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Regarding imaging: yes and no.

And a minor addition:

Using the right tools is the challenge. ;-)

Physical examinations are key. While MDs can do a good job. Best is to educate patients. They can detect even very small changes. (e.g. regular checkups in the shower)

Imaging:

* Mammograms are old but good. technological updates worth it. However, mostly good for "old" breasts (less density)

* MRI is really helpful (esp. with a proper setup; e.g. I have seen images with new coil-designs - really great CNR improvement)

* Ultrasound can help too; esp. for young patients as mammae are too dense usually. Also for biopsy worth it!

The art is to merge the right tools.

I believe that the best is to make your patients the experts of their body and (upcomming) diseases.

Dr. Bitcoin, MD 2y ago

A fee sats for your future.

Radiology is the best job in the hospital. You’ve chosen well. If you enter private practice, pick a group that allows you to interpret good images efficiently…

A lot of hospitals buy shitty machines that work fast. As I’m certain you know, fast MRI necessitates decreased image quality, all else being equal. Hospitals know this but don’t GAF. they buy cheap machines and run them fast; some radiologists don’t mind having no imaging evidence of the problem they didn’t dictate because they couldn’t see it. It’s bad incentive alignment.

Wherever you work, help your institution buy the right equipment. It’s tough and technical and salesman are scumbags.

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Discussion

Marcos Wolf, MD 2y ago

The problem is that doctors (in general) gave away their competence to the industry, Here in Europe, you are not allowed to adjust/change any machine; not even slight changes such as increasing the RAM. Even installing and using self made MR sequences is not allowed on clinical scanners.

And now, the companies let you pay.

This monopoly is even so bad that the companies write the laws nowadays. So that we can not even make new products by ourselves; without 100s of lawyers and product engineers. This reduces the competition and meaningful product upgrades become a rare event.

classical example of centralism and over regulation.

Dr. Bitcoin, MD 2y ago

I was a graduate student at a rather well known not for profit multi specialty private group medical practice located in southeast Minnesota during the time when modifying MR pulse sequences was minimal risk and part of routine clinical care. When I returned some years later as a radiology resident, even the world famous clinic had been hit with the ban on pulse sequences (which was obviated by having patients sign up as research participants in a non-existent study with no research aims).