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Teleradiology day reads shake up the specialty

Teleradiology day reads shake up the specialty

If you forgot your hospital administrator's last birthday, make darn sure you don’t next time around.

In fact, you may not need to genuflect before their hospital administrators anytime soon. But a growing trend of teleradiology-minded folks going after the day-read business is eroding perhaps the most powerful bargaining chip for contract negotiation radiologists ever had. The perceived commoditization of imaging interpretations is thus leaving hospital radiologists with few choices: enhance the quality of their services, be nice to hospital CEOs, or get ready to be replaced by day hawks.

Back in June, the Mercy healthcare system in Toledo, OH, shocked the radiology community when it replaced the local radiology group that staffed its three hospitals with an out-of-town practice-management firm that used teleradiology for primary daytime interpretations. According to the Toledo Blade, St. Vincent Mercy Medical Center had been unable to reach a contract agreement with Consulting Radiologists and decided to hire Imaging Advantage, based in Santa Monica, CA.

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The relationship between the 19-member radiology group and Mercy hospitals that had endured for over half a century broke up nastily last May. Contract negotiations had been stalled for about a year when Consulting Radiologists got—almost literally—its two-weeks' notice. The radiologists were on the faculty at the University of Toledo, which retaliated by pulling all of its radiology residents from the Mercy hospitals. Radiologists from the former group were offered jobs under Imaging Advantage's supervision, but none stayed. The resulting shortage disrupted mammography, interventional radiology, and other imaging-related services. What was meant to be a seamless transition turned, by some accounts, into an administrative nightmare that left in its wake grieving technologists, disgruntled referring physicians, and widespread turmoil.

Circumstances surrounding the case have been tinged with hearsay and misinformation. In early August, an e-mail attributed to teleradiology company NightHawk Radiology advocating the death of the middlemen, hospital-based radiology groups, incited uproar among radiologists. The note, allegedly in a quarterly report, stated that the best strategy to address recent revenue losses and the need for long-term growth would be “bypassing the radiology groups and working directly with the hospitals.” A stream of comments propagated through the Internet also pointed the finger at the Coeur d'Alene, ID, firm for supposedly having a hand in displacing the Toledo radiology group.

In an Aug. 10 letter addressed to its customers, NightHawk Radiology's president and CEO Dave Engert said all the allegations were false. Engert said the remarks were actually excerpts from a report by an independent analyst and erroneously attributed to NightHawk, which had disowned such a strategy.

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