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While this push benefits the speed of care delivery, it can negatively affect radiologists' work-life balance. In fact, the 2019 Medscape National Physician Burnout, Depression, and Suicide Report found that 45% of radiologists suffer from burnout. It's on radiology group and hospital imaging leaders to uncover ways to balance radiologist workload and ambitious productivity goals.
Leaders should consider ways to leverage non-radiologist staff to delegate radiologist workload. Specifically, they should allow non-physician providers to read x-rays and use support staff to minimize radiologist interruptions.
1. Delegate some imaging exam reads to non-physician providers
While other service lines rely heavily on non-physician providers (NPPs) to deliver care, radiology has largely resisted this shift. However, a recent study from the American Journal of Roentgenology found that Medicare diagnostic imaging exams read by NPPs increased by 14,711% from 1994 to 2015, with X-ray and fluoroscopy accounting for the vast majority (94%) of this total. However, it's worth noting that NPPs accounted for only 1.27% of imaging in 2015.
At the same time, scope-of-practices laws for NPPs, including radiology assistants (RAs), are evolving. Last year, CMS changed the supervision requirements for diagnostic tests furnished by RAs from "personal" to "direct," meaning that instead of requiring physicians to be in the room during tests, they must be immediately available.
In response to these trends, leaders should consider incorporating NPPs into diagnostic and interventional radiology workflow to reduce radiologist workload. Typically, NPPs provide preliminary exam reads under the supervision of a radiologist and make clinical recommendations to referring providers for interventional radiology exams. Ultimately the role of NPPs depends on state scope-of-practice laws and organizational preferences, but these staff members can increase overall efficiency, deliver high-quality patient care, and lower overall cost.
2. Minimize radiologist interruptions
On average, radiologists experience interruptions five times an hour, which increases their read time. These interruptions take many forms, from responding to referring physician requests, answering a phone call, talking to a colleague, or managing critical results.
Asheville Radiology lessened this burden by delegating all radiologist critical result calls to non-radiologist staff, called RadReach, so as to minimize interruptions during reads. When a radiologist identifies a critical result, he or she clicks a button in his or her picture archiving and communication system (PACS) enabled by Primordial from Nuance. An alert then goes to one of the two RadReach staff members, who calls the referring physician and transfers the call to the radiologist. This approach ensures that radiologist don't waste any time tracking down the physician or waiting on hold.
Overall, RadReach staff monitor all critical results findings and personally manage about 60% of physician calls. Radiologists own the remaining 40% of calls, because sometimes it is more efficient for the radiologist to call directly. When RadReach manages communication, they save radiologists an average of 18 minutes per case, which equates to 450 minutes daily across the practice. It's been so successful that Asheville uses the same model to track quality initiatives, like incidental findings.
What's next?
Regardless of the strategy, leaders must find ways to reduce radiologist workload. If not, they risk an overburdened and burned-out workforce. Delegating tasks to non-radiologist staff is a cost-effective and efficient way to maintain productivity levels while decreasing radiologist workload. Long term, leaders should explore how to automate route tasks, like implementing an intelligent worklist.