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The Teleradiologist Experience


This series focuses on what it’s like to be a radiologist in a variety of settings. Here, we focused on teleradiology.

Your house. The beach. A hotel room on another continent. If you’re a teleradiologist, your physical location doesn’t matter. Have secure network and proper equipment, ability to read and diagnose.

When teleradiology first entered the industry as a career option, it was pigeon-holed into being an overnight service only. Radiology practices used teleradiology as a way to avoid overnight call. However, in recent years, reading images remotely has ballooned as a viable career option for radiologists who simply don’t want to work in hospitals or imaging centers.

And, the teleradiology track is growing dramatically. According to a recent report from the market research firm Grand View Research, teleradiology is on pace to be a $8.24-billion business by 2024. Currently, X-ray reads account for 30% of the work volume, and CT scans are expected to grow annually by 20% through 2024.

Clearly, working remotely is becoming a more popular option for new and experienced radiologists who don’t want to be tied to a set schedule or office.

In some regards, especially with ease of access and communication with referring physicians, teleradiology mimics academic and private practice. It does, though, offer many differences, present significant benefits, and introduce substantial challenges.

Still, said Michael Rothman, MD, a teleradiologist based in Bethlehem, PA, teleradiology fulfills a need within the radiology and patient community.

“Teleradiology enables me and my colleagues to offer subspecialty coverage and technical training to providers,” he said. “We’re able to provide care to outlying communities so they don’t have to leave their locations to get the same quality of services as they would at larger facilities.”

As a provider, though, there are things you should know before you opt to work remotely as a diagnostic radiologist, he said.[[{"type":"media","view_mode":"media_crop","fid":"52784","attributes":{"alt":"Teleradiology","class":"media-image media-image-right","id":"media_crop_5853355319205","media_crop_h":"0","media_crop_image_style":"-1","media_crop_instance":"6552","media_crop_rotate":"0","media_crop_scale_h":"0","media_crop_scale_w":"0","media_crop_w":"0","media_crop_x":"0","media_crop_y":"0","style":"height: 200px; width: 200px; border-width: 0px; border-style: solid; margin: 1px; float: right;","title":"©LANTERIA/Shutterstock.com","typeof":"foaf:Image"}}]]

Choosing teleradiology has become a more viable career option over the past decade, said Michael Yuz, MD, an executive radiologist with USARAD, a radiology-on-demand company. As the opportunities have expanded, so have the positives that come with the work.

1. Flexibility: As a teleradiologist, Yuz said, you’ll be able to set your down days and hours for work. Getting up early or working later are viable options that you can’t choose if you work in a brick-and-mortar 9-to-5 imaging center.

“Don’t be fooled into thinking you won’t work as much, though,” he said. “You’ll likely actually work more hours than your colleagues in centers or hospitals. It’s not uncommon to work twice as much – to mostly have 12-to-14 hour days.”

2. Lifestyle: If you aren’t tied to an imaging center, you’re freer to choose where you live, and you’ll have more time to interact with your friends and family, Rothman said. If you’re happier where you live and work, you’ll experience less stress in your work life, as well.

3. Subspecialization: Most imaging centers tend to ask their radiologists to be generalists. If you’re a teleradiologist, you have more opportunities to focus on a subspecialty, Yuz said.

“Though, you might be expected to be knowledgeable in all areas, there are opportunities to subspecialize,” he said. “You also have the opportunity to stop in and read for hospital radiologists who don’t have the experience in your area of expertise.”

4. Choose Your Partners: As a teleradiologist, you can be more selective about the imaging centers and hospitals with whom you partner. It’s up to you to decide whether you’d like to work with larger or smaller entities, Rothman said.

But, alongside the benefits that come with working remotely, you will encounter challenges to your daily practice, Rothman said.

1. Absence: You might be working around the clock from your home or vacation site, but your hospital administrators or practice leaders don’t know that. You’re not there for face-to-face conversations, so that can put you at risk.

“As the teleradiologist, I’m the easiest target for cuts because I’m not part of the hospital groups or network for insurance billing,” he said. “They can pick me up and replace me easily.”

2. Economic Downturns: There’s nothing you can do to control this problem, Rothman said. When the economy stumbles, hospitals and imaging centers become more frugal, pulling back on expenditures. That means there’s less cash to invest in the remote reading services you offer.

3. Technology: Again, you’re at the mercy of uncontrollable forces with technology. If your computer or network experiences a glitch, you could find yourself unable to work for an undetermined amount of time. Depending on what your contracts stipulate, Rothman said, you could find yourself unable to meet your professional obligations.

“As teleradiologists, we have to accept that we’re dependent upon electronics,” he said. “But, to do what we do, you have to have 24/7/365 technical support.”

Payment & Reimbursement
Getting paid as a teleradiologist is different from collecting a paycheck from a hospital or imaging center, Yuz said. Despite its reputation, teleradiology doesn’t require less work for more money. In fact, he said, the opposite is true.

In this role, you’ll read more for the same or less pay. Typically, teleradiologists make less than radiologists who work on-site.

The difference comes from reimbursement strategies, Rothman said. When teleradiologists contract with imaging centers or hospitals, they sign over their rights to file reimbursement on their own behalf – the hospital or imaging center files for them. Consequently, any reimbursement paid for teleradiology services gets diluted in the cash flow used to pay for the practice’s working expenses.

In general, he added, you’ll likely be paid in one of two ways – either as salaried, plus bonus, or on a per-click basis, meaning the more you read, they more you get paid. Yuz agreed, adding that you have to not only be fast, but you must also be accurate in your reads.

“If you don’t read well with a low error rate,” Yuz said, “you won’t do well in teleradiology.”

What You Should Know
If you’re considering teleradiology as a career, there are some things you should think about, Yuz and Rothman said.  If you can work within these parameters, teleradiology could be a good career choice.

1. Self-motivation: If you work remotely, there’s no one watching over you to ensure you’re reading images when you say you’ll be. You must be able avoid the distractions – whether they’re family or household chores – that pop up from working at home.

2. HIPAA: Having a dedicated, at-home office space isn’t enough to be a practicing teleradiologist. You must be sure you have a HIPAA-secured network so you’re protecting patient data at all times.

3. Legal Support: Chances are, you’re working with practices and hospitals that are scattered throughout the country – or internationally. You’ll be required to have licenses to practice in all states, and you’ll need legal representation in each state to ensure your liabilities are covered.

4. Personal Contact: Before you opt for teleradiology, honestly assess whether you enjoy face-to-face contact with your referring physicians, Yuz said. If you enjoy meeting with colleagues and having in-person interactions frequently, it’s unlikely you’ll be happy with teleradiology.

5. Speed: Are you fast? Can you read accurately and rapidly? If so, teleradiology could be a good fit. However, if you need to work a little more slowly, you may want to consider working in an office environment.

Ultimately, both Yuz and Rothman agreed, as teleradiology continues to grow and more facilities rely on it for greater subspecialization and timely diagnoses, it’s likely more radiologists will choose working remotely over tying themselves to a facility on a daily basis.

“You can create a lifestyle that meets your needs and still provides you with a reasonable income stream and quality cases with great groups to work with,” Rothman said.

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