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Courtier J, Hess CP. Does Pediatric Radiology Need Faster Horses? Rethinking Strategies to Workforce and Workflow. Acad Radiol 2023; 30:2046-2049. [PMID: 37394413 DOI: 10.1016/j.acra.2023.05.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 05/24/2023] [Accepted: 05/31/2023] [Indexed: 07/04/2023]
Affiliation(s)
- Jesse Courtier
- UCSF Department of Radiology and Biomedical Imaging, Pediatric Radiology UCSF Benioff Children's Hospital, 1975 4th Street, C1758 P, San Francisco, CA 94138.
| | - Christopher P Hess
- UCSF Department of Radiology and Biomedical Imaging, Pediatric Radiology UCSF Benioff Children's Hospital, 1975 4th Street, C1758 P, San Francisco, CA 94138
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Seghers MC, Seghers VJ, Sher AC, Jadhav SP, States LJ, Trout AT, Alazraki AL, Sammer MBK. Working from home during the COVID-19 pandemic: surveys of the Society for Pediatric Radiology and the Society of Chiefs of Radiology at Children's Hospitals. Pediatr Radiol 2022; 52:1242-1254. [PMID: 35229184 PMCID: PMC8885321 DOI: 10.1007/s00247-022-05299-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 12/19/2021] [Accepted: 01/23/2022] [Indexed: 12/25/2022]
Abstract
BACKGROUND Due to the COVID-19 pandemic, some pediatric radiologists have shifted to working from home; the long-term ramifications for pediatric radiologists and departments have not yet been defined. OBJECTIVE To characterize experiences of working from home associated with the COVID-19 pandemic and guide expectations after the pandemic is controlled, via separate surveys of Society for Pediatric Radiology (SPR) and Society of Chiefs of Radiology at Children's Hospitals (SCORCH) members. MATERIALS AND METHODS Two separate surveys were conducted. In the first, SPR members were surveyed Jan. 11 through Feb. 8, 2021. The response rate was 17.0% (255 of 1,501). Survey questions included demographics, information on the ability to work from home and subjective experiences ranked on a scale of 0 to 10. The survey enabled segregation and comparison of responses between those with and without home PACS. In the second survey, SCORCH members were surveyed Dec. 8, 2020, through Jan. 8, 2021. The response rate was 51.5% (51/99). Survey questions included the logistics of working from home, technical specifications and the expectations on clinical duties performed from home. The Wilcoxon rank test was used to determine statistical significance of compared variables between respondents with and without home PACS in SPR members, and expectations between SPR and SCORCH members. Descriptive statistics summarized demographic questions and free text responses. RESULTS The majority of member respondents (81.2%, 207/255) had a home PACS and most departments provided home PACS to faculty (94.1%, 48/51). Overall, radiologists who could work from home were satisfied with their ability to work from home (mean rating: 8.3/10) and were significantly more satisfied than predicted by those without home PACS (5.9/10, P<0.0001). Respondents overwhelmingly indicated they were less able to teach trainees (mean rating: 2.7/10) and had decreased emotional engagement (mean rating: 4.4/10), but had improved research productivity and cognitive ability for research when working from home (mean rating for both: 5.3/10). Regarding the expectations of the ability to work from home after no longer needing to address the pandemic, department chairs generally favored fewer rotations from home, with 97.9% (47/48) indicating working from home should be 60% or fewer assignments, compared with 84.1% (164/195) of individual radiologists (P=0.071). CONCLUSIONS Due to the COVID-19 pandemic, there has been a shift to working from home using PACS. Results of these SPR and SCORCH member surveys can help inform future decisions regarding pediatric radiologists working from home once the pandemic has been controlled.
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Affiliation(s)
- Matthew C. Seghers
- grid.89336.370000 0004 1936 9924Dell Medical School, The University of Texas at Austin, Austin, TX USA
| | - Victor J. Seghers
- grid.416975.80000 0001 2200 2638Edward B. Singleton Department of Radiology, Texas Children’s Hospital, 6701 Fannin Street, Suite 470, 77030 Houston, TX USA ,grid.39382.330000 0001 2160 926XDepartment of Radiology, Baylor College of Medicine, Houston, TX USA
| | - Andrew C. Sher
- grid.416975.80000 0001 2200 2638Edward B. Singleton Department of Radiology, Texas Children’s Hospital, 6701 Fannin Street, Suite 470, 77030 Houston, TX USA ,grid.39382.330000 0001 2160 926XDepartment of Radiology, Baylor College of Medicine, Houston, TX USA
| | - Siddharth P. Jadhav
- grid.416975.80000 0001 2200 2638Edward B. Singleton Department of Radiology, Texas Children’s Hospital, 6701 Fannin Street, Suite 470, 77030 Houston, TX USA ,grid.39382.330000 0001 2160 926XDepartment of Radiology, Baylor College of Medicine, Houston, TX USA
| | - Lisa J. States
- grid.239552.a0000 0001 0680 8770Department of Radiology, The Children’s Hospital of Philadelphia, Philadelphia, PA USA ,grid.25879.310000 0004 1936 8972Department of Radiology, University of Pennsylvania, Philadelphia, PA USA
| | - Andrew T. Trout
- grid.239573.90000 0000 9025 8099Department of Radiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH USA ,grid.24827.3b0000 0001 2179 9593Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH USA
| | - Adina L. Alazraki
- grid.428158.20000 0004 0371 6071Department of Radiology, Children’s Healthcare of Atlanta, Atlanta, GA USA ,grid.189967.80000 0001 0941 6502Department of Radiology, Emory University, Atlanta, GA USA
| | - Marla B. K. Sammer
- grid.416975.80000 0001 2200 2638Edward B. Singleton Department of Radiology, Texas Children’s Hospital, 6701 Fannin Street, Suite 470, 77030 Houston, TX USA ,grid.39382.330000 0001 2160 926XDepartment of Radiology, Baylor College of Medicine, Houston, TX USA
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Pfeifer CM. Public Service Loan Forgiveness as a pediatric radiology recruiting tool. Pediatr Radiol 2021; 51:1938-1939. [PMID: 34117893 DOI: 10.1007/s00247-021-05122-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 05/18/2021] [Accepted: 06/01/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Cory M Pfeifer
- Department of Radiology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390, USA.
