Teleradiology has changed the rules for all veterinary radiologists. Even if you are in private practice and you do not read any teleradiology cases – the rules are different. (Please dont't shoot the messenger...pleeeeze)
At DVMinsight, we are getting more and more calls from practice managers looking for ways to augment their in house radiology coverage. In most cases, they are looking for 24-7 coverage, a faster turnaround for in house films, or in some cases they only have radiologist coverage for a few hours a day.
Whatever the reason, they are looking for ADDITIONAL assistance. These managers are looking to give the in house radiologist assistance. They are not looking for a replacement. In fact, the conversation almost always starts off with “We LOVE our radiologist but….” These managers want to DUPLICATE their radiologist. They are not looking to replace them*.
The fact of the matter is that these managers are looking to give the in house radiologist assistance because the in house radiologist is not providing adequate services. With the advent of teleradiology, providing adequate service essentially means providing 24/7 coverage with a 2-3 hour turnaround time. A single radiologist cannot cover everything without imploding.
This stuff is scary
It is no surprise that augmenting in house coverage with teleradiology is a terrifying proposition for in house radiologists. The first fear is that they will lose their job. The second fear is that they will lose their income.
In most cases, fear of losing their job is an unrealistic one. As stated previously, practice managers are looking to duplicate their radiologist not replace them. Moreover, it is my contention, that an in house radiologist will be able to do a better job than any remote radiologist PROVIDED that they offer their hospital service with a smile. In house radiologists cannot compete on price or turnaround time but no teleradiologist can build a relationship with the hospital that an in house radiologist can. As radiologists we can learn something from top waiters and hotel concierge staff – make your clients and associates happy and they will love you.
Fear of losing revenues is a real fear that must be managed. Most radiologists work on production. If in house films are shipped off site, production will suffer. There is no way around this fact. What many radiologists do not realize is how burned out they are (remember your manager is looking for additional coverage because you cannot keep up). Taking some of the load off will inevitably increase your efficiency and improve your attitude so you can provide a better service to your associates. In many cases, clinicians will be willing to wait for interpretations and have the in house radiologist (who is now cheery and offering service with a smile) read the films. Only STAT and emergency cases will be sent.
Another way to mitigate the effects of teleradiology on your income is to take your extra time and start a local teleradiology company. You should be able to negotiate a higher percentage on your production from local referrals that come directly to you. This is a win-win for you and the practice. The radiologist gets to make more money from reading fewer studies and the practice gets a new source of revenue.
What not to do
Unfortunately** many radiologists fight the inevitable and give practice managers every excuse in the book about why they do not need assistance. What these radiologists do not realize is that all of the major referral hospitals talk with one another. They all know what each other is doing. They all know your excuses before you come up with them. They know that you are scared about the future. Excuses serve only to make you look like you are being difficult, obstructive, and combative.
A 5 step plan for success
A much better approach is to become part of the solution. If your practice manager comes to you asking to augment your service for whatever reason or even if you feel like you are getting overwhelmed at work and want to be proactive, the following is a 5-step program you can use that will save your job and mitigate any loss of revenues.
- Step 1: understand that your practice wants to DUPLICATE you and that is why they are asking for assistance. Although you are giving it your all, you simply cannot cover the caseload and give the practice what they need
- Step 2: understand that radiologists no longer control their domain. Service with a smile will encourage your clinicians to wait for you to read most of their cases.
- Step 3: Agree to work with a teleradiology provider – PROVIDED THAT - you get first crack at the in house cases. One way to do this is to set a time delay***. For example, if you do not get your films read in an hour or two, clinicians then and only then have the option to route cases to a remote provider.
- Step 4: Agree to work with a teleradiology provider – PROVIDED THAT – you are able to start a local teleradiology service where you receive a flat rate per case or a significantly increased production percentage.
- Step 5: Agree to work with a teleradiology provider – PROVIDED THAT – you are part of the decision, planning, and implementation****.
Bottom line: For better or worse, teleradiology has changed our lives. It is not a good thing or a bad thing it is just a thing we all need to deal with. Better to be proactive and part of the solution than be combative and obstructive when your practice manager looks to augment the service that you are already providing.
*In some cases we do get managers that really could not give a hoot about their radiologist and just want the cheapest reads they can find at all cost. If this describes your situation, you have bigger issues. Go get another job because your days are numbered anyway. This article does not apply to those situations as we screen out those clinics pretty quickly and do not generally offer them assistance.
**The reason for writing this article is that I was contacted by practice managers who were so frustrated with their radiologist for becoming obstructive or combative that they were actually looking to FIRE the radiologist or put pressure on the radiologists to get them in line. Follow the 5 step plan and avoid this situation at your hospital.
***With the DVMinsight platform it is very easy to set things up so you get first crack at all in house cases.
****With the DVMinsight platform you can even set up your own teleradiology service where you can have input in picking the radiologists that are assisting you.
For more information about how you can start, maintain, manage, and control your future, please give us a call at DVMinsight. DVMinsight has helped dozens (and dozens) of radiologists navigate the tricky world of teleradiology.