Summer Rads, Makes Me Feel Fine

June 6, 2014

Longer days correspond directly with an increase in volume of imaging studies.

Meteorological and astronomical criteria notwithstanding, the passage of Memorial Day has many folks of the opinion that summer is here. From a teleradiology perspective, it’s hard to argue with this; imaging workload tends to increase with the season (in vRad, they call it the “Summer Surge”), and this year things got hectic even earlier than usual.

There are a bunch of reasons for it, most of which can be boiled down to supply versus demand: Fewer radiologists working, and/or more imaging studies to be read. While it might occasionally be interesting to delve into the specifics of how this comes to be, the more pragmatic issue is how to deal with the extra work when it turns up.

In the first couple of (non-telerad) post-fellowship jobs I held, the folks in charge dealt with it by flogging the employee-radiologists to work harder. There were minor variations in how this played out. In the more dysfunctional place, for instance, the partners at one point distributed a memo saying that “We have to work together” to deal with a case-backlog that had developed by coming in at least an hour early, in exchange for which some pittance of breakfast would be offered. Surprise, surprise, the partners themselves didn’t show up, and you can imagine how eagerly the rads pitched in on subsequent occasions. (The previous year, those partners’ idea of a holiday bonus had been coupons for free turkeys at a local grocery chain.)

It’s a bit of a cognitive disconnect; give a typical salaried rad a stack of extra cases to read, and his first thoughts are not likely to include eagerness or gratitude for the burden. Deep down he knows that reimbursements for these cases are “baked in” to his annual compensation, but he’s more consciously aware that his next paycheck will be the same as if the bundle of extra cases had wound up on someone else’s desk.

As I’ve mentioned in the past, moving to teleradiology was a refreshing change for me (and most of the other remote-radfolk I know): Woeful commentary about the commoditization of our field notwithstanding, it got a lot of us back in touch with the basic connection between work and reward. When reading more means receiving more payment, you stop regarding extra cases as an unwelcome stressor, and instead welcome them as you probably should have in the first place. Radiologists can then, within reason, self-select as to whether they wish to be 15-case-per-hour dynamos or somewhat more considered and/or leisurely.

Taken to the next level, this self-selection can apply not just to the number of cases a rad feels capable of reading in a given duration, but even to the matter of whether s/he takes on extra hours or entire shifts when the practice identifies a need for them. For instance, suppose you know you’ll need 10 extra hours of radiology coverage over the next week, and you have a roster of 10 rads to get it done. If you emulate the turkey-bonusing partners mentioned above, the solution is simple – force each rad to do one extra hour, knowing that at least some of them are going to resent you for it and probably drag their feet the whole time. Or…you can assign a bonus-value per hour (extra pay, time off, etc.), and let the rads who are interested step forward of their own accord. You might find five of them interested in taking on two hours each, or even just one or two willing to shoulder the whole burden. Meanwhile, you no longer have the thorny issue of drafting unwilling participants.

Which brings me back to the phenomenon of the busy summer season in teleradiology, I can’t speak for other outfits, but vRad has a proactive approach when they recognize that there’s going to be a surplus of work: They put the word out to the radiologists as to which hours could use extra help, and on a first-come, first-served basis, rads who respond get put on the schedule. Under certain circumstances, the extra hours worked are compensated at a higher rate than those contractually scheduled.

Some rads are more responsive to this approach than others. I’m certainly not one to easily part with my free time, especially when the weather is nice and the beach is calling me. Still, I keep a watchful eye out for the regular email announcements of available extra hours, so I can reliably grab a few. I tend to sign up for eight to 10 extra hours during my off-weeks, and lengthen three to four shifts during my working-weeks by an hour each.

If I were flat-salaried and my employer came to tell me he expected me to put in those kind of extra hours during the coming season in the name of teamwork or “for the good of the practice…” well, let’s just say I wouldn’t enlist quite as eagerly as I do now.