"When I look at this country," said Paramjit Chopra, MD, who immigrated to the US twenty years ago, "I realize that we are incredibly spoiled. We want everybody to have everything, and we don't want to worry about who's going to pay for it. The basic principle of economics is that there is going to be scarcity." Just the facts at this morning's session on what radiologists need to do to prepare for health care reform, where Chopra led the discussion.
"You're going to get your butt kicked," he said. "You've got to get out there and become a real doctor." In business, he said, you exchange value; if you don't add value, you'll go out of business. Radiologists want to look at images. They want to work nice hours. "Physician comes down to ask you a question, and you say, don't disturb me, I'm reading," he said. "Sound familiar? Well, that behavior is going to get you into trouble."
"Partner means, I got this title so I can get the money that I think I want," he went on. "You become a partner in radiology; then you want titles. You become a director. That means you direct people. How many radiologists do you know who are good leaders? How many of your groups don't fight?" No hands were raised -- but there were a few knowing chuckles.
Chopra recently consulted for a radiology group losing a million dollars a year on its IR program. "They want everybody to do everything except themselves," he said. "Do you think that's sustainable?" He pointed out that MBA graduates don't want to run hospitals or health systems. "My point to this is, what does health care reform mean for us? You need to be a doctor first. It drives me insane. I tell my radiologists, the minute you stop being a doctor, I'll fire you on the spot." According to Chopra, good radiologists make good money -- they should be focused on being a health care provider first, a businessperson or partner later.
"Some of these changes are very simple and fundamental," he said. "If you're taking care of people and doing a good job of it, you'll stay in business. You can't expect to be the guy who comes in, sits, looks at images, walks away and makes a ton of money. That won't last forever. It's already changing."
Harsh words, maybe -- but to me they were a breath of fresh air, an invigorating display of honesty about the facts of the profession. Just yesterday I watched the Mock Jury Trial pivot around the issue of whether radiologists have any responsibility to patients. Just this morning at a breakfast meeting, I learned that malpractice insurers can be persuaded to lower their rates for radiologists because of that same lack of patient interaction. It's an accepted fact about one of the highest-earning subspecialties in the country: radiologists are detached from patients. But should they be? What do you think?