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Pfeifer CM, Reddy N, Burton KR, Griffith B, Bazylewicz MP, Pakkal MV, Milburn JM. The Evolving Status of Fellowships and Mini-Fellowships in Diagnostic Radiology: A Survey of Program Directors and Chief Residents. Acad Radiol 2021; 28:1264-1271. [PMID: 33775517 DOI: 10.1016/j.acra.2021.03.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 02/20/2021] [Accepted: 03/03/2021] [Indexed: 11/29/2022]
Abstract
RATIONALE AND OBJECTIVES Recent changes in radiology fellowships include musculoskeletal radiology adopting a match system, interventional radiology transitioning away from diagnostic radiology to offer direct-entry programs, and a common fellowship application timeline created by the Society for Chairs of Academic Radiology Departments (SCARD). The concept of mini-fellowships has also emerged with the elimination of the oral American Board of Radiology examinations that had been administered in the final year of residency training prior to 2014. This paper seeks to assess the opinions of fellowship program directors, residency program directors, and chief residents regarding these recent changes. MATERIALS AND METHODS This is a cross-sectional study using a web-based survey posed to fellowship program directors, residency program directors, and chief residents in 2020. Questions sought to explore current attitudes toward the following topics: (1) a common fellowship application timeline; (2) a common fellowship match; and (3) the status of mini-fellowships in diagnostic radiology. In addition, the number of fellowship positions for each subspecialty was estimated using subspecialty society directories, Accreditation Council for Graduate Medical Education (ACGME) data, and individual program websites. RESULTS Deidentified responses were collected electronically and aggregated. The three respondent groups preferred a common fellowship application timeline at rates of 67% among fellowship program directors, 80% residency program directors, and 74% residents. A common match system across all subspecialties was preferred at rates of 50% fellowship program directors, 74% residency program directors, and 26% chief residents. There was widespread reported compliance with the SCARD fellowship timeline policy. Subspecialty programs using the match system reported interviewing greater numbers of applicants per position. Fellowship directors and chief residents reported that the most common duration of mini-fellowship experiences was 2 to 3 months. CONCLUSION There is a division between chief residents and program directors regarding the preference for a common radiology match. Adopting a radiology-wide fellowship match would increase the number of interviews required. The SCARD fellowship timeline policy has been successful, and there is support across stakeholders regarding the common timeline. Mini-fellowships are highly variable in length and structure.
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Affiliation(s)
- Cory M Pfeifer
- Department of Radiology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390.
