Radiology Study Finds Increasing Rates of Non-Physician Practitioner Image Interpretation in Office Settings

New research shows that non-physician practitioner (NPP) image interpretation in office settings grew by more than nine percent annually over the course of a decade for ultrasound, computed tomography (CT) and magnetic resonance imaging (MRI) and increased by more than seven percent annually for nuclear medicine interpretation.

In a recent interview, study co-author Richard Duszak, MD, shared his perspective on the increases in NPP image interpretation reported in the study, which was recently published in the Journal of the American College of Radiology.

“The compound growth rate here is pretty staggering: 9 percent per year for X-ray, ultrasound, CT, and MR with (nuclear medicine) not far behind at 7 percent. They’re all growing at a relatively similar rate,” noted Dr. Duszak, a professor and chair of the Department of Radiology, at the University of Mississippi Medical Center.

“It's only about 5.5 percent of all the nurse practitioners and (physician assistants) that we were able to identify (via) Medicare claims (data) that are doing this, but they are empowered, perhaps emboldened, to say, ‘I can look at an ankle X ray, therefore, I'm going to look at a brain CT scan.’ From somebody who spent an extensive amount of time in medical school, in residency, going through board certification, to have folks come out of nurse practitioner school with essentially no training in imaging — which is what the data from nurse practitioner training program literature says — (and attempt to interpret images) is a bit scary.”

(Editor’s note: For related content, see “The Rise of NPP Image Interpretation: What New Radiology Research Reveals,” “Current Perspectives on Radiology Workforce Issues and Potential Solutions” and “Emergency Department Radiology: Study Shows Higher Imaging Orders by NPPs.”)

Dr. Duszak said there was considerable state by state variation with the NPP image interpretation rates. For example, Dr. Duszak explained that the probability of having an office-based NPP interpret imaging in Alaska is approximately 20 percent and noted this would have been closer to zero percent when he was in residency training. He noted the importance of identifying causes behind these trends in outlier states and emphasizing targeted advocacy and education.

“This is an exponential curve. It really is a potential game changer with regard to what's happening in the workforce and in the marketplace. I think (this) really requires a lot more attention, not just from researchers, but from policy makers as well,” emphasizes Dr. Duszak, a member of the Board of Chancellors for the American College of Radiology.

For more insights from Dr. Duszak, watch the video below.