Moonlighting during vacation? 5 short-term process changes to address the radiology workforce shortage
There are five potential process changes practices can make to help address radiology workforce shortages in the short-term, according to new research published Wednesday.
Much has been written about the specialty’s staffing challenges, propelled by burnout, rising imaging volumes, an aging workforce and other factors. Dana Smetherman, MD, MBA—the incoming new CEO of the American College of Radiology—and colleagues suggest several possible solutions in a new AJR [1] clinical perspective piece.
“Rather than working longer and/or faster, there are ways for radiologist to work smarter,” Smetherman, with the Department of Radiology at Ochsner Medical Center in New Orleans, and co-authors wrote April 3. “In this article, we present multiple short-term strategies to increase the effective radiologist workforce and/or increase workforce efficiency, in order to alleviate the current workload challenges.”
The authors derived their solutions from an analysis of possible practice-level changes in personnel, processes and physical plant, estimating the impact from each potential intervention.
Here is a quick rundown of their five process-related suggestions:
1. Avoid teleradiology redundancy: Practices frequently contract with teleradiology groups for weekend and night time hours. Such partnerships involve the outside company performing a preliminary read, while an in-house radiologist handles the final report. However, Smetherman et al. see this as a potential waste of resources. Teleradiology giant vRad has seen a shift in this regard amid the shortage. In 2001, 20% of its interpretations were final reads only, but by 2023 that number is up to 90%.
“Eliminating the duplicate work of reinterpretation and reporting of evening and overnight studies by daytime radiologists has effectively increased the radiology workforce,” the authors wrote. “While there is variable penetration of final reads by teleradiology companies in different markets, there may be opportunity to reduce this duplicate work in some local markets.”
2. Vacation moonlighting: In previous workforce shortages, some private practice radiologists used their vacation time to help others. If about 50% of radiologists are in private practice (13,599) and each gave up a week of vacation time, this would contribute the equivalent of 340 members of the specialty.
“Similar reductions in vacations in the academic workforce would also have the potential to effectively increase the workforce,” the authors wrote. “During the COVID-19 pandemic, many academic centers imposed temporary reductions in conference time, related to travel restrictions and increased work demands. One week of reduced conference time per academic radiologist would yield a similar increase in the effective radiologist workforce.”
3. Internal moonlighting: Practices occasionally offer “internal moonlighting,” allowing members of the organization to put in extra hours on evenings or over weekends. As an example, one practice has created a “bunker shift” that offers a fixed RVU workload and payment to attract the fastest readers. However, some have rules against “double-dipping” that would need to be modified.
“The changes in work schedules may require new human resource policies for paid time off,” the authors wrote. “In addition to internal moonlighting, some practices will allow group members to moonlight for other groups during their time off.”
4. Managing extreme variation: Practices must come up with solutions to address extreme variation in volumes and do so without overtaxing their staff.
“Peaks that are not managed result in long lists of unread studies, which can be demoralizing for the practice’s radiologists,” the authors advised. “The group could develop prospectively defined tiers or thresholds, in terms of worklist backlogs, that are linked to corresponding actions,” they suggested. “Other industries manage increased demand with surge pricing (e.g., Uber).”
5. Reducing low-value imaging: Finding ways to reduce requests for unnecessary imaging exams also can relieve staffing shortages. This could be done by building standard recommendations into report macros and improving image exchange between outside entities so that studies do not need to be repeated.
“No single change addresses the mismatch between supply and demand for radiology services,” Smetherman et al. cautioned. “By creating an inventory of potential solutions, practices can choose the potential mechanism(s) to address the workforce shortage that best fit their needs and local environment.
Read much more, including potential solutions related to personnel and the physical plant, at the link below.
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.