On-call workloads skyrocketed by nearly 300% over past 15 years, with CT a top culprit
The growing use of CT exams has contributed to a nearly 300% increase in radiology workloads over the past 15 years, according to a new analysis.
Imaging experts at one of the Netherlands’ largest general hospitals reported a significant jump in total relative value units during on-call hours between 2006 and 2020.
A leading cause for the spike is the 500% rise in CT utilization, the Dutch researchers noted. They warned hospitals must hire more radiologists and technicians to relieve overworked personnel. Such efforts are key to reducing rising physician burnout rates that continue to threaten patient safety.
“The workload during on-call hours is unlikely to stabilize let alone decrease in the near future, which is worrisome,” R. J. M. Bruls, and colleagues with Zuyderland Medical Center’s Department of Radiology, wrote Monday in Insights into Imaging. “Radiologists experience high rates of burnout and this trend has only been increasing. High levels of burnout amongst radiologists can in turn be detrimental to quality and patient safety.”
For their study, Bruls et al. analyzed x-ray, ultrasound, and CT exams performed at their institution during on-call shifts over a 15-year period. On-call times were defined as weekdays between 6 p.m. and 7 a.m., weekends and national holidays.
Overall workload RVUs dramatically increased, skyrocketing from 6,187 in 2006 to 24,584 in 2020—a 297% jump.
Bruls and colleagues pinned these numbers to their hospital’s 500% utilization hike in CT studies. A majority of that is due to brain CT angiography exams, and CT performed for brain, chest, spine, and pelvic indications. Chest CT for pulmonary embolism alone rose by 1,360%, while spinal exams jumped by 1,720% during the study period.
X-ray orders, meanwhile, significantly decreased, with ultrasounds remaining steady.
The researchers called on national authorities to train and hire more radiologists. And on a local scale, departments may consider deploying physician assistants to manage routine imaging tasks, outsourcing work to teleradiologists, or using artificial intelligence.
Additionally, radiology departments should continuously monitor on-call shifts to implement workload-reducing strategies, including a defined maximum RVU level to avoid burnout and mistakes.
“Radiologists and radiology departments can play an active role to decrease medical imaging overutilization by providing education and feedback to referring physicians,” the authors concluded.
Read the full study in Insights into Imaging here.
Matt joined Chicago’s TriMed team in 2018 covering all areas of health imaging after two years reporting on the hospital field. He holds a bachelor’s in English from UIC, and enjoys a good cup of coffee and an interesting documentary.