Interventional radiologists (IR) are becoming increasingly integral to providing effective and cost-friendly care. But in rural areas, where healthcare is already scarce, recruiting these specialists has become an uphill battle.
Philip S. Cook, took a look at these challenges and offered some solutions in a July 24 opinion piece published in The American Journal of Roentgenology.
The Mayo Clinic Florida radiologist cited a 2017 American College of Radiology (ACR) survey that found 75 percent of respondents believed it difficult to recruit and retain IR to rural and small community hospitals, and nearly 55 percent believed the difficulty was related to interventional radiologists' unwillingness to do diagnostic work.
“The problems are multifaceted and need further examination, but some early solutions are evident,” he wrote. “Most of the stakeholders have both a role and responsibility to address the needs of our rural communities and to ensure optimal quality cost-effective care through IR.”
Work with local hospitals
Cook argued interventional radiologists do not want to perform routine diagnostic procedures, but if they did take on this responsibility, it would allow rural practices to hire additional specialists and build the business.
A lack of volume to perform IR procedures and an inability to keep skills up-to-date are hampering rural facilities’ recruitment abilities, he argued. However, rural practices may be able to overcome these issues with the help of local hospitals.
Cook suggested rural practices could negotiate with local hospitals to cover certain emergency services. He also recommended hospitals and rural locations work together with academic radiology programs to rotate residents, fellows or staff or even receive coverage from a larger city-based group.
Additionally, groups can negotiate the scope of IR coverage required by its hospital contract and to select certain predetermined complex procedures for referral to larger centers.
“These arrangements offer benefits to all stakeholders,” he wrote. “The larger institutions benefit from increased referrals, and the hospital benefits from ensured optimal patient care of the cases that require a higher level of care, expertise, and resources, not only in IR.”
“The rural radiology practice benefits from contractual compliance,” he added. “The interventional radiologists would no longer feel pressured to perform cases that may be beyond the scope of their practice.”
When rural radiology groups cannot recruit directly, they may need to consider a partnership or merger with existing IR and diagnostic practices, Cook suggested.
Subcontracting for IR coverage, creating a regional practice or subcontracting with stand-alone IR practices willing to travel to a rural facility could offer other options to consider, he wrote.
He provided many more solutions in the piece, but when it comes down to it, he wrote, IR services will be necessary for rural patients, whether they travel to their nearest hospital or to their local facility.
“If IR services are not provided, rural patients will not receive optimal care,” Cook wrote. “The problem has been identified early enough to permit development and implementation of focused solutions. Collaboration among organized radiology will be necessary to properly address the challenges.”