| | - Nisha Reddy
- Department of Radiology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390
| | - Kirsteen R Burton
- Department of Radiology & Biomedical Imaging, University of California-San Francisco, San Francisco, CA
| | - Brent Griffith
- Department of Radiology, Henry Ford Health System, Detroit, MI
| | - Michael P Bazylewicz
- Department of Radiology, Department of Radiology, University of Vermont Medical Center, Burlington, VT
| | - Mini V Pakkal
- Joint Department of Medical Imaging, University of Toronto, Toronto, ON
| | - James M Milburn
- Department of Radiology, Ochsner Clinic Foundation, New Orleans, LA
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Lu F, Vijayasarathi A, Murray N, Hamid S, Khosa F. Evaluation of Pediatric Radiology Fellowship Website Content in USA and Canada. Curr Probl Diagn Radiol 2021; 50:151-155. [DOI: 10.1067/j.cpradiol.2020.01.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 11/14/2019] [Accepted: 01/05/2020] [Indexed: 11/22/2022]
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Pfeifer CM, Dinh ML. Discrepancy rates of preliminary and final reports for after-hours pediatric teleradiology interpretations. Acta Radiol Open 2021; 10:2058460121989319. [PMID: 33628460 PMCID: PMC7883166 DOI: 10.1177/2058460121989319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Accepted: 01/04/2021] [Indexed: 11/29/2022] Open
Abstract
Background Children’s hospitals often do not have a high enough volume to justify providing radiologist staffing overnight, leading to hospitals employing teleradiology services to offer preliminary reports. There is limited literature related to discrepancies between preliminary teleradiology pediatric radiologists and final interpretations. Purpose The purpose of this study is to examine discrepancy rates for teleradiologists preliminarily interpreting pediatric exams at a children’s hospital. Material and Methods Eight thousand seven hundred seventy-eight consecutive preliminary reports issued by pediatric teleradiologists were reviewed. The hospital utilized a system in which local onsite radiologists rated the preliminary reports of teleradiologists following the interpretations as part of standard operating procedure. Discrepancies were also rated according to whether the discrepancy was actionable (judged to alter patient management by the final rater) or not. Rates were stratified by modality, preliminary teleradiologist reader, and final rater and compared to each using a normal approximation. The mean discrepancy rates were compared using a z test for proportions. Linear regression was applied to the effect of years of radiologist experience on the total and actionable discrepancy rates. Results The overall actionable discrepancy rate was 1.6%, similar to inter-observer discrepancy rates reported in other studies. There were no significant differences in the actionable discrepancy rates among teleradiologists. There was no correlation between years of experience and discrepancy rate for either the teleradiologists or the final raters. Conclusion Pediatric subspecialty teleradiologists issue reports that mirror discrepancy rates typical of radiologists who issue reports for emergent adult studies. Years of radiologist experience is not a predictor of discrepancy rate.
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Affiliation(s)
- Cory M Pfeifer
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Mary L Dinh
- Penn State Health Milton S. Hershey Medical Center, Hershey, PA, USA
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Transition to ultrasound as the first-line imaging modality for midgut volvulus: keys to a successful roll-out. Pediatr Radiol 2021; 51:506-515. [PMID: 33416922 PMCID: PMC7790938 DOI: 10.1007/s00247-020-04913-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 09/23/2020] [Accepted: 11/09/2020] [Indexed: 12/16/2022]
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Markowitz RI, Taylor GA, Darge K. The impact of per diem senior pediatric radiologists in an academic setting. Pediatr Radiol 2021; 51:686-690. [PMID: 33201319 PMCID: PMC7670107 DOI: 10.1007/s00247-020-04886-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 08/14/2020] [Accepted: 10/13/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Richard I Markowitz
- Department of Radiology, Children's Hospital of Philadelphia, 3400 Civic Center Blvd., Philadelphia, PA, 19104, USA.
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
| | - George A Taylor
- Department of Radiology, Children's Hospital of Philadelphia, 3400 Civic Center Blvd., Philadelphia, PA, 19104, USA
- Department of Radiology, Boston Children's Hospital,, Boston, MA, USA
| | - Kassa Darge
- Department of Radiology, Children's Hospital of Philadelphia, 3400 Civic Center Blvd., Philadelphia, PA, 19104, USA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Foust A, Johnston PR, Kasznia-Brown J, Chu WC, Garcia-Pena P, Daltro P, Das KM, Plut D, Kilborn T, Winant AJ, Lee EY. Perceived Impact of COVID-19 on Pediatric Radiology Departments Around the World: WFPI COVID-19 Task Force Survey Results from 6 Continents. Radiol Cardiothorac Imaging 2020; 2:e200422. [PMID: 33778631 PMCID: PMC7504684 DOI: 10.1148/ryct.2020200422] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
PURPOSE To investigate how COVID-19 has impacted pediatric radiology practice around the world at the present time. MATERIALS AND METHODS This study was based on a survey conducted by the World Federation of Pediatric Imaging (WFPI) COVID-19 task force. Pediatric radiology representatives from countries around the world were identified and asked to complete an electronic survey consisting of 17 questions related to the impact of, concerns surrounding, and education related to COVID-19 on pediatric radiology. For each outcome variable, a pair of 2-way frequency tables was constructed: one against COVID-19 prevalence, and another against region. Tests of independence of the tables' row and column factors were performed based on Fisher's exact test and odds ratios (OR) were estimated via logistic regression models corresponding to these 2-way tables. RESULTS The survey (response rate 87%, 72/83) comprised representatives from 71 countries and Hong Kong across 6 continents. 66/72 respondents (92%) indicated that COVID-19 has resulted in moderate (21/72, 29%), significant (36/72, 50%), or complete (9/72, 13%) change in radiology departments/practices in their countries. The two most frequent concerns over the next four months were personal/family health (54/72, 75%) and exposure (48/72, 67%). 79% (57/72) of respondents indicated some level of discomfort in identifying pediatric COVID-19 imaging manifestations. Changes in resident education were reported by 68/72 (94%) respondents, and 22/72 (31%) were concerned that the likelihood of current trainees pursuing a career in pediatric radiology will be impacted. CONCLUSION COVID-19 has had a substantial negative impact on pediatric radiology practice around the world.
