Radiologists’ brain imaging workloads have drastically increased over recent years, but the uptick has been particularly heavy for imaging trainees.
In fact, Medicare claims for neuroimaging rose by 86% for radiologists but jumped 162.5% for trainees between 2002 and 2018. This disparity also extended to workloads, with work relative value units (wRVUs) jumping nearly 80% for all services compared to 162.3% for radiology interns, residents and fellows, researchers reported Friday in Academic Radiology.
This swell may be due to institutional-specific needs, trainee requirements or broader population-driven trends, the authors hypothesized. The growth in emergency imaging use, they noted, is also a factor.
“One potential explanation for the greater rise among trainees may be the overall increased utilization of advanced neuroimaging in the emergency department, an environment often covered predominately by trainees after-hours and weekends,” Richard Duszak Jr., MD, with Emory University School of Medicine’s Department of Radiology and Imaging Sciences, and co-authors added.
A study published just last week, led by Emory researchers including Duszak, found neuroimaging use rates per 1,000 ED visits increased 72% between 2007-2017, driven primarily by head and neck CT angiography. And a similar investigation, undertaken by Emory Medicine and Mass General, found the increasing use of CT for patients with minor injuries is increasing spine imaging utilization across emergency departments.
For their current study, the group analyzed CT and MRI claims for brain, head and neck, and spine exams spanning Medicare fee-for-service beneficiaries.
Trainees were saddled with more CT claims compared to radiologists overall (196.8% vs.102.9%), along with MRI claims (106.6% vs. 59.9%), the authors reported. In terms of workloads, wRVUs for trainees in neuroradiology subspecialties jumped by 120.3% over the 16-year study period, particularly for head and neck CT (470%), and spine CT imaging (394.2%).
As it stands, radiology training programs design their educational programming based on institutional needs and priorities, Duszak et al. noted, with no national guidelines to lean on.
“Overall, these trends may indicate the need to balance individual trainee education with institutional clinical service needs,” the authors wrote in the study. “The dramatic increases in head and neck or spine imaging suggest that programs may need to make special effort to ensure adequate training of both non-neuroradiology fellowship trained radiologists as well as recruit faculty with appropriate specialization to instruct trainees.”
More research identifying trends in other subspecialties and across non-Medicare payers is needed to inform overall curriculum design for trainees, the group concluded.
Matt joined Chicago’s TriMed team in 2018 covering all areas of health imaging after two years reporting on the hospital field. He holds a bachelor’s in English from UIC, and enjoys a good cup of coffee and an interesting documentary.