Has it come to the point where no improvements in clinical workflow can be made without sacrificing the well-being of radiologists and increasing burnout?
According to a recent editorial in Academic Radiology by Richard H. Cohan, MD, and Matthew S. Davenport, MD, from the Department of Radiology at the University of Michigan Hospital, in Ann Arbor the answer is yes. Declining per-case reimbursement has intensified radiologist’s workloads to keep department and hospital revenues from declining.
“Radiologists are still being told to work faster as the screws continue to tighten: more images, greater case volume, increasing complexity and less time to do the work,” the researchers wrote. “In search of bandwidth, radiologists will also look to the edges of the work day, resulting in longer hours, shorter lunches, and preoccupied evenings...other priorities like education and research fall by the wayside...resident and fellow training are threatened, and radiologist well-being is in jeopardy.”
Evidence suggests that healthcare is approaching a “tipping point”, the researchers explained, in which the rewards of being a radiologist are being outweighed by the pressures of an increasingly demanding workflow. Minimizing human interactions to reduce distractions and improve workflow, however, is not the answer, the authors argued.
“Minimization of human interactions and distancing the radiologist from referring providers to an even greater extent may only add to the likelihood of burnout,” the researchers wrote.
Speed is also a significant contributor to burnout, in which radiologists unconsciously or consciously believe working faster and longer are contributing to medical error which may instill guilt and professional dissatisfaction. However, data regarding this topic is still needed.
“If data were to show that faster or longer reading up to a certain threshold is safe and effective (i.e., different from but unexpectedly noninferior to previous behaviors), that data might mitigate the emotional burden on affected radiologists, at least to some extent,” the researchers wrote.
To avoid comprising radiologists to maximize reimbursement, department leaders and hospital administrations must accept the threat and consequences of burnout and take necessary steps to ensure that revenue doesn’t trump a radiologist's wellbeing.
“They [hospital administration] must respond proactively to the risks of disenfranchising the human beings working in their health care systems, most of whom have a strong desire to deliver the best possible health care to their patients,” the researchers concluded. “Steps must be taken to ward against a commoditized and more error-prone paradigm.”
A recent graduate from Dominican University (IL) with a bachelor’s in journalism, Melissa joined TriMed’s Chicago team in 2017 covering all aspects of health imaging. She’s a fan of singing and playing guitar, elephants, a good cup of tea, and her golden retriever Cooper.