A radiology department at one Midwest academic medical center tallied $1.2 million in unreimbursed costs from multidisciplinary conferences in a single year, according to new research published Nov. 1.
Such gatherings are a crucial component of modern medicine, allowing physicians to engage around complex issued related to diagnosis, staging and treatment for numerous diseases. However, they can place a heavy burden on radiology and other specialties, stealing away time that could be spent on billable hours, experts detailed in JACR [1].
University of Wisconsin-Madison aimed to quantify the cost of this work, prospectively surveying members of its radiology department about the time they spent preparing for, and presenting at, these conferences. Physicians devoted a total of 3,358 hours in 2021 alone, equivalent to the work of nearly two full-time employees. This amounts to $1,155,152 in unreimbursed radiology departmental costs, the study’s authors estimated.
“Radiologist time devoted to [multidisciplinary conferences, or MDCs] at the survey institution was substantial and preparation time was disproportionately drawn from personal and academic time,” radiologist and lead author Lindsay M. Stratchko, DO, and colleagues concluded. This, they added, “may have negative implications for burnout, recruitment and retention, and academic productivity unless effectively mitigated.”
Individual section chiefs at UW-Madison assign radiologists to MDCs based on their expertise, interest and availability. A negotiated institutional policy requires formal interpretation of outside images, along with making the patient list available more than 24 hours prior to the event, allowing for adequate documentation and prep.
The study gathered data from the three months ending Dec. 20, 2021, and multiplied the results to estimate costs and time spent for an entire year. There were 375 MDCs at the institution during the study period, annualized to 1,233, nearly 98% of which were held virtually due to the pandemic. A total of 326 radiologists filled out the 15-question survey, for a response rate of 87%. They dedicated 1,013 hours on multidisciplinary conferences during the three-month period, extrapolated to 3,358 over an entire year.
Stratchko et al. calculated cost amounts using compensation information from the Association of Administrators in Academic Radiology. All told, 70 full-time-equivalent radiologists contributed to conferences across nine subspecialty sections. Per-event prep and presentation time was 2.7 hours at an annualized cost of $46,440 for each weekly multidisciplinary conference. Radiologists said they used a combo of personal (50%), academic (42%) or clinical time (35%) to prepare. Members of the specialty devoted an average of nearly 48 hours (or 1.2 weeks) of time per year to MDCs, the authors estimated.
In a corresponding editorial [2], experts said the data underline the need for solutions to this problem. Departmental leaders should consider awarding relative value units for time spent on multidisciplinary conferences and hiring more physicians to handle this work.
“Ultimately, the issue of MDCs boils down to equity and citizenship,” Erin N. Gomez, MD, and Linda C. Chu, MD, both with Johns Hopkins in Baltimore, wrote Nov. 1. “Although some radiologists may be more skilled at staffing MDCs, distribution of workload among divisions should be attempted, with each member contributing to a minimum number of conferences. However, the most robust strategy for equity is to ensure that academic radiology departments are adequately staffed, and that the effort contributed to MDCs by radiologists is compensated with time, RVUs, money, or a combination thereof.”
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.