
  - conversation, but
• 3:43
  - there's something driving this increased volume. And it's
• 3:46
  - it's like 15%
• 3:48
  - more per year or more than that even.
• 3:50
  - Even. So that's kind of the pressure is
• 3:52
  - that you have this huge volume that's increasing
• 3:55
  - every year.
• 3:56
  - You don't have an increase in radiologists
• 3:59
  - because the radiologists
• 4:00
  - radiologists who are graduating from residency, it's capped.
• 4:04
  - They don't make more radiologists per year. It's
• 4:06
  - fixed.
• 4:07
  - And it's been fixed for a while. And,
• 4:09
  - in fact, I think it went down several
• 4:11
  - years ago because they wanted to allocate more
• 4:13
  - spots,
• 4:14
  - in the ACGME to primary care field. So
• 4:17
  - you you have the same number or less
• 4:20
  - number of radiologists, and you have 15% increased
• 4:22
  - growth every year. So that mathematical equation equals
• 4:26
  - drinking from a fire hose.
• 4:27
  - Yeah. Yeah. I appreciate how you laid that
• 4:29
  - out. And
• 4:31
  - the the demand's not going the other direction.
• 4:33
  - Right? You know, even with with radiologist caps,
• 4:35
  - like,
• 4:37
  - you're not gonna mask your way out of
• 4:39
  - this problem with more radiologists. So then that
• 4:41
  - brings us to something else you brought up
• 4:43
  - on...
• 4:44
  - In your earlier answer,
• 4:45
  - AI. Right?
• 4:47
  - Yeah. You know, you're gonna need AI to
• 4:50
  - imagine get through all of this. And and
• 4:52
  - for a lot of people, I've heard it
• 4:53
  - referred to radiology as, like, the front door
• 4:56
  - for AI medicine.
• 4:58
  - The number I have in front of me
• 4:59
  - is... It it accounts for roughly 76%
• 5:02
  - of of all AI enabled medical devices authorized
• 5:05
  - by the FDA.
• 5:06
  - So I was
• 5:08
  - curious to hear, like, where the technology is
• 5:10
  - genuinely helping right now.
• 5:12
  - Clearly, like, I don't think radiologists are being
• 5:15
  - pushed out of a job anytime soon right
• 5:17
  - now. Correct me if I'm wrong there. But
• 5:19
  - where is it genuinely helping out, and where
• 5:22
  - is that line you have to draw to
• 5:24
  - really protect clinical judgment there?
• 5:27
  - Yeah. No. That's a great question. And and
• 5:29
  - and like as I alluded to earlier, my
• 5:31
  - mom told me I'd be out of a
• 5:32
  - job eight years ago. And now when people
• 5:34
  - say AI is gonna take your job, my
• 5:36
  - response is, I hope AI actually does more
• 5:39
  - soon. Right. You know, based on the volume
• 5:42
  - that we have.
• 5:44
  - AI has transformed
• 5:45
  - radiology,
• 5:47
  - not only radiology, but all of our lives,
• 5:49
  - and it will continue to do so. I
• 5:51
  - I see where it's going, and
• 5:54
  - and I don't think it's necessarily a bad
• 5:56
  - thing. I actually think it could be
• 5:59
  - a very positive thing. It could be a...
• 6:01
  - I mean, there's always a chance it could
• 6:02
  - be a bad thing. It depends on what
• 6:04
  - happens with it. But
• 6:06
  - in large part, for radiology,
• 6:08
  - AI has been very helpful, and and it's
• 6:10
  - been helpful in several ways. So one is
• 6:13
  - image interpretation. Right? It's really helped in figuring
• 6:15
  - out what is more important, what are the
• 6:18
  - problems, like, where... What's more acute, what do
• 6:20
  - you need to look at sooner. There are
• 6:23
  - certain imaging modalities where AI is very helpful
• 6:25
  - in finding, you know, the problem faster than
• 6:27
  - a human eye can.
• 6:29
  - So that's one way. The other one is
• 6:32
  - report generation. So there's a lot... There are
• 6:34
  - a lot of companies who are doing AI
• 6:35
  - and report creation.
