Multispecialists are the new generalists—it’s time radiology embrace the change

The term general radiologist has evolved to define the growing number of providers operating within multiple specialties. And these generalists turned multispecialists will be key to the medical field’s future.

That was the argument put forth by a group of rads in a March 5 opinion piece published in JACR. Across age, gender, and practice size, billed work for nearly 85% of general radiologists is primarily within two or more particular subspecialty areas, with few rads working exclusively in a single subspecialty.

And while demand for more subspecialized care increases and most residents pursue fellowships, the jack-of-all-trades will play a crucial role moving forward, according to David C. Youmans, MD, with Princeton Radiology Associates, in New Jersey and colleagues wrote Friday.

“Multispecialty radiologists have played, and continue to play, a vitally important role in a wide variety of diagnostic and interventional radiology settings and are likely to become even more valuable as more referrals originate from less rigorously trained providers,” the authors added.

For example, these rads cover a wide range of common exams and low complexity procedures important in rural and underserved areas where patients have limited access to quality imaging. Multispecialists are also suited to work overnight and general emergency department shifts along with many other routine imaging services, the authors noted.

Similarly, this new breed of generalists can easily slot into smaller hospitals and clinics that cannot staff an array of subspecialists. Corporate, private and academic practices all have similar problems, Youmans et al. wrote, in which multispecialty rads can cover short-notice volume surges and changing practice needs.

“A dedicated multispecialist … reading examinations in several disciplines may perform that additional diagnostic function at least as well as highly subspecialized radiologists reading outside their areas of fellowship training and may more than offset perceived deficiencies of a traditionally defined ‘generalist,’” they added.

These new generalists must, however, consult with or pass studies on to, subspecialists when exams go beyond their scope of knowledge.

Youmans and co-authors suggest a renewed focus on training and sustaining multispecialty radiologists to benefit the specialty, patients and practices.

A formal general and multispecialty fellowship could offer training across anatomic areas and interventional procedures. Further education in informatics, business administration and leadership is also important.

“In light of emerging literature indicating how many radiologists actually practice as multispecialists, training programs should evolve to meet actual practice needs,” the group concluded.

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Matt joined Chicago’s TriMed team in 2018 covering all areas of health imaging after two years reporting on the hospital field. He holds a bachelor’s in English from UIC, and enjoys a good cup of coffee and an interesting documentary.

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