Tag: workflow

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Is The Radiology Home Workstation Becoming Too Good?

home workstation

At the home of most radiologists nowadays, you will find a computer remotely hooked up to a Picture Archiving And Communication System (PACS) where they can look at films and dictate cases. As I sit typing this blog, I am staring at a home workstation across the room myself. It enables me to read studies from home with all the comforts thereof. Additionally, I find that the chair here is comfier, the mouse works a bit better, and there are fewer glitches on it than the ones at work. But this presents an issue that even I have felt a few times. Why go into the hospital when I can do some of the same things with one home’s amenities and work even more efficiently? Is there any role for reading from an on-site computer?

Well, if you do read in the reading room at your facility, gone are the days when most specialists would come down often to the department to read over a film in your reading room. Instead, you are lucky to get a few stragglers-by, usually, a resident who wants to learn a bit, or maybe a physician with a family member that needs a read on a film. Yes, the din of conversation of colleagues has continued to melt away slowly. But, with decreasing clinical interactions, even on-site, do our comfy home workstations represent the final nail in the coffin for working at the hospital? And what do we lose by being able to do our work at home more efficiently than from the workplace? Let’s summarize some of the most significant losses and problems in this new world as we work at our home workstations instead of on-site.

Future Colleagues And Friends (Outside of Radiology)

Some of the most excellent docs that I have encountered; I have only met because they stopped by the reading room to look at a film with me. And, slowly, over time, I got to know them better. Eventually, we might have lunch together on occasion or see each other at some staff meetings. It’s just not the same when you get a ring from a doctor to look at a film. And even with fewer interactions at work, these new potential connections are lost.

Meaningful Interactions And Learning Opportunities

When a fellow specialist walks into the reading room to look at a study, they will typically talk about their work. And, usually, I will learn something new about their specialty. Maybe, it’s a new technique that the surgeon uses or a new technology that the gastroenterologist operates. Regardless, fewer interactions at home without our colleagues means fewer opportunities to learn about other areas in medicine.

Teaching Opportunities

Likewise, sometimes I want to bring home an essential point to a clinician that came down to check out a study. Perhaps, it’s when to use contrast on a CT scan. Or, maybe it’s when they should order a V/Q scan. These were teachable moments to make sure that clinicians used imaging appropriately. Now, some of these focused teaching opportunities to improve care are lost.

Increasing Burn-Out (For Some)

Then, of course, with the complete loss of foot traffic at home instead of work, we lose some sense of connection to others. This disconnect can lead to a loss of meaning in our work. On-site, you are more likely to hear about what happened in the operating room or the patient on the floor. Working from home can distort your sense of reality. And, us results-oriented radiologists can lose a sense of meaning in our work, causing burnout.

So, Is The Home Workstation Too Good?

I have to admit. Sometimes, it is pleasant to be able to read studies from the comfort of home. And, there are certainly moments to take advantage of that. But, I believe that there is still a time and a place to spend some time at the hospital workstation. The home workstation will never be too good to replace the imaging center environment entirely. Although we may not realize it at any given moment as we work from the hospital, most of us still receive fringe benefits. I don’t think the home workstations will ever entirely replace on-site work!

 

 

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How To Add A New Modality To Your First Practice Fresh Out Of Fellowship

modality

The most significant controversies in private practice often stem from workload/relative value unit (RVU) or differences in “earnings” among physicians. Anytime one physician “works more” or earns less on a daily rotation, partners and employees interpret that difference as unfair. Even more so, radiologists heighten this perception when one physician performs this rotation more than others. So, imagine starting and attempting to introduce a new procedure or imaging modality to a radiology practice right after graduating from a fellowship. Often, this will tip the workflow balance for an entire radiology business. So, how do you incorporate this new work into a practice’s current workflow? And what might you need to do to sway your partners to change the workflow for this new procedure in your practice? Today, we will delve into what you need to know as a new radiologist fresh out of fellowship who wants to start a new program or modality.

Show That The New Modality Increases Practice Value

To begin the process, you need to demonstrate that the new procedure adds value to the practice. What do I mean by that? Well, your job (if you choose to do so) becomes to convince your partners that your procedure or modality will eventually increase or at least maintain business.

How do you go about this process? One of the easiest ways to accomplish this goal is to give a practice-wide presentation. To do so, you need to show that your new modality will provide revenue above and beyond what the practice brings in. If this is not the case, you should demonstrate how the new procedure may act as a loss leader or at least increase ties with the hospital for all to benefit.

Another option to increase the buy-in of the partners would be to perform the art of “politicking.” Talk to your partners individually to get them to understand what the new procedure/modality will bring to the practice. So, when it comes time to discuss adding your new procedure to the daily rotations, each radiologist will be on board.

And finally, you need to consider what the practice will need to add and the costs to start the new procedure or modality. Is this procedure going to take away from other businesses in the practice? Or, in the case of new high-tech equipment, are the costs prohibitively expensive? These items are crucial to think about before beginning the new procedure.

Make A New Schedule That Is Fair For Everyone

Next, you need to think about not just the procedure value but also you should develop ways to incorporate the new procedure into the schedule reasonably. The less onus on the partners to establish a new schedule, the more likely you will be able to add the new modality to the practice. So, come up with ideas about how to add the new procedure. Perhaps you want to first tack it on to a current rotation. Or maybe, it is worthwhile to go full-steam into a new daily or weekly rotation. You must consider working out these factors before “going live.” If you cannot accomplish this, the chances of creating a new addition to practice dramatically decrease.

Be Aware Of The Politics

Sometimes beginning a new venture can wreak havoc on a practice or hospital system. For instance, adding a new SPECT/CT to one site may take away business from another within the system. This new equipment and procedure may decrease the employment opportunities for technologists within the site that does not have the latest technology. And, you may get a lot of pushback when you try to add it to the site. Therefore, taking the politics of the practice and hospital before beginning the new procedure is crucial.

Don’t Overwhelm The Decision Makers

These steps listed above are instrumental to creating something new in your practice. However, you have to tread very carefully. Frequently, your partners may be busy with lots of other practice requirements. So, try not to overwhelm them. What do I mean by that? Ensure the new procedure will not burden the partners and employees significantly. In the beginning, consider taking on much of the excess work yourself to get the new modality started within the schedule. Remember, you are the champion of this new procedure. So, it would help if you put in additional work to begin up front. If not you, then who else will do it?

Bottom Line For Starting A New Procedure Or Modality

Whenever you want to start something new within a practice, it is not enough to jump right in and begin. You need to put in much forethought and work before beginning. Starting something new not only affects the person initially responsible for developing the initiative. Instead, incorporating new procedures into the schedule affects the entire practice due to its effect on workflow. So, show that the modality increases practice value, demonstrate how to incorporate it into the schedule reasonably, be aware of the politics, and take on much of the initial grunt work yourself at the beginning. If you can accomplish these steps, you markedly increase the chances of starting a new procedure or modality within your practice for the benefit of all!