5 Reasons Why Radiologists Are 'Real Doctors'

I have heard from multiple people that radiologists aren't real doctors. I might have even thought that, too, prior to radiology residency. But having done a PhD and getting exposure to the joys of imaging, I didn’t care going in to it. Then I started radiology residency, and it became crystal clear that not only are radiologists

I have heard from multiple people that radiologists aren't real doctors. I might have even thought that, too, prior to radiology residency. But having done a PhD and getting exposure to the joys of imaging, I didn’t care going in to it.

Then I started radiology residency, and it became crystal clear that not only are radiologists "real doctors," they are where doctors go when they need help with their patients.

I came up this list of why radiologists are real doctors. Feel free to disagree.

0. The formal reason they are doctors is because they have doctoral degrees. (So do PhDs you might think, but that doesn't make them "real medical doctors," so on to the real first point.)

1. Besides having graduated from medical school, radiologists have completed internships just like any other subspecialist, and are independently licensed physicians. In a pinch, I would trust a radiologist over a physiatrist or psychiatrists in a majority of clinical scenarios (especially when it comes to making a diagnosis).

2. Radiologists are consultants to pretty much every specialty. That means they have to know a heck-of-a-lotta stuff about normal anatomy and even physiology in order to successfully take on that consultant role. For example, when my younger brother (a 'real' internal medicine doctor) teasingly said radiologists aren't real doctors, I simply asked him what is the difference between a Monteggia and Galeazzi fracture? It seems to me a 'real doctor' should know about fractures and trauma since trauma (unintentional injury) kills more Americans than stroke.

3. Imaging is pretty much in every diagnostic algorithm (at least ones that 'real doctors' need beyond the most common or trivial medical problems). There is no getting away from it — modern society does not deal well with ambiguity, and imaging, as a powerful tool with radiologists as the primary operators to sort or destroy that ambiguity, is only going to become bigger and better. If the medical professionals that medical doctors go to for help getting a diagnosis aren’t real doctors, please let me know who is.

4. Two letters: IR. Need I say more?

Ok, for those who don't know what IR means regarding radiology, I will say more. Vascular and interventional radiology, or just "IR" as it is commonly known, is the growing field encompassing "minimally-invasive" image-guided procedures. What are image-guided procedures? For example, 15 or 20 years ago, if someone had an abscess (a collection of germs and dead cells), that person would have to undergo a major operation to have the abscess drained, since antibiotics or other anti-germ medicines only go where blood flow goes. So no surgical drainage of the abscess meant either weeks to months of sickness while the body walled off the collection of germs, or death if the germs were robust enough or the host person's body wasn't fast enough at cellular masonry. Now, instead of a major operation, most of the time, people with abscesses can jump in the CT scanner, get some sedating medicines, and let the interventional radiologist guide a needle into the pocket of germs, drain the germs, and put a small tube to drain any residual germs and be out of the hospital the next day or so and the tube pulled a week later at follow-up. That is only one example of image-guided procedures.

Another example is x-ray guided vertebroplasty, or spine bone fixation. What previously was a painful back surgery, interventional radiologists can now do with a single needle stick. By guiding a needle into the spine bone under x-ray guidance, the interventionalist can inject cement and fix the broken spine bone while almost instantly relieving the back pain. And the patient can go home that same day.

There are many more IR procedures you can see at the Society for Interventional Radiology website. If the medical professionals that even surgeons go to for help aren't real doctors, I don’t want to be a real doctor.

5. I mentioned in a previous post how the term "doctor" means "teacher." Radiologists routinely teach other doctors. Whether it is explaining post-surgery anatomy to internal medicine doctors, or showing the surgeons subtle imaging findings that will change their surgical approach, radiologists teach doctors about their patients' disease process without actually meeting the patient.

Just as a picture can be worth a thousands words, a real radiology doctor's interpretation of a study really can be worth the radiation, the time a claustrophobic patient anxiously waits in an MRI tube, or the thousand dollars the scan costs if it means getting the patient the right diagnosis, so they can have the correct treatment and their problem fixed.