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Affiliation(s)
- Alexandra Foust
- From the Department of Radiology, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, United States of America (A.F., P.R.J., A.J.W., E.Y.L.); Department of Radiology, University of Bristol, Bristol, United Kingdom (J.K.); Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China (W.C.C.); Department of Pediatric Radiology, University Hospital Materno-Infantil Vall d’Heborn, Barcelona, Spain (P.G.); Alta Exelencia Diagnostica and Department of Radiology, Clinica Diagnostico por Imagem (CDPI), Rio De Janeiro, Brazil (P.D.); Department of Radiology, College of Medicine and Health Sciences, Al Ain, United Arab Emirates (K.M.D.); Department of Pediatric Radiology, Clinical Radiology Institute, University Medical Center Ljubljana, Ljubljana, Slovenia (D.P.); Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa (T.K.)
| | - Patrick R. Johnston
- From the Department of Radiology, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, United States of America (A.F., P.R.J., A.J.W., E.Y.L.); Department of Radiology, University of Bristol, Bristol, United Kingdom (J.K.); Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China (W.C.C.); Department of Pediatric Radiology, University Hospital Materno-Infantil Vall d’Heborn, Barcelona, Spain (P.G.); Alta Exelencia Diagnostica and Department of Radiology, Clinica Diagnostico por Imagem (CDPI), Rio De Janeiro, Brazil (P.D.); Department of Radiology, College of Medicine and Health Sciences, Al Ain, United Arab Emirates (K.M.D.); Department of Pediatric Radiology, Clinical Radiology Institute, University Medical Center Ljubljana, Ljubljana, Slovenia (D.P.); Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa (T.K.)
| | - Joanna Kasznia-Brown
- From the Department of Radiology, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, United States of America (A.F., P.R.J., A.J.W., E.Y.L.); Department of Radiology, University of Bristol, Bristol, United Kingdom (J.K.); Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China (W.C.C.); Department of Pediatric Radiology, University Hospital Materno-Infantil Vall d’Heborn, Barcelona, Spain (P.G.); Alta Exelencia Diagnostica and Department of Radiology, Clinica Diagnostico por Imagem (CDPI), Rio De Janeiro, Brazil (P.D.); Department of Radiology, College of Medicine and Health Sciences, Al Ain, United Arab Emirates (K.M.D.); Department of Pediatric Radiology, Clinical Radiology Institute, University Medical Center Ljubljana, Ljubljana, Slovenia (D.P.); Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa (T.K.)
| | - Winnie C. Chu
- From the Department of Radiology, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, United States of America (A.F., P.R.J., A.J.W., E.Y.L.); Department of Radiology, University of Bristol, Bristol, United Kingdom (J.K.); Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China (W.C.C.); Department of Pediatric Radiology, University Hospital Materno-Infantil Vall d’Heborn, Barcelona, Spain (P.G.); Alta Exelencia Diagnostica and Department of Radiology, Clinica Diagnostico por Imagem (CDPI), Rio De Janeiro, Brazil (P.D.); Department of Radiology, College of Medicine and Health Sciences, Al Ain, United Arab Emirates (K.M.D.); Department of Pediatric Radiology, Clinical Radiology Institute, University Medical Center Ljubljana, Ljubljana, Slovenia (D.P.); Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa (T.K.)
| | - Pilar Garcia-Pena
- From the Department of Radiology, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, United States of America (A.F., P.R.J., A.J.W., E.Y.L.); Department of Radiology, University of Bristol, Bristol, United Kingdom (J.K.); Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China (W.C.C.); Department of Pediatric Radiology, University Hospital Materno-Infantil Vall d’Heborn, Barcelona, Spain (P.G.); Alta Exelencia Diagnostica and Department of Radiology, Clinica Diagnostico por Imagem (CDPI), Rio De Janeiro, Brazil (P.D.); Department of Radiology, College of Medicine and Health Sciences, Al Ain, United Arab Emirates (K.M.D.); Department of Pediatric Radiology, Clinical Radiology Institute, University Medical Center Ljubljana, Ljubljana, Slovenia (D.P.); Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa (T.K.)
| | - Pedro Daltro
- From the Department of Radiology, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, United States of America (A.F., P.R.J., A.J.W., E.Y.L.); Department of Radiology, University of Bristol, Bristol, United Kingdom (J.K.); Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China (W.C.C.); Department of Pediatric Radiology, University Hospital Materno-Infantil Vall d’Heborn, Barcelona, Spain (P.G.); Alta Exelencia Diagnostica and Department of Radiology, Clinica Diagnostico por Imagem (CDPI), Rio De Janeiro, Brazil (P.D.); Department of Radiology, College of Medicine and Health Sciences, Al Ain, United Arab Emirates (K.M.D.); Department of Pediatric Radiology, Clinical Radiology Institute, University Medical Center Ljubljana, Ljubljana, Slovenia (D.P.); Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa (T.K.)
