Dayhawk teleradiology phenomenon unsettles radiology market

The commercial success of nighthawk teleradiology services has spawned an emerging dayhawk teleradiology market. The process is generating a new menace to conventional radiology groups.

"The new dayhawk market threatens the very existence of not just some radiologists' lifestyles but even their jobs," said Dr. Giles W. L. Boland, an associate professor of radiology at Harvard Medical School, and medical director of teleradiology at Massachusetts General Hospital.

Boland details the dayhawk threat in a May commentary (AJR 2008;190:1161-1162).

The dayhawk phenomenon has grown out of hospital satisfaction with the rapid service hospitals receive on outsourced off-hour interpretations by nighthawk teleradiology groups.

Hospital administrators and referring physicians have begun to wonder why their local radiology groups cannot deliver the same level of service for daytime radiology reads that they are receiving from nighthawk groups.

Since many radiology groups are understaffed and cannot readily provide rapid subspecialty daytime reads, however, some have been forced to outsource an increasing number of daytime interpretations to the acquisitive teleradiology companies. Teleradiology firms are positioned to respond to the new dayhawk market based on the logistic infrastructure built for nighthawk services, Boland said.

Radiology groups who readily outsourced their off-hour responsibilities in the hope of making their practices more attractive in a tight labor market have inadvertently created a competitive dayhawk market.

"The speed with which competition has been introduced into the radiology market has caught some radiology groups by surprise. Some have already lost either part or all of their existing franchise," Boland said.

The success of commercial teleradiology companies has drawn in larger entrepreneurial radiology groups. This shifting market has resulted in an intense phase of industry consolidation. Smaller radiology groups, particularly those delivering substandard customer service, are at significant risk of losing out.

"They are at a particular disadvantage because they often cannot offer the full range of subspecialty services that increasingly is being demanded of them," he said. "Consequently, some radiologists can no longer assume long-term job security because their core value proposition can now be outsourced."

The dayhawk teleradiology shockwave has had an unsettling effect on radiology's vision of the future.

While teleradiology has much to offer, radiologists, referring physicians, teleradiology companies, and patients face a future full of uncertainty and risk, according to Boland.

"As teleradiology comes of age, it is not yet clear who will end up the ultimate winners and losers," he said.