AI not 'economically viable' if it doesn't replace at least some radiologists, experts claim
With many healthcare organizations in the midst of making decisions around investing in artificial intelligence, now is the time to consider how the technology may affect the workforce, experts caution.
The role AI will play in the future has been the topic of heated debate in recent weeks, with the CEO of one of the largest health systems in the U.S. suggesting he is ready to replace radiologists with AI in certain situations. This notion was met with much criticism from rads, but the authors of a new paper in European Radiology say it might be time to think realistically about how the technology will affect physician roles in the future.
“The current positioning of AI in radiology is internally inconsistent. AI is promoted as augmenting clinicians and keeping radiologists and technologists fully in the loop, while its economic value proposition, as in other industries, is labor substitution, thus delivering more output with fewer staff,” noted co-authors Merel Huisman, of the department of radiology and nuclear medicine at Radboud University Medical Center in the Netherlands, and Renato Cuocolo, with the department of medicine at the University of Salerno in Italy. “It is time we confront the possibility that, for AI to be economically viable, it may indeed need to substitute human roles.”
The duo questioned whether investing in AI is economically sustainable without reducing the human workforce. They offered the example of agentic AI chatbots that assist patients with basic tasks, such as setting and cancelling appointments; this frees up staff to complete more complex tasks, but it also eliminates the need for lower tier human support. A similar scenario has played out in manufacturing, where automation has reduced the number of workers required to maintain the same production.
While medical settings are vastly different and AI integration requires significantly more consideration, the authors caution that “radiology is not immune to these market forces.” Although AI, in most cases, cannot outperform human readers, it can execute many tasks with accuracy on par with radiologists. This, the team argues, supports using AI to replace humans in certain scenarios.
“If an AI system offers performance matching a human reader, clearly, the primary mechanism to extract value from it cannot be represented by improved clinical performance. Rather, operational efficiency becomes the main added value provided by AI,” the authors contend, adding that this is already playing out in some cancer screening settings.
The bottom line is that any investment in AI will come with added expenses. At what cost exactly—whether at the expense of human labor or otherwise—is yet to be determined.
“Historically, productivity gains in healthcare rarely translate into reduced workload. Instead, they expand service capacity and diagnostic volume,” the authors noted. “AI is therefore more likely to shift radiologists toward supervising larger exam volumes and AI outputs rather than creating additional patient-facing time. If AI merely makes a radiologist 10% more accurate but does not increase their speed or reduce the need for downstream testing, it is a cost-adder, not a cost-saver, unless this leads to quantifiable health gains such as [quality-adjusted life years].”
With this in mind, the duo suggested now is the time to “realistically reassess how radiologists create value.”
“Ignoring the economic drivers of automation will not prevent workforce transformation; it will only reduce our ability to shape it,” they added. “The future role of radiologists, and the thriving of the profession, will likely depend less on image interpretation alone and more on how effectively we manage, validate, and clinically contextualize automated diagnostic systems.”
The full paper can be viewed here.
In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She began covering the medical imaging industry for Innovate Healthcare in 2021.