Develop a System for Work Distribution

April 30, 2013

Radiologist hate feeling like they’re doing most of the work. The solution? Develop a work distribution system. Here are three options.

As a parent of three kids, I have found that few things create more arguments than the question of who needs to do what chores. The only solution is to have a system. Which system may not be important, but having one means that there is an element of fairness.

The same is true with work distribution. Other than maybe money, few things seem to anger radiologists than feeling they are doing the most work, which, of course, it always seems you are.

A couple good options:

Incentive model. Incentives can promote efficiency and productivity. Basically, when there is extra work to do, those who do it get paid for it. Downside to some is that this promotes fast work, rather than quality work, but if your group is made up of good quality radiologists this shouldn’t be an issue.

One caveat: There needs to be a basic threshold of work done before this “activates.” So measure the average workload for several weeks and then include that as a threshold in the policy. Want to go the extra mile? Track productivity over a number of months to create a running average for the practice. Then create a standard deviation for that average and require that the average plus standard deviation be exceeded for several days before allowing incentives.

Shared work list. Working collaboratively and where everyone can see you is always helpful. There is a peer pressure effect to it, where you realize everyone can see what you are doing. Downside is that the amount of work done can be quite asymmetric at times, particularly if there are slower readers and faster readers. It relies on a group with fairness and equanimity, and an understanding that it is the time that is being shared, not the number of cases.

It also works best with a single specialty or in groups where everyone reads similar (or at least balanced) modalities. Going the extra mile: Assign a value to each type of test (such was with RVUs) and send everyone an anonymous monthly report with their productivity.

Distributed work list. This is where each reader gets their own cases each day. It requires an automated or protocol system to send work to a work list for each MD, based on the most common patterns. Downside is no one knows what the others are doing unless they look, and that may not promote helping each other; When it’s busy, someone has to pick up the pieces.

This may work best with groups with many younger partners or associate and in groups with different reading speeds or styles, so that everyone reads a “fair” number of cases. But have a system to deal with overflow beyond the typical. Going the extra mile: Employ a daily super-reader who sees a master work list and re-distributes the work throughout the day. That could be an administrator or a rotated job between the radiologists.

No one system is better than the other. Each has pros and cons, so discuss them among the group. The only real mistake is to have no system at all.