Memoirs of a Teleradiologist: Round Two

So you’re considering a move from onsite radiology work to a teleradiology gig. You look into your options to see if it’s viable, and find what appears to be a major roadblock: To keep your income even close to its current level, you’re going to have to read a lot more cases than you already do. 

Even without such a jump, your workday is far from a lackadaisical walk in the park. It’s easy to conclude that the only possibilities are A) accepting a much smaller paycheck for your current volume of work, or b) Throwing caution, scruples, and quality to the wind in order to double your productivity, even if it means generating some lousy reads in the process.

Perhaps, you might reason, there are efficiencies built into the telerad model which will increase productivity without sacrificing quality - and you’d be right. Working remotely inherently guarantees that you’ll never get called away from your desk to place an IV, operate a fluoro case, or spend five to 10 minutes in the sonography room because the tech is in over his head.

Diagnostic mammograms won’t interrupt your workflow. Contrast reactions and other “we need a doctor” incidents in the scanning suites, hallways, or waiting areas will cease to show up on your radar. For that matter, time you would have spent commuting, even dolling yourself up for work, can instead be spent reading cases. If your last office job had you in the car 30 minutes each way, you stand to reap an hour of productivity right there.

As much ground as such things might gain you, they probably won’t catapult you into the “I never thought I could read so many more cases” territory on their own. The extra edge is what you’re seeking when you weigh one telerad entity against another, that is, who’s going to help you be all you can be, for lack of a better turn of phrase.

I’ve found the most important factor to be the support staff. Consider two extreme hypotheticals: One telerad operation gets you the referrals and has a skeleton-crew of part-time office workers to handle the basic accounting and paperwork. They’ll tell you what computer equipment you need and give you access to their website and/or software, through which you have access to cases. Want anything else? YOYO (you’re on your own).

The other operation has a regular human hive in an office building, or maybe even its own building entirely. Their approach is that, as a radiologist, any time you spend doing nonradiologist stuff is wasted. Pursuing licenses and credentials? They have you execute a limited power of attorney, and do it for you. Computers and software? They send whatever you need, and have a 24-7 support staff ready to deal with any troubles you have. When not solving problems, the tech staff is busy working on the next round of upgrades and beta tests. Issues with clarifying clinical histories, patient identities, fetching priors? You don’t pick up the phone and start wading through a maze of touchtone menus, transfers, and on-hold purgatories; instead, you IM one of the 24-7 support staff. While you proceed with other cases, your support relentlessly pursues whatever you needed, only messaging you again when she has results in hand. The same goes for chasing down a clinician when you need to give critical results.

You might be concerned that such a robust support network costs money, and wonder whether such costs translate into a bigger slice taken from your reimbursements than if you had gone with a smaller, leaner telerad entity. In truth, the only way you could know for sure would be to get access to the ledgers of these companies and compare them against one another, and of course that’s not going to happen anytime soon.

What you can do, however, is look at their proposed schemes for your compensation. If two companies are offering you similar sums per CT, for instance, but one of them supports you with a small army of staff while the other just shrugs and wishes you good luck on your own, well, as a favorite pharmacology professor of mine liked to say, it doesn’t take Brain of Britain to figure out who’s giving you the better deal.

You might be getting the impression that I’m predisposed to going with the larger, more established telerad entities. To a certain extent, you’d be right; I’ll touch on more of the advantages of playing ball with the Big Boys next time.

Click here to read Eric Postal, MD’s Memoirs of a Teleradiologist, Round One