Of the five policy areas measured, only on the topic of health care policy as a whole, did radiologists self-report higher competence than other doctors, even if it still ranked below the actual "competence" measure. Here, radiologists gave themselves an average of 2.43, compared with other doctors, who gave themselves a 2.33.

For the four business topics, radiologists reported, on average, across-the-board less-than-competent rankings. For IT, they gave themselves a weighted average rating of 2.48 (nonradiologists: 2.69); for knowledge of equipment and test costs, a 2.15 (nonrads: 2.23); for practice management, a 1.97 (nonrads: 2.16); and for marketing, a 1.94 (nonrads: 1.95).


Wondering whether attending radiologists, who have been playing the game longer, might be more knowledgeable, the researchers separately compared attending rads to nonrads, and trainee rads to nonrads. Here, some, but not all of the differences disappeared. Attending radiologists were still significantly less likely to report competence than nonradiology attending docs in information technology, practice management, test costs and patient safety. Trainee radiologists reported less competence in information technology and practice management than nonrad trainees, although curiously enough, trainee radiologists reported slightly, but significantly, higher competence in health care policy than their nonrad peers.

Study limitations

The researchers acknowledged some limitations of their studies, which have not been published in a journal yet. In surveys like this, respondents tend to inflate their competence, so their actual understanding could be lower than reported here, and self-reported competence could differ from the results gotten from other tests, such as objective assessments of knowledge.

However, the researchers didn't think it plausible that radiologists were somehow more critical of themselves or more likely to underrate their competence than doctors from the other 35 or so specialties included in the surveys.

"We all went through the same medical school training," Sharpe said. "All kinds of personalities are represented in radiology, so presumably they would have similar types of self evaluation" as other physicians.

Education

If there is a difference between radiologists and other specialties, what could account for it? Possibly the nature of radiologist education, the researchers suggested.

"There's so much information that needs to be known on the interpretive side, it leaves less time for the noninterpretive topics," said study co-author Natesan. "There's not as much time or effort put in for formalizing education in these areas."

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