Can AI Help to Save the Practice of Radiology for the Future?

In what was perhaps one of the most memorable openings in literature in English, Charles Dickens began his immortal A Tale of Two Cities with this: "It was the best of times, it was the worst of times, it was the age of wisdom, it was the age of foolishness, it was the epoch of belief, it was the epoch of incredulity, it was the season of light, it was the season of darkness, it was the spring of hope, it was the winter of despair, we had everything before us, we had nothing before us, we were all going direct o heaven, we were all going direct the other way--in short, the period was so far like the present period, that some of its noisiest authorities insisted on its being received, for good or for evil, in the superlative degree of comparison only." And yes, that was one long, run-on sentence….! And yes, participating in RSNA 2017, this year's edition of the annual RSNA Conference (sponsored by the Oak Brook, Ill.-based Radiological Society of North America), did bring to mind Dickens' astonishing opening to his great 1859 novel. And though I saw no one at RSNA 2017 who reminded me at all of Sydney Carton, Lucie Manette, Charles Darnay, or Madame Defarge, I did actually think a bit about France in 1775 (on the eve of the French Revolution). Here's the thing: the practice of radiology, as we've all known it, is moving into uncharted territory now, as the financial, operational, and medical practice model on which it's been based, is shifting under the feet of today's radiologists. With both Medicare and private-insurer payment under accelerating threat (let's face it, diagnostic imaging procedures are an easy target for reimbursement deficit-hawk types), and with the demands for speed of turnaround for interpretive reports also accelerating, there are literally not enough hours in the day for practicing radiologists to make up growing income shortfalls from ongoing reductions in payment from all sources.