• 6:38
  - That's probably, in my book, the most effective
• 6:40
  - use of AI currently.
• 6:43
  - A lot of our... You know, rate... There
• 6:45
  - was a huge... And I always like to
• 6:46
  - say this. There was a huge trick played
• 6:48
  - on radiologists maybe twenty years ago. We used
• 6:50
  - to dictate on a on a recorder, where
• 6:52
  - we would literally dictate into a tape and
• 6:55
  - a transcriptionist would type it out later and
• 6:57
  - we would sign the report. Many of the
• 6:58
  - older radiologists listening now would remember that. That
• 7:01
  - was actually very efficient because I could just
• 7:03
  - see a negative chest x-ray and just say
• 7:04
  - negative chest x-ray and that's it.
• 7:07
  - Now at some point, I'd say about twenty
• 7:09
  - years ago, they said, you know what? We're
• 7:10
  - gonna forget the transcriptionists, and you're gonna create
• 7:13
  - all your own reports. So you're gonna become
• 7:15
  - a transcriptionist.
• 7:16
  - So for, I would say, fifteen years, it
• 7:19
  - was really
• 7:20
  - difficult because we're not transcriptionists, and we didn't
• 7:22
  - have the software to do that. So report
• 7:25
  - generation with AI is...
• 7:27
  - The reason I bring up that story is
• 7:29
  - because that is,
• 7:30
  - really a low hanging fruit. It's really helped
• 7:32
  - to eliminate that
• 7:35
  - headache for a radiologist.
• 7:36
  - The last thing I would say AI is
• 7:38
  - helping with is efficiency.
• 7:40
  - So, like, work list management, finding out what
• 7:43
  - you read,
• 7:44
  - who reads what, and when.
• 7:46
  - Those those types of tasks which, you know,
• 7:49
  - it's difficult for humans to do because there's
• 7:52
  - so many
• 7:53
  - permutations of who's reading when and what is
• 7:55
  - available. And AI, that's an easy task.
• 7:58
  - So things like that are also super helpful.
• 8:02
  - But ultimately, to answer your question,
• 8:05
  - you cannot have AI
• 8:07
  - be the
• 8:08
  - last
• 8:09
  - gatekeeper between a radiologist's
• 8:11
  - image
• 8:12
  - and what happens to that patient.
• 8:15
  - You need to have a radiologist, a human
• 8:16
  - radiologist,
• 8:18
  - somewhere in there
• 8:20
  - who is going to view, evaluate, and ultimately
• 8:23
  - sign off on the report.
• 8:25
  - Because you can't... You know, we... If we
• 8:27
  - get to a world where,
• 8:29
  - AI is just
• 8:31
  - dictating and looking at all reports, we're... We
• 8:33
  - are all in big trouble. That is the
• 8:36
  - dystopian future we don't want. So,
• 8:40
  - again, to answer your question, the radiologist clinical
• 8:42
  - judgment has to be the final gatekeeper
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  - because
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  - I don't believe
• 8:47
  - that AI or computers should be making that
• 8:50
  - call, and that's the end.
• 8:52
  - Yeah. Right. And and and you get to
• 8:54
  - some really... I mean, you used the word
• 8:56
  - dystopian, but you... If you if you follow
• 8:58
  - this this thread long enough, you're getting some
• 9:00
  - really thorny questions about ethics and
• 9:03
  - philosophy
• 9:04
  - even that we probably don't have time to
• 9:07
  - to entertain on this podcast today. But,
• 9:09
  - I I I do wanna wanna get to
• 9:11
  - something a a little bit more that that
• 9:13
  - builds on this
• 9:14
  - is a lot of these challenges, a lot
• 9:16
  - of these pressures that they're not going away
• 9:18
  - as we talked about. And as you mentioned,
• 9:19
  - you hope AI can do more to to
• 9:22
  - to to alleviate some of the burden on
• 9:24
  - radiologist plate right now, but there's also uncertainty.
• 9:27
  - There's this continuous work... Workload pressure. They're drinking
• 9:29
  - from a fire hose as you talked about.
• 9:32
  - How do you build, I guess,
• 9:34
  - a a culture of physician engagement
• 9:38
  - to help, you know, support retention, to keep
• 9:41
  - people going,
• 9:42
  - especially especially as they're drinking from fire hose.
