For years, the mantra of quality radiology groups was to provide excellent service. And that would involve establishing a presence at all times. But, like many other former tenets of radiology practices, Covid has been turning over many assumptions about our work. Now that we have a situation where physical presence in the hospital can jeopardize radiologist safety, radiology groups have been decreasing their in-hospital staffing. However, potentially reducing staffing can increase patient barriers to quality care. So this begs the question, how are radiologists replacing physical presence in the radiology department without jeopardizing care? I am going to talk about how many groups are going about this process. Then, let’s discuss the reasons why some radiologists will always still need to remain on-site. Finally, we will use a crystal ball and decide where this is all heading.
Ways Radiologists Are Decreasing Physical Presence Without Jeopardizing Care
Less Physical Patient Facetime And More Apple Facetime!
Interventionalists and mammographers, if they haven’t already, will followup patients without an on-site visit. We see even more utilization of online communications via Zoom, Google Meet, Facetime, and whatever other technology rears its head. It also enables radiologists to maintain efficiency and have office hours between reading films at home.
Increased Ordering Of Hands-off Testing
We are noticing an increase in those tests that do not involve a radiologist presence. For instance, if a mammographer cannot be on the site to see patients, instead of a hands-on ultrasound for a positive mammographic finding, he may recommend a breast MRI. Or, radiologists will be more apt to followup findings when they may have suggested a physical procedure such as a biopsy in the past. All these changes are presently occurring below the surface, but they are happening.
Replacing In-Person Interaction With Referring Clinicians
Since the advent of PACS, most radiologists have already noticed a steady decline in direct physical interactions with their clinicians. Surgeons and internal medicine physicians come down much less frequently to review films than ever. And, today’s pandemic is further catalyzing this change. We are seeing even fewer of our colleagues and having more phone interactions than ever before. Even extracurricular activities with our fellow physicians are decreasing. Hospital meetings are becoming online.
More Tech Issues Resolved Remotely
Many radiologists are increasing the physical barriers between the technologist and the radiologist. In the past, radiologists would often ask a question from their technologist, and she would stop by. No longer. Radiologists are tackling these same issues with a phone call or a text. It has become less feasible to have that direct physical technologist interaction.
More Remote Teaching For Residents
And, finally, training is not immune to the Covid world. Already, online seminars have replaced in-house lectures at most training programs throughout the country. And, I would not expect that to go back to the traditional in-person norm entirely. It becomes more accessible than ever before to teach from a remote site.
So, What’s Left For The Radiologist To Do At The Hospital?
Alright, even with all these factors allowing radiologists to practice off-site, some radiologists must remain as a physical presence in the hospital. Of course, some procedures will always involve a human being. Administration of radioactive treatments, interventional procedures, and emergency coverage for contrast injections will continue to require a radiologist on-site. But, compared to all the roles a radiologist can perform off-site, it is indeed limited. Don’t expect to see as many radiologists sticking around the treatment facilities as they did before. Many practices have reduced their on-site staffing by as much as 30-70% during this crisis.
How Will Radiologist’s Presence At The Hospital Ultimately Evolve?
Many changes are currently in motion, making it even easier to perform more activities outside the confines of a typical hospital or imaging center without jeopardizing care. And, facetime, ordering preference changes, and other remote capabilities are some ways that radiologists have been decreasing physical presence at primary sites. In time, we may begin to see some return of radiologists back to the hospital as the risks to radiologists dwindle. Nevertheless, don’t expect radiologists to return to the same complement on-site after the dust settles as the tools for remote patient care have developed. When culture changes, even temporarily, some of it always sticks. Radiologists are by no means immune!