| | - Karuna M. Das
- From the Department of Radiology, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, United States of America (A.F., P.R.J., A.J.W., E.Y.L.); Department of Radiology, University of Bristol, Bristol, United Kingdom (J.K.); Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China (W.C.C.); Department of Pediatric Radiology, University Hospital Materno-Infantil Vall d’Heborn, Barcelona, Spain (P.G.); Alta Exelencia Diagnostica and Department of Radiology, Clinica Diagnostico por Imagem (CDPI), Rio De Janeiro, Brazil (P.D.); Department of Radiology, College of Medicine and Health Sciences, Al Ain, United Arab Emirates (K.M.D.); Department of Pediatric Radiology, Clinical Radiology Institute, University Medical Center Ljubljana, Ljubljana, Slovenia (D.P.); Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa (T.K.)
| | - Domen Plut
- From the Department of Radiology, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, United States of America (A.F., P.R.J., A.J.W., E.Y.L.); Department of Radiology, University of Bristol, Bristol, United Kingdom (J.K.); Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China (W.C.C.); Department of Pediatric Radiology, University Hospital Materno-Infantil Vall d’Heborn, Barcelona, Spain (P.G.); Alta Exelencia Diagnostica and Department of Radiology, Clinica Diagnostico por Imagem (CDPI), Rio De Janeiro, Brazil (P.D.); Department of Radiology, College of Medicine and Health Sciences, Al Ain, United Arab Emirates (K.M.D.); Department of Pediatric Radiology, Clinical Radiology Institute, University Medical Center Ljubljana, Ljubljana, Slovenia (D.P.); Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa (T.K.)
| | - Tracy Kilborn
- From the Department of Radiology, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, United States of America (A.F., P.R.J., A.J.W., E.Y.L.); Department of Radiology, University of Bristol, Bristol, United Kingdom (J.K.); Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China (W.C.C.); Department of Pediatric Radiology, University Hospital Materno-Infantil Vall d’Heborn, Barcelona, Spain (P.G.); Alta Exelencia Diagnostica and Department of Radiology, Clinica Diagnostico por Imagem (CDPI), Rio De Janeiro, Brazil (P.D.); Department of Radiology, College of Medicine and Health Sciences, Al Ain, United Arab Emirates (K.M.D.); Department of Pediatric Radiology, Clinical Radiology Institute, University Medical Center Ljubljana, Ljubljana, Slovenia (D.P.); Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa (T.K.)
| | - Abbey J. Winant
- From the Department of Radiology, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, United States of America (A.F., P.R.J., A.J.W., E.Y.L.); Department of Radiology, University of Bristol, Bristol, United Kingdom (J.K.); Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China (W.C.C.); Department of Pediatric Radiology, University Hospital Materno-Infantil Vall d’Heborn, Barcelona, Spain (P.G.); Alta Exelencia Diagnostica and Department of Radiology, Clinica Diagnostico por Imagem (CDPI), Rio De Janeiro, Brazil (P.D.); Department of Radiology, College of Medicine and Health Sciences, Al Ain, United Arab Emirates (K.M.D.); Department of Pediatric Radiology, Clinical Radiology Institute, University Medical Center Ljubljana, Ljubljana, Slovenia (D.P.); Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa (T.K.)
| | - Edward Y. Lee
- From the Department of Radiology, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, United States of America (A.F., P.R.J., A.J.W., E.Y.L.); Department of Radiology, University of Bristol, Bristol, United Kingdom (J.K.); Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China (W.C.C.); Department of Pediatric Radiology, University Hospital Materno-Infantil Vall d’Heborn, Barcelona, Spain (P.G.); Alta Exelencia Diagnostica and Department of Radiology, Clinica Diagnostico por Imagem (CDPI), Rio De Janeiro, Brazil (P.D.); Department of Radiology, College of Medicine and Health Sciences, Al Ain, United Arab Emirates (K.M.D.); Department of Pediatric Radiology, Clinical Radiology Institute, University Medical Center Ljubljana, Ljubljana, Slovenia (D.P.); Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa (T.K.)
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Arm position on portable neonatal/infant ICU chest radiograph can mimic lamellar effusion. J Med Imaging Radiat Sci 2020; 51:624-628. [PMID: 32684501 DOI: 10.1016/j.jmir.2020.07.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 07/05/2020] [Accepted: 07/05/2020] [Indexed: 11/21/2022]
Abstract
INTRODUCTION/BACKGROUND Arm malposition in neonatal ICU radiographs may result in overlap of the arm soft tissues and chest wall giving the appearance of lamellar effusions. We aimed to determine the frequency of arm malposition on portable neonatal/infant intensive care unit (N/IICU) chest radiographs and the proportion of these mimicking lamellar effusions. MATERIAL AND METHODS We evaluated a subgroup of supine portable chest radiographs performed at the N/IICU. Two reviewers, at a tertiary pediatric hospital located in the USA, evaluated each radiograph in consensus and classified arm position for either side independently as (1) acceptable: arm abducted and separated from the chest and (2) compromised: arm down and in contact with chest soft tissue. The compromised cases were evaluated regarding any overlap between soft tissues of the arm and chest of sufficient degree to mimic a lamellar effusion. RESULTS We reviewed 300 radiographs performed at the N/IICU (600 hemithoraces). The mean age was 1.8 ± 1.8 months. Of 600 hemithoraces, 233 (39%) showed arms down and in contact with the chest. In seven (1%) cases, the arm position was compromised and mimicked a lamellar effusion. We identified 32 (5%) true lamellar effusions in the whole sample; in 14 of the 32 cases with lamellar effusion, the radiographs were performed with the arms down. CONCLUSION Portable chest radiographs performed in the N/IICU without proper arm abduction represent a potential for misinterpretation of chest radiographs. Although the prevalence of mimickers of lamellar effusion is only around 1%, the prevalence of arms down on a portable chest radiograph is considerably high (39%).