• 9:45
  - That's really hard because you can't
• 9:47
  - you can't take away the demand. Right? The
• 9:49
  - work is gonna be there. How do you
• 9:51
  - how do you build a a positive culture
• 9:55
  - in in this environment, and what does it
• 9:57
  - look like? What does it... An actual positive
• 9:58
  - culture look like?
• 10:00
  - Yeah. No. Another great question. You know, if
• 10:03
  - I can just take one step back and,
• 10:05
  - you know, there are a lot of radiologists
• 10:07
  - perhaps listening to this or administrators. And
• 10:10
  - what I've what I've seen out in the
• 10:11
  - field is that there are a lot of
• 10:13
  - radiologists currently who are
• 10:15
  - just really disgruntled and confused
• 10:18
  - and
• 10:20
  - burnt out. All of those things are emotions
• 10:22
  - that radiologists are dealing with. And so it's
• 10:24
  - super important that we talk about how do
• 10:28
  - we capture these smart, well trained, educated individuals
• 10:32
  - who can help patients
• 10:34
  - and make them so that they have something
• 10:36
  - positive that they can be proud of. I
• 10:38
  - would say radiologists...
• 10:39
  - At at the top of that pyramid,
• 10:42
  - radiologists need to have a loud and commanding
• 10:44
  - voice in the practice of radiology,
• 10:46
  - period. End. Like, that's that's the goal. You
• 10:48
  - have to have radiologists
• 10:50
  - be the people who drive the ship.
• 10:53
  - Now, how do you do that? Well,
• 10:55
  - you have to you have to, you know,
• 10:57
  - you can't eliminate administrators and you can't eliminate
• 11:01
  - people who are going to help you to
• 11:03
  - build the company who are not radiologists,
• 11:06
  - But you need to have radiologists who are
• 11:07
  - part... Who are bought into, like, a partnership,
• 11:10
  - ownership,
• 11:11
  - radiologist centric decision making. You need to have
• 11:14
  - radiologists be able to vote in a democratic
• 11:16
  - manner as to... You know, let them know
• 11:19
  - let them know what
• 11:20
  - what we are building
• 11:23
  - and let them... Let... Let's hear their voice.
• 11:25
  - Let them have a democratic vote. But how
• 11:27
  - do you do... Put that all together? Well,
• 11:29
  - I I don't know. I think my opinion
• 11:31
  - on that, and, obviously, Vituity's opinion on that
• 11:33
  - is you have to have a company that's
• 11:35
  - run by doctors, run by radiologists
• 11:38
  - so that we have the final say in
• 11:40
  - where this whole thing goes.
• 11:43
  - Again, I'm not saying that we don't need
• 11:45
  - administrators
• 11:46
  - and we don't need, you know, business people
• 11:48
  - and finance people. Those people are important too.
• 11:51
  - But, ultimately,
• 11:53
  - the radiologists and the doctors need to make
• 11:54
  - that call. And that's how you build a
• 11:56
  - group that
• 11:58
  - these radiologists, I think, could be proud of
• 12:00
  - and look back twenty years from now and
• 12:02
  - say, wow. Something special happened there.
• 12:04
  - You you talked a bit there too about,
• 12:06
  - you know, do the radiologists really interacting with,
• 12:09
  - you know, administrators,
• 12:11
  - folks on the business end of things. I
• 12:13
  - also wanna hear more about how,
• 12:16
  - radiologists can interact
• 12:18
  - with the rest of the care team. I...
• 12:20
  - I've heard it said, like, you know, radiologists
• 12:22
  - can be sort of, quote, unquote, invisible to
• 12:25
  - the rest of the care team because their
• 12:26
  - work will... Their work is is visible,
• 12:29
  - but but they're not necessarily involved in all
• 12:31
  - the conversations.
• 12:33
  - What Yeah. Doctor Lin does a more integrated
• 12:36
  - radiology,
• 12:37
  - you know, radiology in practice look like? And
• 12:40
  - I guess what has to change to make
• 12:42
  - that a reality?
