Steeped in Clinical Demands, Rads Gun-Shy about Practice Management, Patient Safety

Radiologists—and many practicing physicians—are so busy learning the clinical demands of their profession that they just don’t have time to keep up with the latest in operational needs, according to a new study. When researchers Richard Sharpe and Rajni Natesan--who both hold MBAs in addition to their MDs — embarked on a survey to find out just what their counterparts understood about the business demands of operating a practice, the results surprised them. Sharp and Natesan asked docs at residency programs nationwide to rate on a scale of one to five their own competence in understanding healthcare policy, malpractice, quality assurance, patient safety, and imaging costs. “What we found was kind of striking,” Sharpe said. “For many of the topics, about one-third to one-half of radiologists felt they were not competent. Attendings that had been practicing felt more competent than residents, but across the spectrum, we saw a block of opportunities for improvement.” Attending radiologists rated themselves as significantly less competent in patient safety than non-radiologists; both radiologists and non-radiologists consistently rated themselves as less than competent in quality assurance--a key component of the emergent meaningful use standards. “The same applies to healthcare policy and malpractice,” Sharpe says. “These are the people who are future doctors and the future healthcare environment requires that they understand these concepts.” Added Natesan in an e-mail, “In a time of healthcare reform, radiologists need to be ambassadors of change…to positively guide reform both for the benefit of patients and for the future of our specialty. But our findings raise concern that we may be insufficiently prepare for this task" According to Sharpe, medical education is “classically focused on developing excellent clinical or interpretive skills,” but in the coming years, must broaden to include “non-interpretive topics” within curriculum. For doctors already working in the field, he says, some sites are adapting through the integration of monthly policy conferences, or hiring on experts for consulting purposes. Furthermore, he says, “There is absolutely a movement towards incorporating a lot of these types of programs into continuing education. “We’re seeing lots of weekend courses that are popping up,” he says. “ACR has an entire course devoted to becoming a healthcare leader. They’re coming up with Healthcare Quality advanced degrees. "Essentially, a lot of what we’re talking about is a transition from the older way of thinking about healthcare errors as bad apples to thinking about these things as being system-based." Added Natesan, "We hope to use this data as a self-reflection tool, to demonstrate where we need to improve to prepare ourselves for the changes ahead."