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Ayyala RS, Baird GL, Sze RW, Brown BP, Taylor GA. The growing issue of burnout in radiology - a survey-based evaluation of driving factors and potential impacts in pediatric radiologists. Pediatr Radiol 2020; 50:1071-1077. [PMID: 32474773 DOI: 10.1007/s00247-020-04693-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Revised: 03/27/2020] [Accepted: 04/23/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Burnout in medicine, and specifically radiology, has been receiving more attention. Little data-driven literature is available regarding risk factors/causes to ultimately help guide the development of potential solutions. OBJECTIVE To survey pediatric radiologists, a cohort with a documented high prevalence of burnout, and to understand the impact of clinical demands on nonclinical tasks and the implications of burnout on mental health. MATERIALS AND METHODS A survey of Society for Pediatric Radiology (SPR) North America attendings was performed regarding institutional factors contributing to burnout, including call burden, clinical demands, departmental support and administrative/academic tasks. Questions regarding mental health and wellness resources were also included. Generalized linear modeling assuming binomial distribution was used for analyses with SAS 9.4. RESULTS The response rate was 305/1,282 (24%) with 53% of respondents female. Respondents reported that both the number and complexity of clinical cases have increased since they first started practice as an attending, while the time for interpretation has not changed, P<0.0001. Using a scale of 0 (never), 1 (rarely), 2 (sometimes), 3 (frequently) and 4 (always), covering multiple hospitals (2.2) and administrative tasks (2.4) were the most stressful job factors. For those in administrative roles, the most stressful job factors were job-related tasks affected teaching duties (2.0) and decreased overall job satisfaction (2.0). Of the respondents, 52% said they know a physician affected by work stress-related mental illness and 25% know a physician who has contemplated or committed suicide. While 39% of the respondents have resources available to address burnout, only 33% utilize these resources. CONCLUSION Increasing clinical demands and additional institutional/departmental factors play a potential role in burnout, which has serious implications for the mental health of pediatric radiologists.
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Affiliation(s)
- Rama S Ayyala
- Department of Diagnostic Imaging, Rhode Island Hospital - Hasbro Children's Hospital, Warren Alpert Medical School of Brown University, 593 Eddy St., Providence, RI, 02903, USA.
| | - Grayson L Baird
- Department of Diagnostic Imaging, Rhode Island Hospital - Hasbro Children's Hospital, Warren Alpert Medical School of Brown University, 593 Eddy St., Providence, RI, 02903, USA
| | - Raymond W Sze
- Department of Radiology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Brandon P Brown
- Department of Radiology, Riley Hospital for Children at Indiana University Health, Indianapolis, IN, USA
| | - George A Taylor
- Department of Radiology, Boston Children's Hospital, Boston, MA, USA
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12
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The importance of fostering workplace wellness in pediatric radiology. Pediatr Radiol 2020; 50:465-466. [PMID: 32166362 DOI: 10.1007/s00247-019-04570-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 10/14/2019] [Accepted: 11/04/2019] [Indexed: 11/27/2022]
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13
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The future is now: insights into finding tomorrow's pediatric radiologists. Pediatr Radiol 2020; 50:161-163. [PMID: 31802181 DOI: 10.1007/s00247-019-04577-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 10/11/2019] [Accepted: 11/12/2019] [Indexed: 10/25/2022]
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14
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Pfeifer CM. The Impact of Decreased Interest in Pediatric Radiology. J Am Coll Radiol 2020; 17:72-74. [DOI: 10.1016/j.jacr.2019.07.029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Revised: 07/26/2019] [Accepted: 07/27/2019] [Indexed: 11/30/2022]
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Farmakis SG, Hardy AK, Thomas KB, Lampl BS, McDaniel JD, Bowling RH. Changes in factors influencing fellowship choices among radiology residents from 2008 to 2018 and methods that may increase interest in the pediatric radiology subspecialty. Pediatr Radiol 2019; 49:1132-1141. [PMID: 31165184 DOI: 10.1007/s00247-019-04430-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 03/16/2019] [Accepted: 05/15/2019] [Indexed: 11/21/2022]
Abstract
BACKGROUND Fewer residents are choosing a career in pediatric radiology, which is contributing to an ongoing shortage of pediatric radiologists. OBJECTIVE To identify potential causes of reduced interest in pediatric radiology as a career given a projected worsening of a nationwide shortage of pediatric radiologists. MATERIALS AND METHODS An online questionnaire using previously published questions was approved and distributed by the Program Directors in Diagnostic Radiology to diagnostic radiology residents on behalf of the Society for Pediatric Radiology (SPR). Descriptive statistics including means with standard error and independent t-tests were used to compare mean scores between survey years. RESULTS Nearly all of the 353 respondents (90.9%) planned on pursuing a fellowship. The majority (57.7%) identified their fellowship subspecialty before the 3rd year of residency with only 5.7% selecting pediatric radiology. Overall, 18.2% of survey respondents favored academic practice compared to 40% in the pediatric radiology subgroup. Fellowship choices were most strongly based on area of strong personal interest, marketability and area of strong personal knowledge, while the pediatric radiology subgroup emphasized area of strong personal interest, increased interaction with other physicians and enjoyable residency rotations. The pediatric radiology subgroup believed their impact on patient care was more significant than other subspecialties. Pediatric radiology job opportunities were thought to be more limited, geographically confining, and to have lower salaries than other subspecialties. More flexible job opportunities and higher demand were identified as factors needing to change before a resident would consider a pediatric radiology career. CONCLUSION The influence on fellowship selection is multifactorial. By emphasizing the favorable job market and marketability of pediatric radiology in all practice types/geographic locations, correcting perceived salary gaps and stressing the impact on patient care as early as medical school, the number of residents choosing a career in pediatric radiology may grow.