• 12:44
  - Yeah. Yeah. No. I mean, that's another interesting
• 12:46
  - question. And and, you know,
• 12:48
  - radiologists
• 12:49
  - changed and transformed
• 12:51
  - a ton since it, you know, really came
• 12:53
  - into being in the nineteen fifties.
• 12:56
  - You know, the the old days of radiologists
• 12:58
  - sitting in a dark room
• 12:59
  - and reading films on an alternator and having
• 13:02
  - ER doctors come down and
• 13:04
  - say, hey. Can you look at the study
• 13:06
  - with me? And looking together, those days are
• 13:08
  - are gone. I mean,
• 13:10
  - there are small cases here and there of,
• 13:12
  - you know, that still existing.
• 13:15
  - But because of the volume and because
• 13:18
  - of everything that's happening in tech,
• 13:20
  - it's hard for radiologists to really just be
• 13:22
  - a... You you know... It's not like analog
• 13:23
  - anymore where it's one to one. Like, yeah.
• 13:25
  - I'm gonna go over a film with you.
• 13:27
  - We need to use... The answer to your
• 13:29
  - question is really we need to use tech.
• 13:31
  - Tech is going to enable
• 13:33
  - fast communication
• 13:34
  - in our faster paced digital world.
• 13:37
  - And without technology,
• 13:39
  - it's gonna be really hard to
• 13:42
  - be able
• 13:43
  - to be engaged and integrated. So, you know,
• 13:46
  - things that I can think of as an
• 13:47
  - example.
• 13:48
  - You know, using immediate live video if if,
• 13:51
  - you know, pushing a button and saying, hey.
• 13:53
  - The ER doctor wants to talk to you
• 13:54
  - real quick. Either a video or a a
• 13:55
  - voice feed,
• 13:57
  - asking a quick question or going through an
• 13:59
  - intermediary. So we use, you know, things like,
• 14:02
  - assistants,
• 14:03
  - who are real humans, by the way, not
• 14:05
  - AI.
• 14:07
  - Real human assistants or,
• 14:09
  - scribes, people to kind of communicate.
• 14:12
  - So those... That technology,
• 14:14
  - has to be developed further.
• 14:16
  - We have to find ways to close the
• 14:17
  - loop faster. So if we have things that
• 14:19
  - are critical that we need to report to
• 14:21
  - people, how do we get that information to
• 14:22
  - the ER doctor as soon as possible
• 14:25
  - without...
• 14:26
  - You know, the... In the in the old
• 14:27
  - days, we'd probably write a note, but but
• 14:29
  - now it has to be something faster.
• 14:31
  - How do I transfer orders that... From an
• 14:33
  - EMR that a doctor wants to communicate to
• 14:35
  - me
• 14:36
  - but doesn't have the time to call me?
• 14:38
  - How do I get that information?
• 14:40
  - And and the ultimately, the end the end
• 14:42
  - answer is technology. Like, we have to use
• 14:44
  - technology. We have all this great technology. That
• 14:46
  - is what's going to bring us closer as
• 14:48
  - radiologists
• 14:49
  - to the clinicians and actually, in the end,
• 14:51
  - to the patient.
• 14:53
  - Really interesting to think about technology being this
• 14:55
  - conduit here to bring back interaction that used
• 14:58
  - to happen more
• 14:59
  - in in the past. Right? Is that is
• 15:01
  - that fair? Like, technology is now going to
• 15:03
  - hopefully return a bit of that more back
• 15:05
  - and forth and interaction that that that you
• 15:07
  - had once upon a time.
• 15:09
  - Yeah. It it is interesting because, you know,
• 15:11
  - it was... It's more... Like I said, I
• 15:13
  - call it, like, analog versus digital. In in
• 15:14
  - the old days, it was literally a conversation.
• 15:16
  - You know, you come down physically. I'm gonna
• 15:19
  - see you as a person in my space,
• 15:21
  - and we're gonna talk about it with our
• 15:22
  - with our voices.
