When economic pressure is applied, it is not time to cut service and reduce time spent consulting or reviewing clinical data. It is time to increase those value added services and more.
The radiology business world has been full of articles about threats to our financial well-being. Amongst them, articles have talked about Accountable Care Organizations (ACOs) and several articles recently talked about effects of bundling of codes. In some cases, these articles have implied or even stated that there could be pressure on radiologists to limit their review of clinical information, reduce time in communication or attention to detail.
Certainly that suggestion is an affront to our professional and Hippocratic sensibilities. None of us entered the profession of medicine or radiology with the intent of modulating our level of service by the amount we are paid. Yet, it does make me take stock of what to do in the face of economic pressure. No one, including physicians, is immune to feeling strained when faced with a potential reduction in what they are paid. So should we look for ways to reduce service provision or save time in our interpretations or interaction with referring physicians in order to cut our overhead? Should we cut corners? Reduce time spent in consultation or review of clinical data?
Quite the opposite. I would suggest that our value is in doing those things and more. In the past it has been suggested to me that radiologists might be less important as other physicians became more familiar with new technology. But I have found the reverse to be true. As other specialists have become overloaded with more and more data, and often larger patient loads, it is increasingly difficult for them to master this art. Sure some pieces have been bitten off of the radiology pie, but the pie has also gotten bigger and more complicated.
At the same time we have increasingly been able to broaden our consultative role. We are able to access additional information to aid in our interpretation. Electronic records are ubiquitous. Orders and clinical routers contain evermore information for us to review. I spend more time reviewing this information and using it for interpretation than ever. With physician extenders and others who are less familiar with radiology ordering many studies, use of the radiologist as consultant has grown. That means we are even more valuable than in the past.
So when economic pressure is applied, it is not time to cut service and reduce time spent consulting or reviewing clinical data. It is time to increase those value added services and more.
But how do you do that? It is easier than you might think. It requires a little extra thought and effort but it can pay off - in personal satisfaction, patient care, and maybe even your pocket.
Take everyday reading examples like spine MRI interpretation. Make following your reports on the films easier by using spine level labels. In routine studies, make identification of your impression points simple by using features like “key” images on your PACS or saving and emailing relevant images in your reports if you can. Help referring physicians know that something of relevance was found by making phone calls a routine, not just for critical findings. Maintain relationships with the referring physician, by following-up on important findings needing further radiological work-up. Reduce the burden on referring office staff by pressing to have your staff or the technical-side staff track down relevant comparison studies from outside facilities. Make it easy for your referring physicians to know what to do with reports, by putting special emphasis on impressions needing follow-up in your report.
Many referring physicians will appreciate the extra effort. It might even mean more referrals and improve your bottom line.