Radiologists today have to analyze upwards of 100 medical images each and every day – a feat not easily accomplished considering they must also produce in-depth diagnostic reports for each, alerting physicians to any critical test results or follow up recommendations for patients, and interpreting incidental findings appropriately. Despite the jump in caseloads and pace a correlating increase in radiology reimbursement has not been observed. The overwhelming scenario currently facing radiologists reminds me of the “chocolate factory episode” of I Love Lucy. With the significant rise in studies and the complexities that follow, how can radiologists possibly keep up?
According to the fourth-quarter survey from the Medical Imaging Confidence Index (MICI), radiologists do not think they will receive adequate radiology reimbursement levels from Medicare for diagnostic and interventional radiology services. They are most skeptical about this when compared to five other topics and trends that touch radiologist every day and are viewed with more optimism. It’s not a surprising outlook, as radiologists now have to read 30 percent more studies in order to be reimbursed at the same rate as times past and documentation demands have grown more than ever before for all physicians.
Because of these mounting pressures, fewer radiologists are filling today’s residency programs. In return, the number of new jobs available for radiologists is 16 percent higher today than in 2015, according to the American College of Radiology (ACR). A recent report revealed only 53 percent of radiologists are satisfied with their overall career. Many noted bureaucratic tasks as the prime cause of their burnout, with “spending too much time at work” coming in as a close second.
I recently spoke with Dr. Lincoln Berland, professor emeritus of radiology at UAB School of Medicine, for more insight on the problem. According to Dr. Berland, 10 years ago radiologists read about 30 medical images a day, which doubled to 60 images just five years later. Today, the number has grown to more than 100 images each and every day. Patients are sicker, regulations and best practices abound and in-depth diagnostic imaging reports are highly scrutinized by physicians and patients. Physicians of all specialties need help.
This is like the infamous I Love Lucy “chocolate factory episode,” that features Lucy and Ethel with new jobs that send them to the factory’s conveyer belt. The task seems simple at first, to wrap each piece of chocolate coming down the line. However, the pace accelerates; the conveyor belt gets out of hand, and speeds up so much that it becomes impossible to deal with each piece of candy. Though Lucy and Ethel try their best, Lucy finally exclaims, “We’re fighting a losing game!”
Similarly, radiologists face an escalating pace in a job that requires much greater precision, where a backlog of cases causes much greater risk and with seemingly no end in sight. With a shortage of radiologists, and no one to share the workload how are radiologists able to keep up?
Fortunately, advances in health IT have given rise to tools that help radiologists save time, be more efficient and focus on the more critical tasks at hand. For example, machine learning that can make radiologists’ workflow so efficient and intuitive that the most urgent cases are dealt with first without their having their hands on every piece of chocolate. Sophisticated computer systems can sift through vast amounts of data available in healthcare today, picking up on patterns and continuously “learning” to help alert physicians to next steps or considerations that might be missed. While not replacing the important role of radiologists, this technology can amplify the efforts of clinicians and help ease frustrations by helping them prioritize –whether its high-risk studies or critical information needed in documentation to alert others in the care process. What’s more, the machine can perform this process automatically – giving radiologists more time to focus on patient care. In addition, the data collected can be analyzed to identify trends, opportunities and potential issues to improve clinical and financial performance.
As the healthcare industry continues to modernize its processes and procedures, my hope is that the advanced tools and intelligent systems, will relieve some of the pressure from radiologists, and resident programs will return to capacity. In the future, I’m confident that radiologists will be able to more efficiently deliver quality care and receive adequate reimbursement for diagnostic and interventional radiology services helping them be more satisfied.
Karen Holzberger is the vice president and general manager of Nuance’s Healthcare’s diagnostic solutions business. Karen joined Nuance in 2014 with more than 15 years of experience in the Healthcare industry. Prior to Nuance, she was the vice president and general manager of Global Radiology Workflow at GE Healthcare where she managed service, implementation, product management and development for mission critical healthcare IT software. Karen attended Stevens Institute of Technology where she earned a B.S in Mechanical Engineering.