Tips for a physician in getting the right job, part XVI: Assessing the relationship between the group and the hospital(s)

For those job seekers seeking a position with a group of physicians, it is critical to assess the relationship of the hospital administration to the group, and also to physicians generally. Ideally, the relationship should be one of partnership, with mutual cooperation and seeking to understand and help each other. A hostile association could be due to 1 or both parties. An antagonistic relationship could mean that the group will be forced out or that its practice will not thrive, or that the hospital will not do well, or all 3.

Implementation of 24/7 radiology services in an academic medical centre level 1 trauma centre: impact on trauma resuscitation unit length of stay and economic benefit analysis

STUDY OBJECTIVE

To evaluate the impact of 24/7 radiology services on trauma resuscitation unit (TRU) length of stay (LOS) for patients with minor trauma and to analyse the economic benefits of such an impact from trauma centre perspective.

METHODS

The study was HIPAA compliant and had IRB approval. Data were extracted from hospital and radiology information systems. Inclusion criteria specified patients: (a) with minor trauma (i.e., Injury Severity Score<16 and Maximum Abbreviated Injury Scale<4); (b) cross-sectional imaging performed between 12 and 7AM; and (c) admission during 2006 (before 24/7 coverage; comparison group 1) or 2007 (24/7 coverage). Mean, median, standard deviation, and variance for the groups were determined. The theoretical economic benefit achieved with 24/7 radiology coverage was estimated from decreases in TRU LOS for each patient.

RESULTS

Totals of 1087 and 1323 patients for 2006 and 2007, respectively, met our selection criteria. Mean TRU LOS decreased from 11.19 to 8.25 h (26%; P<0.001). The median decreased from 10.8 to 7.2 h (33%; P<0.001). The (Q3-Q1) indicator, used as a proxy for variance and spread, decreased from 7.36 to 5.76 h. Theoretical economic benefits from 24/7 radiology coverage were achieved by the product of TRU bed fixed costs with mean decrease in TRU LOS for the calendar year 2007, which equaled $340,069.

CONCLUSION

The economic benefits of 24/7 radiology services are related to LOS, which can be shortened by limiting patient discharge delays resulting from report unavailability. This can be a cost-saving replacement for conventional radiology practice when the trauma centre makes appropriate use of vacant TRU beds to realise its opportunity cost.

Radiologist report turnaround time: impact of pay-for-performance measures

OBJECTIVE

Expedited finalized radiologist report turnaround times (RTAT) are considered an important quality care metric in medicine. This study was performed to evaluate the impact of a radiologist pay-for-performance (PFP) program on reducing RTAT.

MATERIALS AND METHODS

A radiologist PFP program was used to assess its impact on RTAT for all departmental reports from 11 subspecialty divisions. Study periods were 3 months before (baseline period) and immediately after (immediate period) the introduction of the program and 2 years later after the program had terminated (post period). Three RTAT components were evaluated for individual radiologists and for each radiology division: examination completion (C) to final signature (F), C to preliminary signature (P), and P to F.

RESULTS

Eighty-one radiologists met the inclusion criterion for the study and performed a final signature on 99,959 reports during the baseline period, 104,673 reports during the immediate period, and 91,379 reports during the post period. Mean C-F, C-P, and P-F for all reports decreased significantly from baseline to immediate to post period (p < 0.0001), with the largest effect on the P-F component. Similarly, divisional C-F, C-P, and P-F also significantly decreased (p < 0.0001) for all divisions except the C-F for nuclear and neurovascular radiology from baseline to immediate period and the C-P component from baseline to post period for cardiac radiology.

CONCLUSION

A radiologist PFP program appears to have a marked effect on expediting final report turnaround times, which continues after its termination.

Advancing radiology through informed leadership: summary of the proceedings of the Seventh Biannual Symposium of the International Society for Strategic Studies in Radiology (IS(3)R), 23-25 August 2007

The International Society for Strategic Studies in Radiology (IS³R) brings together thought leaders from academia and industry from around the world to share ideas, points of view and new knowledge. This article summarizes the main concepts presented at the 2007 IS³R symposium, providing a window onto trends shaping the future of radiology. Topics addressed include new opportunities and challenges in the field of interventional radiology; emerging techniques for evaluating and improving quality and safety in radiology; and factors impeding progress in molecular imaging and nanotechnology and possible ways to overcome them. Regulatory hurdles to technical innovation and drug development are also discussed more broadly, along with proposals for addressing regulators’ concerns and streamlining the regulatory process.