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Affiliation(s)
- Shannon G Farmakis
- Department of Radiology, SSM Health Cardinal Glennon Children's Hospital, St. Louis University School of Medicine, 1465 S. Grand Blvd., St. Louis, MO, 63104, USA.
| | - Anna K Hardy
- Department of Radiology, St. Louis University School of Medicine, St. Louis, MO, USA
| | | | | | | | - Rebecca Hulett Bowling
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA
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16
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Pfeifer CM. A Comparison of Neuroradiology and Pediatric Radiology Job Boards. Curr Probl Diagn Radiol 2019; 48:329-332. [DOI: 10.1067/j.cpradiol.2018.03.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Revised: 03/15/2018] [Accepted: 03/16/2018] [Indexed: 11/22/2022]
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17
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The hidden consequences of burnout in pediatric radiology. Pediatr Radiol 2019; 49:712-713. [PMID: 31069471 DOI: 10.1007/s00247-019-04363-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Accepted: 02/17/2019] [Indexed: 10/26/2022]
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18
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Ayyala RS, Ahmed FS, Ruzal-Shapiro C, Taylor GA. Stressors contributing to burnout amongst pediatric radiologists: results from a survey of the Society for Pediatric Radiology. Pediatr Radiol 2019; 49:714-722. [PMID: 31069472 DOI: 10.1007/s00247-019-04370-z] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 02/04/2019] [Accepted: 02/21/2019] [Indexed: 11/25/2022]
Abstract
BACKGROUND A recent study showed a high prevalence of burnout in pediatric radiology. OBJECTIVE The purpose of this study is to evaluate potential stressors contributing to burnout in pediatric radiology. MATERIALS AND METHODS Society for Pediatric Radiology members received an invitation for an anonymous survey evaluating stressors contributing to burnout. Stressors evaluated included call burden, financial stress, work-life balance, health care evolution and job market changes, and radiology as a career choice. Additional questions regarding demographics were obtained. RESULTS The response rate was 460/1,453 (32%). The prevalence of emotional exhaustion was 66% (286/435), depersonalization was 61% (265/433) and perceived lack of personal accomplishment was 15% (67/436). In a backward selective logistic regression model, work-life imbalance and call burden were the only significant factors predicting higher emotional exhaustion (P<0.001). Using a similar model, work-life imbalance, call burden and decreased rate of reimbursement were significantly associated with higher probability of depersonalization (P=0.033, 0.0002 and 0.015, respectively). Emotional exhaustion and depersonalization were significantly associated with higher odds of a radiologist's wish to work in another medical specialty (P=0.011 and 0.002, respectively). CONCLUSION Key stressors contributing to burnout in pediatric radiology include work-life imbalance, pediatric call burden and a decreased rate of reimbursement. Burnout in pediatric radiology is a serious issue that needs to be addressed and prioritized on the individual and departmental/institutional levels and further investigated to develop effective interventions to mitigate it.
