Radiology crunch prompts imagers to work smarter

November 7, 2003

Demand for imaging services is predicted to far outstrip radiologist availability in coming years, but group practices are finding ways to make the most out of their day. In the short term, signs indicate that the radiologist shortage may be taking a

Demand for imaging services is predicted to far outstrip radiologist availability in coming years, but group practices are finding ways to make the most out of their day. In the short term, signs indicate that the radiologist shortage may be taking a breather.

While the U.S. population is growing at 1% per year, imaging procedures are growing at 4.5% per year, and relative value units at 6% per year, according to American College of Radiology research director Jonathan Sunshine, Ph.D. He presented his findings at the 2003 Economics of Diagnostic Imaging symposium in Arlington, VA, on Thursday.

In response, radiology groups are looking to technology and smarter staff deployment to make up the difference. Roughly half of imaging practices have some form of PACS now, according to preliminary findings from a 2003 ACR survey. In the best-case scenario, Sunshine said, the technology allows groups to save time by prefetching cases, minimizing interruptions from referring physicians, and reducing downtime. Routing work to locations that have readers who would otherwise be waiting for the next batch of cases can eliminate the need for more than one radiologist on night call or make the most of different centers' off-peak hours.

Seventy-five percent of practices have some form of teleradiology - usually within the practice or to members' homes and more rarely to out-of-group radiologists.

While only one in six practices has voice recognition software, about half have some sort of standardized dictation template that can save transcriptionist time. Other groups save time by employing nurses or physician assistants to do high-level tasks that technologists can't do and radiologists find distracting. Technologist assistants can do paperwork and basic patient prep, freeing technologists to use their time more efficiently.

Most essential was using radiologists only to do things that can only be done by radiologists, according to Sunshine.

"It may seem faster to hang your own films, but you're paid as much as 10 times more than the office staff," he said. "Unless you can hang film 10 times faster, it's inefficient."

While groups sort out their efficiencies from within, the search for outside answers, at least in terms of new hires, appears to be tapering off. The latest data on job recruitment advertising suggest the market is softening, for now.

Ads in radiology journals were down a third in August through October compared with the same period last year. The number of vacancies in academic departments, another barometer of market pressures, dropped from an average of five or a little over in 2002 to four in 2003.

"I'm quite confident that the easing of the shortage is real," Sunshine said.

Why it's down is another question entirely. Sunshine speculated that radiologists are sticking with their careers longer following the stock market downturn, that increased productivity is filling the gaps for the moment, or that turf may be eroding fast enough that radiologists are seeing less than expected of the reported imaging boom.

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