Should Radiologists Work in Shifts?

Have you noticed that our work as radiologists seems to be getting busier at night and on weekends? The urgency and pressure clearly increases. In our practice, there is general agreement that there is a mismatch between our staffing and the workload. We put radiologists in work slots based on our desire to work a “normal” daytime shift, like bankers and postal workers. It seems we are relatively overstaffed during the day and understaffed at night and on weekends based on the volume of work.

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We cover several hospitals and imaging centers and the workload varies by location and time of year. This is further complicated by the fact that certain radiologists can only cover certain slots. One hospital is busier than the others. In theory, everyone is supposed to pitch in remotely and if they are caught up on their own work list they are supposed to help out the guys who aren’t. In practice, this turns out to be highly dependent on the individual radiologist. Some help out more than others.

Our group still considers call to be an extension of the workday. The radiologist on weeknight call has already worked a full day and weekend call is an add-on to a regular work week. Fortunately, an in-house “nighthawk” service was created and a normal call weekday is only about 13 hours long and weekends 14 hours, although you are actually on call all night. I don’t know about you, but after 12 or 13 hours of staring at a monitor, I’m just not as sharp as I was when I started. I’m also not as sharp on Sunday evening as I am Monday morning either. Many job classifications including airline pilots and long haul truckers have limits set for how long they are allowed to work per day. Perhaps radiologists should have a maximum number of hours to work per day or week also.

Some groups have addressed this issue by staggering the shifts that radiologists work, realizing that there is no real end to the day and ferrying in fresh bodies from the bench can lessen the strain imposed by long workdays. Having worked in a practice where the night shift was rotated amongst all the radiologists, it usually took me at least a week to recover from working a week of nights. The normal human diurnal cycle means that most of us will not be as effective working off hour shifts, especially long off hour shifts.

Some of the teleradiology companies had the smart idea of employing people who lived around the world so they could work a “normal” daytime shift and cover the night time shift half a world away. This tends to be a credentialing nightmare and leads to the further commoditization of our specialty, although the thought of living in Australia or Switzerland definitely intrigues me.

It seems that the only way to work a reasonable number of hours and still get the work done is to work shifts similar to Emergency Room physicians. Given the specialization of our imaging services this would be a scheduling nightmare and bound to lead to disgruntlement in the ranks. In my crystal ball I see lines of radiologists slowly trudging into and out of a drab radiology factory around the clock much like the opening scene of the Tom Hanks movie “Joe Versus the Volcano.” Anyone have a more cheerful suggestion?