• 15:24
  - Tech is going to bring that... It's gonna
• 15:26
  - bring the efficiency because now I can maybe
• 15:28
  - talk to two or three people almost simultaneously,
• 15:31
  - either by Internet messaging or chats or maybe
• 15:35
  - on a note on the PAC system that
• 15:37
  - is a live feed,
• 15:39
  - maybe a video, you... Or maybe using my
• 15:41
  - assistant. So you can have multiple avenues of
• 15:44
  - communication at the same time with multiple people
• 15:47
  - that's faster, that doesn't require someone to walk
• 15:49
  - down to your reading room.
• 15:51
  - That's how tech will help. It's it's basically
• 15:54
  - speeding up the communication.
• 15:55
  - But the communication is the same and just
• 15:57
  - as effective,
• 15:58
  - but that tech allows us to
• 16:01
  - compress
• 16:02
  - all of this geographic space into more of
• 16:04
  - a digital space. I'm not sure if that's
• 16:06
  - too esoteric or makes sense, but that's kind
• 16:08
  - of the the idea is that you're
• 16:11
  - you're really digitalizing
• 16:13
  - this communication.
• 16:14
  - Yeah. No. No. I... Yeah. I... I'm tracking.
• 16:16
  - I'm sure sure listeners are as well.
• 16:19
  - I I wanna get here now to sort
• 16:21
  - of the consolidation
• 16:23
  - component of this.
• 16:25
  - Between 2014
• 16:26
  - and 2023,
• 16:28
  - I believe radiology
• 16:29
  - only practices dropped by nearly a third. You
• 16:32
  - know, as all this consolidation happens, and I
• 16:35
  - imagine this goes back to some of your
• 16:36
  - comments earlier, doctor Lin, about the importance of
• 16:38
  - physician leadership,
• 16:40
  - but can you expand a little bit more
• 16:42
  - why physician leadership, autonomy,
• 16:44
  - local decision making are really
• 16:46
  - so important now in in this in this
• 16:49
  - rapid... Rapidly consolidating market. Can can you expand
• 16:52
  - on that?
• 16:53
  - Yeah. As we all know, I mean, there's
• 16:55
  - a... There there is a lot of investment
• 16:58
  - in radiology currently, whether it's on the AI
• 17:01
  - side, whether it's on the PACS or IT
• 17:03
  - tech side,
• 17:05
  - even on the radiologists
• 17:07
  - themselves. The the management and ownership of radiologists,
• 17:12
  - you know, has become corporatized.
• 17:14
  - And so there are a lot of groups
• 17:15
  - out there, and and, you know, we all
• 17:17
  - know who they
• 17:18
  - are, that...
• 17:20
  - Where the group itself is actually a corporate
• 17:22
  - entity, like, not radiologists,
• 17:25
  - perhaps outside investors or private equity. And then
• 17:28
  - there are groups that are
• 17:30
  - radiologist owned.
• 17:32
  - Those are becoming fewer and far... More far
• 17:34
  - in between because a lot of those groups
• 17:36
  - have been consolidated into the corporatized model.
• 17:40
  - Vituity radiology is
• 17:43
  - one of... I would say is hopefully is
• 17:44
  - gonna become one of the largest
• 17:47
  - doctor physician radiologist owned practices.
• 17:51
  - Why is that important? Well,
• 17:53
  - there is a fundamental
• 17:55
  - advantage for companies that are doctor owned or
• 17:58
  - radiologist owned, and that is that the actual
• 18:01
  - people making the decisions
• 18:03
  - are the people closest to the patients and
• 18:05
  - the practice of medicine.
• 18:06
  - Once you put the doctor behind
• 18:10
  - a administrator
• 18:11
  - or a business person or an investor,
• 18:14
  - the
• 18:14
  - the arrows aren't all aligned anymore.
• 18:17
  - You know? There's there's gonna be misaligned
• 18:20
  - interests.
• 18:21
  - So you have to align incentives, and that's
• 18:24
  - very important for why
• 18:25
  - there's a fundamental advantage to doctor owned,
• 18:29
  - radiology groups.
• 18:30
  - The other part is, I would say, if
• 18:32
  - you're... If a radiologist is making all decisions,
• 18:35
  - we have to end up living with those
• 18:37
  - consequences.
• 18:38
  - Right? I make a decision. I wanna do
• 18:40
  - this.
