Radiologist income, receipts, and academic performance: an analysis of many nations.

Background Considerable interest exists in comparison between healthcare systems across multiple countries, especially where cost enters the discussion. Purpose To evaluate the relationship between radiologists' income, receipts for studies, and academic performance across multiple countries. Material and Methods The annual income of radiologists and receipts for computed tomography (CT) and magnetic resonance imaging (MRI) were obtained based on a survey sent to expert radiologists practicing in 23 countries of varying developmental status. Articles published in generalist radiology journals determined the academic performance of each country. Results Among the developed countries, Canada has the highest estimated annual income for both private ($700,000/year) and university radiologists ($600,000/year) while Spain has the lowest income for private practice ($68,000/year) and Portugal has the lowest income for university practice ($57,300/year). Among the developing countries, Saudi Arabia has the highest incomes for both private ($210,000/year) and university ($140,000/year) radiologists and Vietnam has the lowest incomes for both private ($30,000/year) and university ($6,000/year) radiologists. Total receipts for CT and MRI studies ranged from $80/study (Portugal) to $1000/study (USA) in developed countries, and ranged from $30/study (Egypt) to $700/study (Saudi Arabia) in developing countries. A moderate correlation ( r = 0.482) was seen between radiologist's income and the receipts for combined practice in all countries. The radiology journal academic quotient was highest in The Netherlands among developed countries, and Turkey among developing countries. Conclusion A relatively broad range of radiologists' income is observed among developed and developing countries, which shows correlation with the receipts for advanced imaging studies. Countries with an acceptable compromise between income, receipts, and academic performance, may be the best models for other countries to emulate.

Decreased hepatocellular carcinoma tumor burden with the achievement of hepatitis C virus sustained virologic response: unlocking the potential of T-cell-mediated immunosurveillance.

We describe two cases of patients with hepatitis C virus (HCV) treated with direct-acting antiviral (DAA) therapy who had dramatic improvement in hepatocellular carcinoma (HCC) tumor burden with DAA therapy alone. Both patients were diagnosed with HCC on screening magnetic resonance imaging shortly after beginning DAA therapy. Both patients achieved sustained virologic response (SVR) with dramatic improvement in HCC tumor burden on follow-up imaging without HCC treatment. Patients with multifocal or advanced HCC are infrequently treated with antiviral therapy for HCV. As a result, these cases provide unique insight into the ongoing debate regarding the impact of SVR on existing and recurrent HCC. We review the current literature regarding this debate, as well as the theory of immunosurveillance. We postulate that DAA therapy activates CD8+ T cells to induce a T-cell-mediated response and increased immunosurveillance to virus-induced liver cancer.

Health care reform in the USA: Recommendations from USA and non-USA radiologists.

AIM: To compare the opinions and recommendations of imaging specialists from United States (USA) and non-USA developed nations for USA health care reform. METHODS: A survey was emailed out to 18 imaging specialists from 17 non-USA developed nation countries and 14 radiologists within the USA regarding health care reform. The questionnaire contained the following questions: what are the strengths of your health care system, what problems are present in your nation's health care system, and what recommendations do you have for health care reform in the USA. USA and non-USA radiologists received the same questionnaire. RESULTS: Strengths of the USA health care system include high quality care, autonomy, and access to timely care. Twelve of 14 (86%) USA radiologists identified medicolegal action as a major problem in their health care system and felt that medicolegal reform was a critical aspect of health care reform. None of the non-USA radiologists identified medicolegal aspects as a problem in their own country nor identified it as a subject for USA health care reform. Eleven of 14 (79%) USA radiologists and 16/18 (89%) non-USA radiologists identified universal health care coverage as an important recommendation for reform. CONCLUSION: Without full universal coverage, meaningful health care reform will likely require medicolegal reform as an early and important aspect of improved and efficient health care.