'Tremendous pressure' to keep up with radiologist workloads results in another missed diagnosis
Reports of another missed radiological finding are currently circulating, and individuals involved in the latest situation are pointing fingers at the "tremendous pressure” radiologists are under due to their ever-growing workloads.
Several news outlets in New Zealand are reporting on the case of a woman whose lung cancer diagnosis was delayed by several years due to an interpretation error. In November of 2016, the woman underwent an abdominal CT scan to assess her bowel at Hawke's Bay Hospital in New Zealand. Though the imaging was completed for reasons unrelated to anything that would raise suspicion of lung cancer, her scan revealed a 14mm by 12mm nodule in the base of her right lung.
It was not until early 2020 that she received a diagnosis of lung cancer, during which time her prior imaging was revisited. The radiologist who made the error agreed that the lesion was visible and that it should have been reported on at that time and investigated further. This prompted an adverse event review by the hospital.
During the review, the radiologist involved reported that the radiology department had been hampered by staffing issues, especially during 2016 and 2017, when the error was made, according to multiple New Zealand media outlets. The radiologist stated that the department’s burdensome workload resulted in reduced reading times and that their departmental standard of double reading scans was “virtually unattainable” as a result. He maintained that he and others raised their concerns and requested additional resources, but that the issue was never addressed.
After the review was complete, Deputy Health and Disability Commissioner Vanessa Caldwell noted that, while the mistake was unacceptable, it was possible that it was the result of “broader systems and organizational issues.”
New Zealand is currently plagued by radiology staffing shortages, but they are far from the only area impacted. In September, radiologists in British Columbia penned a letter to Health Minister Adrian Dix pleading for immediate action to address the backlog of “hundreds of thousands” of patients waiting for care, and in the United States the Medicare population has significantly outpaced the number of radiologists entering the field over the past decade.
As reports of missed diagnoses become more frequent, experts have brought to light a number of culprits that have exacerbated the issue of mounting workloads, including an increased demand for imaging and backlogs of patients who delayed imaging exams during the height of COVID. However, as many studies have indicated, the growing use of medical imaging coupled with the lagging growth of new radiologists entering the field will inevitably increase the presence of human error.
In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She began covering the medical imaging industry for Innovate Healthcare in 2021.