Measuring radiologist workload: Progressing from RVUs to study ascribable times

Abstract

The RANZCR 2016 study ascribable times are ready for use by the Australian and New Zealand radiologist and nuclear medicine specialist community. We hope these times will also stimulate further data collection in our two countries towards a robust, bi-national study ascribable times database.

Estimating the productivity of radiologists in Brazil: the search for a benchmark

“…We found that radiologists in Brazil have productivity levels similar to those of radiologists in some other countries (1,4) , despite the fact that they may not have the same level of technological support and infrastructure.…”

“…It is noteworthy that the recommended or suggested productivity target is somewhere in between the minimum and maximum values reported in our study, given that these numbers would apply to the working hours in which radiologists are solely dedicated to image reading, and not involved in other activities that naturally make up their routine (4) , such as patient care; case discussion with referring physicians (medical consultation); interventionist procedures; treatment of complications; participation in administrative and clinical meetings; supervisory tasks; technical training; establishing standards for reports, protocols, and procedures; participation in and creation of quality programs; review of reports. It is also important to emphasize that, even when these professionals are fully devoted to reading examinations, their work routine encompasses at least four steps (4) : pre-examination assessment, which may include interviewing the patient and the referring physician to decide on the appropriateness of the study and the technique chosen; monitoring the execution of the examination to ensure patient safety and image quality; image reading/interpretation, which can include analysis of the patient clinical history and other radiological and laboratory tests; and preparation of the report and possible clarification about the findings to patients and referring physicians.…”

“…Another factor that is likely to influence this rate is the limited availability of technological resources that have proven to boost productivity, such as integration of the imaging storage, patient medical record, and voice recognition systems, as well as the scanning (digitizing) of physician requests and patient questionnaires (17) . In addition to the well-known limitations of the public sector, public hospitals tend to attract a significant number of high-complexity cases that require more analysis time and are often also teaching/ research institutions, which could have an impact on the productive capacity of the clinical staff who end up taking on multiple functions (4) .…”

“…Studies conducted in the United States, Europe, and Australia have shown an increase in the workload and productivity of radiologists in recent decades (1,4,5) . A recent survey conducted by the Colégio Brasileiro de Radiologia e Diagnóstico por Imagem (CBR)-Brazilian College of Radiology and Diagnostic Imaging-showed that the majority (approximately 62%) of radiologists in Brazil work 8-12 h per day and that approximately 7% work > 12 h per day (6) .…”

“…However, estimating the "true productivity" of these professionals is a great challenge, because their work encompasses at least four aspects: pre-examination assessment of the case to evaluate the appropriateness of the study; imaging quality check; image interpretation; and preparation of reports/providing consultations to patients or referring physicians (5) . In addition, the daily routine of radiologists includes other activities that cannot be easily quantified, such as participation in multidisciplinary meetings, teaching, research, and administrative tasks (4) . We also believe that there are differences in work environment, remuneration model, examination complexity, location, and subspecialty that can affect the number of reports issued.…”