A Peek at Post-Peak COVID Practice

An ACR panel shares insights on what your practice could face in the next phase of the outbreak.

The next wave of the pandemic is just beginning to roll out, but it is likely to present as much uncertainty as the initial phase, particularly for smaller groups, industry leaders say. But, having an idea of what to anticipate can help you and your colleagues navigate the unsure waters.

Recently, the American College of Radiology’s (ACR) Commission on General, Small, Emergency and/or Rural Practice convened a panel of industry experts nationwide to offer perspectives on what the coming weeks could bring, as well as how lessons learned from the past few months can carry over. The group published their thoughts in the June 15 Journal of the American College of Radiology.

Recruitment Efforts

After initially asking some providers to take additional time off or placing some on furlough, the panelists said practices could now find themselves faced with new staffing questions. It is possible, they advised, that many groups will need to pause or significantly reconsider current recruitment efforts or expansion plans until they have a much more concrete idea of what their imaging volumes will be. But, for those who continue with recruitment efforts, using a video interview model can be a safe and efficient way to screen potential candidates.

The panelists did indicate that, at least within their own practices, that current signed contracts would be honored and new hires would start on time.

Volume Changes

Even though more facilities are starting to offer elective services again, the timing and rate of any increase in imaging volume is still in flux. And, much will depend on the level of patient comfort with accessing imaging services also varies by geographic location, the panelists said.

To help increase volume levels, they suggested providing urgent imaging services at outpatient facilities for patients who have been triaged from urgent care centers or telemedicine visits instead of emergency departments or other hospital-based facilities. This can be helpful during surge or peak COVID-19 volumes, they said. They also echoed the need for extended operating hours to accommodate for more spaced-out appointment times and physical distancing requirements.

Financial Effects

Although opinions have been mixed about whether radiology could face further consolidation due to the pandemic, the panelists did warn that pressures from the outbreak might push the industry in this direction. Those of you in smaller groups with fewer resources might feel compelled to abandon your “go-it-alone” approach, while others who are already highly leveraged could feel the need to re-organize to avoid financial failure.

“It is possible that the severe stress placed on many practices and health systems could lead to greater marketplace consolidation or bankruptcies,” they wrote.

Still, it is too early to know what they long-term stability of most practices will be, they contended. Consequently, they recommended practice leaders continue to monitor their local infection rates, system capacity, and any other region factors that could directly influence the rebound of their imaging volumes. It is also imperative for groups to investigate strategies that could, at least, contribute to short-term solvency while creating a more cohesive, long-term plan.

The Lasting Impacts

Still, your doors will re-open, and your imaging volumes will rebound. But, COVID-19 will leave an indelible imprint on radiology. There will be some effects that are here to stay, the panelists said.

Remote work: Whether it is traditional teleradiology or a work-from-home arrangement, the panelists agreed that practices and hospitals will see sustained levels of radiologists working outside their facilities going forward. Already, groups are seeing a bump in requests – from both current radiologists and job applicants – to work from home for both personal and family safety reasons. 

“Practices may have to adjust current job offerings to attract the best candidates if volumes return quickly and the job-market tightens,” they wrote. “During the recovery phase, hospitals may be more willing to negotiate the total number of on-site providers needed to facilitate an increase in teleradiology services.”

Cleaning and Protection: Augmented sanitation and disinfection procedures are certainly here to stay, the panel confirmed. Offices and departments will continue to use lengthier cleaning protocols and will require consistent use of personal protective equipment for the foreseeable future.

It is possible, however, they said, that waiting room restrictions and other physical social distancing measures could begin to relax, but each practice must make that determination based upon their location infection statistics and patient comfort levels.

The panel included: Anthony Gabriel, M.D, MBA, co-founder of Radiology Partners, Benjamin Strong, M.D., chief medical officer of vRAD, Cathrine Keller, M.D., managing physician of Lake Medical Imaging, Daniel Rodgers, M.D., president of Kanawha Valley Radiologists, Howard Fleishon, M.D., MMM, FACR, vice chair of the ACR Board of Chancellors, and Lyndon Jordan III, M.D., FACR, president and managing partner of Wake Radiology.