Cardiothoracic radiologist and associate professor of radiology @Penn @RogueRad recently joined JAMA Editor in Chief @KBibbinsDomingo to discuss how AI could play a crucial role in improving access to medical imaging in diverse settings. ja.ma/3yGv95s

This is intended to increase the perceived value of doctors, especially radiologists. What it actually does, is quietly admit that the first 10,000 chest X-rays analyzed by a doctor shouldn’t be trusted due to the difficulty. Can’t think of a better AI endorsement.

Not a single vascular trained neurologist (stroke neurologist) in this country is waiting for a radiologist to interpret the CT scan. I interpret my studies and I do an effective job doing so. By the time the read is back, I’ve already pushed TNK, sent the patient to the angiosuite, and moved on to my next patient.

While in California, undertook a full-body scan at the Beverley Hills Medical Imaging Clinic run by former Delhiite Puneet Chandak — and ran into an old friend (and more recent critic!) @anupamkher, who was there for the same thing!

Radiology used to have something that was almost invisible because it was so routine: The reading room consult. Rounding teams came down. Surgeons pulled up their cases. Internists brought the scan that didn't quite fit the clinical picture. Sometimes the radiologist solved the problem. Sometimes the clinician supplied one piece of history that completely changed how the images were interpreted. And usually everyone simply walked away a little sharper. But something else was happening during all of those conversations. We were learning each other. As a radiologist, I learned what individual physicians cared about. I knew which findings mattered to a particular surgeon. Which measurements an oncologist was following. Which details a specialist wanted emphasized. What questions they were really asking, even when the order just said "pain." And they learned me. They knew who was reading their study. They knew they could walk in, point at something, challenge an interpretation, or ask, "What do you think?" That relationship created context. It created feedback. It created trust. And over years, it created a kind of institutional knowledge that never appears in the medical record. When radiology becomes a report produced by someone hundreds or thousands of miles away, we don't just lose proximity. We risk losing that entire feedback loop. The report may still be technically excellent. But the radiologist knows less about the physician. The physician knows less about the radiologist. The radiologist sees less of what happened after the report. And both sides lose opportunities to make each other better. The reading room was never just a room. It was where imaging became part of the clinical conversation. We should think very carefully before designing that conversation out of medicine. Inspired by a conversation yesterday with @PaleoOnc . Also @909One and @brianchiong .

Wow…Roland Fryer and @BillAckman have created a $1 million prize for academic truth-telling, the Carob Trust Prize for Academic Courage. “The prize awards $1 million each to as many as five social scientists a year who have demonstrated intellectual independence, published findings that were attacked rather than answered, and been validated by the evidence—despite the professional cost. The selection criteria are designed to distinguish courage from contrarianism: Nominees must show a sustained commitment to following logic and evidence regardless of pressure, a willingness to ask questions others avoid, and work that has shifted academic debate, public discourse or policy—often despite being misread, mischaracterized or vilified at the time of publication.”

We should have an AI limerick contest @woojinrad @RSNA

Boxes everywhere. False positives and false negatives left and right. I would gladly pay more than a dollar per exam to make this garbage go away. I honestly can’t wait to dump it. Clearly RadNet must know something I don’t.

A call to abandon performative physical examinations. Join me? Physical Examination for Asymptomatic Adults | New England Journal of Medicine nejm.org/doi/full/10.1056/NE…