Radiologist builds a practice on remote reads

Teleradiology has allowed an Oklahoma radiologist to build a solo practice from home. Dr. Byron Marr explains how he works and why he has chosen this approach.

Lately I've been feeling like a lucky driver who walks away unscathed from a car crash or like the protagonist of a movie who steps aside just as a piano comes hurtling from an upper story window. While other physicians struggle with rising malpractice rates, lower reimbursement, medical politics, and myriad other challenges, I'm enjoying medicine and my family more than ever before. Improving digital technology and the shortage of radiologists have made me able to build a "remote" radiology practice, which allows me to escape much of the negativity with which my peers must contend.

Using a computer at home, or a laptop when I travel, I receive images from hospitals around my home state of Oklahoma and from several other states in which I am licensed. I usually start work at about 10 p.m. and knock off at about 3 a.m. I sleep until about 10 in the morning and then spend the rest of the day with my two young children.

I receive a baseline of films from two local hospitals and as many additional films as I care to read from other hospitals both in and out of the state. I have been practicing this way for over a year, and I'm enjoying my new lifestyle immensely. Moreover, the income I am earning exceeds what I was earning in a group practice.

How and why did I come to practice this way? I believe the answers to these questions are important to those interested in the future of diagnostic imaging delivery.

In the last several years prior to establishing a remote practice, I became increasingly dissatisfied with the dynamics of contemporary group radiology practice. The hours were long and not amenable to my status as a new father. The bureaucratic and political challenges of participating in group governance and dealing with affiliated hospitals and payers were taking their toll.

At about this time, I heard from one of a handful of companies engaged in "virtual radiology." The Radlinx Group (http://www.radlinxgroup.com) connects hospitals, medical groups, and solo radiologists who require additional coverage with radiologists like me who are looking to read remotely. These radiologists may read from their offices or from their homes. I chose to read from home, for the reasons stated above.

Radlinx makes the technical connections necessary for the hospital or medical group to send studies to various offsite radiologists on their team. They also act as a staffing firm, scheduling physicians to read at appropriate times and handling the business side of the equation. In some ways, these companies are similar to locum tenens firms. But instead of sending physicians out to work at remote locations, they send the work to the physician.

Improvements in technology such as broadband have helped make this process easier and less expensive, but the basic technology required for the transfer of studies offsite has been in place for years. The difference now is that the shortage of radiologists has made offsite reading a necessity for some hospitals, groups, and solo physicians. In order to provide night, weekend, and vacation coverage, an increasing number of imaging service providers must turn to the offsite option. Even daytime studies are being shifted offsite because of excess volumes. This trend may culminate in studies being sent overseas.

Radiologists like me are able to develop a new style of practice free of many of the traditional headaches physicians must face. I conduct initial readings in several modalities. Sometimes I am able to receive the image, interpret it, and send my interpretation back to a remote location before the patient has gotten off the CT scanner. By reading at home I am uninterrupted and undistracted.

I still review a wide range of studies that are interesting and keep me professionally challenged, but almost my entire focus is on medicine. Best of all, I can even read on vacation. It's good to know while you are staying in hotels and purchasing multiple airfares that you can pay for a vacation while you are on it.

I am certainly not gloating about my good fortune when I say that the decision to "go remote" was one of the best I have ever made. Rather, I am sharing the message that there are still satisfying ways to practice medicine if you are willing to look for them.

To contact Dr. Marr about this article, please e-mail buzzmarr@sbcglobal.net.