Now well into the second year of the podcast from the AJNR, I think it’s an interesting time, and perhaps an important time, to survey listeners. What I would like within the next few weeks is for podcast listeners to post comments to this thread.
What do you like about the podcast? What don’t you like? How can we improve or add new and interesting content that would make these podcasts more useful to you?
Thanks to all of our listeners for their support, as well as their feedback.
What Do You Think About Our Podcasts?
The comment below was sent to the Journal by Dr. John Terry and reproduced here on the blog with his permission:
In response to your request for comments, I believe the podcast presentation is just right. The only improvement I could suggest would be more, perhaps all, articles summarized. Interviews have been a nice addition.
As a demographic, I am a general radiologist with a 10% neuroradiology practice share. I spent 800 hours in CME per year, 100 hours in neuroscience, 30 hours in neuro-imaging, and 70 hours in the related subspecialties of Neurology, Neurosurgery, and ENT.
I would like to share a perspective I have noted in participating in these related subspecialty CME presentations.
Neuroradiology, for all its sophistication, is often not well grounded from a clinical, neuropathologic perspective, and this weakness is often reflected as open disrespect shown to Neurologists, Neuro-oncologists, and other specialties.
Now the Neurology community is currently in a state of choas. On one hand, Neurology is a discipline requiring the highest level of academic ability combined with the best clinical skills. In short, Neurology requires the best physician trainees. At
the same time, the income of Neurologists is among the lowest for specialists, in part because modern practice places a comprehensive neuro-imaging study ahead of Neurology referral, resulting in dramatic decrease in the volume of primary Neurology referrals.
Recruitment has become a critical issue within the Neurology community because higher incomes in competing specialties draw many of the best prospects.
From the perspective of the Neurology community, the solution is obvious: Neurologists interpret neuroimaging exams with a higher level of basic neurologic knowledge and substantially increased income, clinical referral volume, and recruitment.
Just my observation, but I would be surprised if more than 50% of neuro-imaging remains in the hands of neuroradiologists 10 years from now.
Neuroradiology tends to be somewhat insular, almost “clubby”, and I fear our leadership may not recognize this threat until it is too late!
Anyway, I would recommend steering AJNR to clinically based material, possibly “collection” issues of articles from clinical journals; non-radiologist editors; and fellowship training that includes Neurology, ENT, and Neurosurgery board review courses.
For the podcast, you might recommend and link the weekly Neurology, American Journal of Neurosurgery, and Neurosurgery podcasts as an easy way to facilitate a broader knowledge base for your listeners.
Thanks again for you excellent work.
Dr. Terry: I am not sure whether your comment is relevant to the topic of AJNR Podcasts however it brings up some interesting issues. 1) First and foremost we would agree that quality of patient care is the primary concern here. For most subspecialty trained neuroradiologists, we read over 50 cases a day of neuroradiology studies. Our volumes are very high and justify our claim of added expertise in the field. It’s currently 10:30 am and I have read 22 mixed CT and MRI neuro cases. I will leave at 6 PM tonite. High volume leads to improved accuracy. The volume of cases most neurologists see are far far fewer and usually not the difficult cases of academic neuroradiology. 2) We read the entire study with the expertise of having done general radiology and having training in brain, spine and head and neck radiology as well. Therefore we are in the best position to assess the “outside the normal field of view” renal masses, ovarian cysts, parotid lesions, upper mediastinal masses that pervade so-called “neuroradiology studies”. We have a year of internship and 4 years of general radiology under our belts. 3) the advances in the field of neuroimaging have been made by neuroradiologists and members of radiology departments—we have built the field. We have been the drivers behind DWI imaging, SWI imaging, DTI, etc. I believe that we have “earned” our stripes as far as being leaders in the field. 4) When most neurologists went into their field they knew what they were choosing. They chose a profession where part of the reward and the value was patient interaction. Why now do they believe they should, with little or no training, be able to shift to a whole new profession just on the basis of interacting with neuroradiology studies. I used to do 12 conscious sedations a day but I never felt like I should be an anesthesiologist or bill for their work. 5) As for the clinical interaction, I would agree that I have learned more in multidisciplinary conferences over the past 10 years about patient care than I would in many pure neuroradiology forums. Yes, we need that clinical interaction and should NOT be insular. 6) What I see is that neurologists rely so heavily on neuroimaging nowadays that that “higher level of basic neurologic knowledge” is totally ignored once our imaging shows them the pathology and the correct diagnosis. The best neurologic exam is one that is accompanied by the neuroradiology study.
IMHO
Thanks for the interesting sidelight, and while there is much to be stated, I’ll remain true to blog style, and keep this short. Comments on the Podcasts will be taken to heart. More articles? More interviews? What do you think? And, go ahead and tell us where you are using the Podcast. Driving to work? Driving home? Lunchtime? While working out? In knowing how the Podcasts are utilized, we can better suit them to your needs. Thanks again.