Many radiology practices don't use off-hours services, despite their benefits

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A recent study in the Journal of the American College of Radiology found that radiology practices that can provide sufficient professional interpretation of their current image volume do not contract for off-site interpretations, even if the cost is lower.

Scott Kennedy from the Yale University School of Medicine in New Haven, Conn., and colleagues sought to compare radiology practices that use external, internal and no off-hours services.

From August 2005 to June 2006, the researcher randomly selected 300 non-specialty hospitals from the AHA Guide 2005 Edition. The investigators obtained a total of 115 responses (a 38.3 percent response rate), with 64 from radiology practices that used external off-hours services, 13 from practices with internal services and 38 from practices with no services.

Kennedy and colleagues compared the demographics of the practices in the three categories, and tabulated answers to category-specific survey questions. Responses were analyzed using descriptive statistics.

The researchers found that radiology practices using internal off-hours services were significantly larger (mean size, 19.9 full-time radiologists) than those using external off-hours services (mean size, 8.2 full-time radiologists) and those not using any off-hours service (mean size, 10.7 full-time radiologists).

A sufficient number of radiologists or residents covering nights had the highest reported importance in the decision not to adopt an external service, the authors wrote. Cost and quality concerns also were cited by the surveyed.

The consistency of interpreting radiologists known to a practice had the highest importance in the decision to use an internal rather than an external off-hours service, the investigators said. Frequent reasons cited for radiologists to take regular internal off-hours employment were financial incentives provided and a preference for off-hours shifts.

Despite the growth of external off-hours services, the researchers found that the financial incentives and quality assurances afforded by internal off-hours services will continue to make them an attractive option.