Oil Boom Town Radiology

Ever wonder what it would have been like to practice medicine in “Gold Rush” times? Sacramento sawbones setting up both “forty-niners” and politicians for impending statehood in 1850. Or how about Skagway surgeons binding up busted Klondike “stampeders” returned from the Chilkoot Trail in 1898?

Though perhaps perceived as fantasy or fictional inspiration for a screenplay, it is quite real in communities experiencing rushes related to “black gold” or “Texas tea” (circa Beverly Hillbillies).

Since Roentgen’s discovery postdated the earlier rush by nearly 50 years and immediately preceded the latter, there was no “gold rush” radiology. Not the case with oil, however. These booms cause countless manifestations and unforeseen ramifications throughout the radiology departments on the front lines of the oil fields. For more established oil producing areas, delivering requisite radiologic services to the oil industry population has long been standard procedure.

However a number of newly discovered shale formation oil deposits have been identified in locations where radiology departments are not accustomed to the 24/7 relentless demand for our services. Imaging centers are built, but take time to erect. More CT scanners are added. Staffing requirements change, driving the demand for housing which has long since been devoured by oil activity workers. More affordable housing has to be built requiring more roads, water and sewer, along with all the other infrastructure necessary to develop new residential areas. More trucks. More cars. More people. More roads. Record setting ER visits.

The resulting exponential growth frequently eclipses our ability to keep pace in existing radiology departments and challenges our institutional leadership roles since our administration and colleagues may think we are slow to respond. It forces us to re-engineer our thought processes when planning our departmental short and long term goals. Timely performance of simple day-to-day readings, procedures and other departmental activities is transformed into unexpected challenges since we run out of hours in the day and radiologists for the task at hand.

What’s a radiologist to do? Dig a little deeper. Take a lesson from past Olympians and those who have already begun training for the next summer games. They’ve already embarked on their four-year plan. They have visualized where they need to be in the summer of 2016 and over the next four years they will figure out how to get there.

We must visualize our own long term plans and analyze projected volume increases (like never before) while carefully scrutinizing scanner and staff increases. We need to compare our individual RVU workloads against regional and national benchmarks and honestly determine whether we need additional radiologist manpower or an internal pep talk to work more efficiently. Perhaps we need a new strategy toward more streamlined patient throughput, additional support staff or a mid-level provider, any of which are less costly than another radiologist.

One thing I have learned from years of IR work is that there is almost always a way to get it done or to achieve the desired result. Our challenge in an overextended boom town practice, or for that matter, any practice that is similarly stressed, is to clearly visualize our own podium finish and then find a way to get there.

Ken Keller, MD, FACR, serves as medical director of the Department of Radiology at Trinity Health in Minot, ND, where has been since an attending radiologist since starting practice in 1983. He is particularly interested in interventional and breast imaging.