Radiology, along with most other specialties, has been forced to rethink patient care during the pandemic. And many have found success with expanded off-site reading programs.
In fact, a survey of nearly 300 practices published in mid-May found a 65.2% increase in the proportion of sites installing home workstations, with 73.6% switching normal daytime shifts to internal teleradiology.
A number of experts believe remote reading is the new normal, and while the majority of telerads would like to make the change permanent, authors of an Aug. 9 discussion piece published in JACR say there is a “definite” need for on-site radiologists in many areas, including interventional procedures and fluoroscopy.
David Fessell, MD, a radiology professor at Taubman Center in Ann Arbor, Michigan, and the ACR’s Chair of the Commission on Leadership and Practice Development, Frank J. Lexa, MD, MBA, asked four radiology leaders how they intend to handle the work from home revolution.
1. NYU Langone Department of Radiology
Professor and Chairman Michael P. Recht, MD, said he is “very much” in favor of remote reading and noted that about one-quarter of his faculty took part in this practice—thanks to a wellness initiative—prior to COVID-19.
The increased autonomy and flexibility improved work-life balance for the nearly 70% who have taken advantage of the program during the pandemic. Recht anticipates most will want to continue, but maintained it’s critical to have some rads on-site to talk with referring providers and help trainees, among other reasons.
“There is no need to have all of our 232 radiologists on-site each day,” he said Sunday. “Allowing each to read from home one or two days per week allows for improved faculty morale with no negative effects on the value radiologists bring to our patients or referring physicians.”
2. Texas Health Presbyterian Dallas Department of Radiology
The Dallas-based institution already utilizes a blended on-site-off-site model which allows it to handle quick volume surges and enhance subspecialty coverage, said Cindy Sherry, MD.
During COVID-19, more cases were read remotely, but in order to return to the “familiar competitive business of medicine,” she deemed it “imperative” to reestablish their pre-pandemic balance.
“Our hospital presence is essential to sustain our contracts, build our practice, be an influential part of our medical communities, and secure our future,” Sherry added.
3. UC San Diego Health Department of Radiology
Alexander Norbash, MD, chair and professor of radiology, said there are clear advantages and disadvantages to telecommuting, including more at-home time, but real potential for radiologists to pass up on late shifts.
He said having these physicians in-house contributes to a sense of team, and noted many radiology nonphysicians don’t have the opportunity to telecommute, which could lead to problems.
“A gradient of resentment including non-telecommuters could develop if a teleradiology strategy is not carefully constructed and deployed,” he said, noting such programs must be thoughtfully utilized.
4. Chambersburg Imaging Associates
Robert Pyatt, MD, a board-certified radiologist with the Pennsylvania provider, said they plan to reduce on-site staffing, which should boost the efficiency and turnaround times of at-home staff.
He did express concern that with fewer rads in the office, potential coverage shortages could surface in interventional radiology and critical care.
“We must be very careful to not fall into ‘risky’ behavior with a borderline response for requests for any on-site studies,” Pyatt said.