• 18:41
  - I'm gonna live with it because that... I'm
• 18:42
  - actually the practicing radiologist. So we understand the
• 18:44
  - workflow, the technology,
• 18:46
  - the clinical nuance,
• 18:49
  - what actually improves patient care. Those are things
• 18:51
  - we deal with daily. And so it's important
• 18:53
  - for us to be the people who decide
• 18:55
  - that. Right? If you're an investor, let's just
• 18:57
  - say, and you're making those decisions based on
• 19:00
  - a dollar sign,
• 19:02
  - ultimately you don't have to live with that
• 19:04
  - consequence. You can just
• 19:06
  - do something else. But the radiologist has to
• 19:08
  - live with that consequence, and that may not
• 19:10
  - be aligned. And we have many examples of
• 19:12
  - how that's not aligned.
• 19:14
  - So that's why it's so important to be
• 19:16
  - physician owned and radiologist owned and having the
• 19:18
  - radiologist drive the decisions, as I mentioned earlier.
• 19:22
  - And that goes even deeper when you talk
• 19:24
  - about technology and deployment of technology. Because, again,
• 19:29
  - we're radiologists. We're doctors. Like, our main goal
• 19:32
  - is to take care of patients. And so
• 19:34
  - things like... You know, these are bigger questions,
• 19:36
  - but how is that patient data gonna be
• 19:38
  - used?
• 19:39
  - Are... If we make any efficiency gains, you
• 19:42
  - know, let's say I can read faster or
• 19:43
  - better,
• 19:45
  - Are those gains gonna be reinvested in
• 19:48
  - in us as radiologists or invest... Reinvested in
• 19:51
  - our patients, or
• 19:53
  - is that gonna be extracted into, like, a
• 19:55
  - profit pool?
• 19:57
  - So, like, those questions are much bigger and
• 19:59
  - I I... Probably outside the scope of this
• 20:01
  - conversation. But I think, ultimately,
• 20:04
  - radiologist
• 20:05
  - slash physician ownership
• 20:07
  - in a model
• 20:09
  - keeps the
• 20:10
  - center
• 20:11
  - of
• 20:12
  - of what we're doing
• 20:13
  - in medicine
• 20:14
  - rather than outside
• 20:16
  - outside of medicine and patients.
• 20:19
  - But the physician ownership really helps,
• 20:21
  - as you said, sort of align incentives, but
• 20:23
  - align incentives in a way that services the
• 20:26
  - patient. Correct?
• 20:27
  - No. Yes. Exactly.
• 20:30
  - Excellent.
• 20:31
  - Doctor Lin, it... It's been wonderful having this
• 20:34
  - conversation with you today on the podcast.
• 20:36
  - I'm gonna ask you a final question here.
• 20:38
  - So if listeners remember just one thing from
• 20:40
  - from this conversation,
• 20:42
  - what should it be?
• 20:44
  - I think
• 20:45
  - the one thing I would say is that
• 20:47
  - we have to we have to ask what
• 20:49
  - is the best model
• 20:51
  - for ultimately taking care of patients
• 20:53
  - and patient imaging.
• 20:55
  - That is, I think, the key. And we
• 20:58
  - talked a lot about tech and how
• 21:00
  - physician ownership, how all of that will hopefully
• 21:03
  - make our lives
• 21:04
  - as radiologists better and help patients. But the
• 21:07
  - ultimate question is,
• 21:09
  - what
• 21:10
  - model,
• 21:11
  - what way of doing things will
• 21:14
  - benefit patients the most? And the one thing
• 21:16
  - I want you to take come away with
• 21:18
  - is, there has to be a future where
• 21:20
  - radiologists
• 21:22
  - have a seat at the table and drive
• 21:24
  - decisions
• 21:25
  - because that's ultimately how patients will benefit.
• 21:28
  - Doctor Lin, we'll leave it there. Thank you
• 21:30
  - so much for coming on the podcast today.
• 21:33
  - Thank you so much, Brian, for giving me
• 21:34
  - the time. We also wanna thank our podcast
• 21:37
  - sponsor, Vituity.
• 21:38
  - You continue to more podcasts from Becker's Healthcare
• 21:41
  - by visiting our podcast page at beckershospitalreview.com.