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Affiliation(s)
- Rama S Ayyala
- Department of Diagnostic Imaging, Rhode Island Hospital - Hasbro Children's Hospital, Warren Alpert Medical School of Brown University, 593 Eddy St., Providence, RI, 02903, USA.
| | - Firas S Ahmed
- Department of Radiology, Columbia University Medical Center, New York, NY, USA
| | - Carrie Ruzal-Shapiro
- Department of Radiology, Columbia University Medical Center, Morgan Stanley Children's Hospital, New York, NY, USA
| | - George A Taylor
- Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
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Ruddell JH, Eltorai AEM, Mark AS, Raman S, Sams CM. What's missing? An analysis of pediatric radiology fellowship website utility and recruitment potential. Pediatr Radiol 2019; 49:723-726. [PMID: 30911780 DOI: 10.1007/s00247-019-04381-w] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 01/22/2019] [Accepted: 02/10/2019] [Indexed: 12/01/2022]
Abstract
BACKGROUND Pediatric radiology fellowship web pages convey practical information and provide an opportunity to impress upon visitors the mission and principles that are core to the program. OBJECTIVE The goal of the study was to assess pediatric radiology fellowship program websites and identify potential areas for improvement because applications and enrollment have been steadily declining since 2013. MATERIALS AND METHODS We evaluated 41 websites of pediatric radiology fellowship programs for 17 criteria. We classified programs by region, size and separate web page status. We compared the met criteria using the Kruskal-Wallis and two-sided t-test, accounting for any unequal variances and distributions. RESULTS Of the websites evaluated, the average content score was 42.3%, meeting only 7.2±2.9 of the 17 criteria. Programs in the Northeast were associated with higher online comprehensiveness (P=0.034), as were programs with a separate website for pediatric radiology (P<0.001). We also noted a higher number of positions offered per year than there were fellows enrolled (2.73±2.3 versus 1.39±2.3; P<0.001). CONCLUSION The future of diverse pediatric radiology fellowship training opportunities is increasingly influenced by the availability and transparency of fellowship program and training attributes online. With an average content score of 42.3% across the examined fellowship websites, it is evident that there is room for improvement in the information provided by the pediatric radiology fellowship programs, particularly with respect to providing alumni information and job dispositions, listing current fellows whom applicants may contact regarding the program, and including realistic call and other work expectations of fellows.
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Affiliation(s)
- Jack H Ruddell
- Warren Alpert Medical School, Brown University, Providence, RI, USA
| | - Adam E M Eltorai
- Warren Alpert Medical School, Brown University, Providence, RI, USA
| | - Andrew S Mark
- Warren Alpert Medical School, Brown University, Providence, RI, USA.,Division of Pediatric Imaging, Department of Diagnostic Imaging, Hasbro Children's Hospital, Rhode Island Medical Imaging, Warren Alpert Medical School of Brown University, 593 Eddy St., Providence, RI, 02903, USA
| | - Sasha Raman
- Warren Alpert Medical School, Brown University, Providence, RI, USA
| | - Cassandra M Sams
- Warren Alpert Medical School, Brown University, Providence, RI, USA. .,Division of Pediatric Imaging, Department of Diagnostic Imaging, Hasbro Children's Hospital, Rhode Island Medical Imaging, Warren Alpert Medical School of Brown University, 593 Eddy St., Providence, RI, 02903, USA.
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Chan SS, Francavilla ML, Iyer RS, Rigsby CK, Kurth D, Karmazyn BK. Clinical decision support: the role of ACR Appropriateness Criteria. Pediatr Radiol 2019; 49:479-485. [PMID: 30923879 DOI: 10.1007/s00247-018-4298-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 08/13/2018] [Accepted: 10/24/2018] [Indexed: 11/29/2022]
Abstract
Clinical decision support is a way to decrease inappropriate imaging exams and promote judicious use of imaging resources. The adoption of clinical decision support will be incentivized by requiring the use of approved mechanisms to qualify for Medicare reimbursement starting in January 2020. Insurance providers base their reimbursement policies on Medicare, so clinical decision support could soon become relevant to pediatric imaging. We present the process behind the American College of Radiology (ACR) Appropriateness Criteria (a set of appropriate use criteria developed by the ACR) that will form the basis for software that can be used to fulfill the criteria for clinical decision support. For most organizations, this software is expected to be the easiest way to implement clinical decision support. Clinical decision support will affect how providers order imaging exams. This article should help readers understand how clinical decision support is expected to change the practice of the ordering providers, how the ACR Appropriateness Criteria are related to clinical decision support and how the ACR Appropriateness Criteria are developed. This will help the interpreting radiologist better communicate with the referring clinician, including informing the latter about how the clinical decision support software is making decisions.
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Affiliation(s)
- Sherwin S Chan
- Department of Radiology, Children's Mercy Hospital, University of Missouri at Kansas City, 2401 Gillham Road, Kansas City, MO, 64108, USA.
| | - Michael L Francavilla
- Department of Radiology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Ramesh S Iyer
- Department of Radiology, University of Washington, Seattle Children's Hospital, Seattle, WA, USA
| | - Cynthia K Rigsby
- Department of Medical Imaging, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - David Kurth
- American College of Radiology, Reston, VA, USA
| | - Boaz K Karmazyn
- Department of Radiology and Imaging Sciences, Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, IN, USA
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Ayyala RS, Ahmed FS, Ruzal-Shapiro C, Taylor GA. Prevalence of Burnout Among Pediatric Radiologists. J Am Coll Radiol 2019; 16:518-522. [DOI: 10.1016/j.jacr.2018.08.016] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 08/10/2018] [Accepted: 08/17/2018] [Indexed: 10/28/2022]
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